HIV self-testing kits: challenges and opportunities

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Tuesday 24th September 2013

Last month the Department of Health announced that from April 2014 it will be legal to sell and promote HIV self-testing kits across the UK, including Scotland. These kits allow people to take a blood or saliva sample in their own home, anaylse the sample and instantly interpret the results themselves.

This change brings both opportunities and potential challenges. Here we take a look at some of these, and examine just what the change might mean. To hear more and take part in the discussion, join us for the HIV Scotland Self-Testing Seminar on the 26 November, part of European HIV Testing Week 2013.

What is the law now, and what will the change mean?

Currently - and until the change comes into force next year - the sale or distribution of self-testing testing kits is banned in the UK. It is possible to access kits via the internet, but these are not legally supplied and as they aren’t regulated there’s no way to know the results they give are reliable.

The change in the law will mean that from April 2014, strictly regulated kits will be available and legal to supply and sell. The aim is to make it easier for people to get tested as early as possible.

Isn’t it already legal to test for HIV with a kit at home?

Until next April it’s not legal to sell or promote an HIV self-testing kit that gives an instant result. But it is legal to supply what’s often called a ‘home-sampling’ kit: a kit that allows the user to collect their saliva or blood sample themselves and then post it to a service for testing. Results for this kind of kit are not given instantly – they are provided by a health practitioner, usually by phone or in person once the sample has been tested.

Self-testing: the opportunities

We know that the stigma attached to HIV means that some people are reluctant to use existing testing services. Removing the ban on the sale of self-testing kits should make it easier for people to get tested as early as possible, giving the potential to:

  • Reduce the rates of late, and very late, diagnosis;
  • Ensure that greater numbers of people access treatment earlier, improving treatment outcomes;
  • Help reduce the rates of new HIV infections as fewer people unknowingly transmit HIV; and
  • Give people greater choice and control.

Legalising the sale of self-testing kits in the UK also means that they can be regulated and accompanied by reliable information. This should include how to interpret the result and what to do afterwards (including advising people to get a follow-up test to confirm if the test indicates a positive response).

Self-testing: the challenges

While many people welcome the lifting of ban on the sale of self-testing kits, others have raised concerns. Some key issues that need to be considered include:

  • Concerns about false-positive results. The British HIV Association have stated that self-tests have significant false-positive result rates, and they stress that home tests should not be used as a substitute for the testing currently available in healthcare and other settings.
  • Clarity on how people whose tests indicate a positive result will be connected to psychological support and appropriate health care, and the transfer into support and care will be monitored.
  • How the change in policy will be evaluated, particularly monitoring its effectiveness in reducing undiagnosed infections, its impact on health and wellbeing and the uptake of services.
  • What information will (or should) be included within the testing kits.
  • How testing kits will be made available, promoted and distributed and how variations across Scotland might impact on outcomes.

Moving forward

There’s clearly a great deal to be clarified before the change in law on self-testing comes into force in April 2014. Join the discussion and sign up for the HIV Scotland Self-Testing Seminar on the 26 November, part of European HIV Testing Week 2013.