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Australia has an opportunity to lead the world in developing a best practice approach to HIV home testing, according to Burnet’s Head of HIV Research, Associate Professor Mark Stoové.
While the Therapeutic Goods Administration (TGA) is yet to sanction the use and sale of any self-testing kits in Australia, two types, an oral fluid test and finger prick test, have been approved by the US Food and Drug Administration.
Associate Professor Stoové believes there are doubts whether the oral fluid test approved for home use in the USA would meet Australian standards.
“It has 91 percent sensitivity to HIV infection, which means about one-in-10 people with established HIV would be missed with this test so, in other words, they would receive a false negative result,” Associate Professor Stoové told Joy94.9.
“That would not currently meet TGA standards, it’s not good enough. What we need is some movement on the types of self tests that we may want to introduce into Australia that are likely to comply with TGA standards.”
Those tests are more likely to include a home-based finger prick test, several versions of which are undergoing Australian trials, with the cost of each kit forecast at around $25.
“That would equate to a gay man who would like to test four times a year, $100 a year for the security of knowing they’ve tested, and that’s not a bad option,” Associate Professor Stoové said.
While there’s been a substantial increase in the number of HIV tests occurring in the community and conducted by GPs in Australia over the past decade, Associate Professor Stoové said there’s been little change to the frequency with which gay men test.
It’s recommended that ‘high risk’ gay men test every three months, but research data shows that as few as 15 percent of men who meet that criteria are testing at that rate.
“What we really need to do is make testing as easy as possible for people to do, and that does not involve fixed-site testing at services that require an appointment and sometimes require you to come back for a test result,” Associate Professor Stoové said.
“I’m not sure that a self-test would potentially be suitable for somebody who’s never tested before; there’s a lot of information that can be provided for someone during the pre- and post-test counselling process.
“But men who are used to attending their GP or sexual health centre or PRONTO! and are routinely engaged in testing, to help them do that more frequently and according to guidelines would be a very useful exercise.
“If we can get those high risk men ordering a test online and sent to their house and we provide them with appropriate support services if they had a positive test, that would really go a long way in expanding the reach of testing, and expanding the potential for testing in a prevention context.”
Associate Professor Stoové drew a parallel with HIV self-testing and the introduction of home pregnancy tests in Australia in the 1960s.
“There was a certain hysteria at the time about putting women in control of their own sexual health, but that’s exactly what we need to do with gay men with this aspect of their sexual health,” he said.
“Even though self-testing is available in other countries, there are aspects of their systems that are less than efficient, so there is an opportunity for Australia to lead the world in developing a best practice approach to home testing.”