HIV Self-Tests

Products

The sale of HIV self-tests has been allowed in many countries since June 19, 2018. Before that, for example, a medical consultation or a visit to a testing center was required. In other countries, self-tests have been available for several years. Products include, for example, the autotest VIH, the Exacto self-test and INSTI (blood), and the OraQuick (saliva). It is important to use a high quality test with the CE mark. With these, both sensitivity and accuracy are very high (over 99%).

How it works

HIV self-tests detect antibodies to the HIV virus (HIV-1 and HIV-2). Thus, it is an indirect method. It usually requires a small blood sample from the fingertip. Saliva tests are also available that show good results (e.g. OraQuick, also an antibody detection). The result can be available within 10 to 20 minutes, depending on the test. It is important to note that antibodies are formed within a few weeks. Therefore, the test cannot be performed immediately after unprotected sexual intercourse or suspected exposure. A reliable result can only be expected 12 weeks (3 months) after a possible infection. This period is called the diagnostic window. It is significantly shorter for laboratory methods under medical supervision. The self-test is therefore not indicated immediately after a possible infection. The patient should report immediately to the physician or to an emergency department!

Indications for use

As an HIV test for self-testing. Other STDs cannot be checked with this test and the test can only be used once.

Result

In case of a reactive (so-called “positive”) result, the patient should contact his or her health care provider. A reactive result does not indicate infection with certainty because the tests can very rarely “overreact.” Confirmation with laboratory methods is required. No definitive diagnosis should be expected from an HIV self-test. A non-reactive (“negative”) result means that there is a high degree of certainty that there is no infection. However, the diagnostic window of 12 weeks must be observed (see above).

Benefit

Early detection of infection allows rapid initiation of antiretroviral treatment and a reduction in the risk of transmission. Because the service is low-threshold, confidential, anonymous, and discreet, the number of HIV tests performed may increase. As a result, people can be reached who would otherwise not get tested. The self-test gives more security for the sexual life. For example, both partners can check themselves.

Risks

Doing the HIV self-test (with blood) is more complicated than other self-tests, such as a pregnancy test. This can lead to errors and possibly false results. As with the pregnancy test, a control line or checkpoint appears, which can be used to verify that the test worked. A positive result can greatly upset individuals, and a negative result can lead to misinterpretation.