The FDA recently approved the over-the-counter sale of the OraQuick In-Home HIV rapid test, to be available by October for sale online and at retailers. It is an oral test that gives you results in 20 minutes. Given that the CDC recently estimated that 240,000 Americans have HIV and don’t know, this is wonderful news. Many people are afraid of asking their doctors for a test, because of the stigma attached to it and the fear of finding out they have the virus, so it is hoped that over-the-counter availability may increase testing rates. It has not been clarified what the price will be or whether it will be behind the pharmacy counter, both issues that may influence the test’s accessibility and desirability, but this new ruling may still make HIV testing more convenient and popular.
When getting testing at a health center, you receive counseling from a health educator on your test date and when you get your results. This ensures that you get adequate information and support, two things that may not be as available at home. With that in mind, here are some good things to know about at-home HIV testing before you try it:
1) It is an oral test, but it’s not testing your saliva. From the OraQuick website:
“…the OraQuick ADVANCE® HIV-1/2 Test does not use saliva, but rather absorbs antibodies directly from the blood vessels in the mucous membranes of the mouth. OraQuick ADVANCE® detects antibodies for HIV, not the virus itself.”
Your saliva doesn’t have enough of the virus to spread or test for infection but your mucous membranes do, so it’s important to a) make sure to perform the test correctly and b) use protection even with oral sex!
2) Timing is everything. It can take 3-6 months for a test to turn positive after HIV infection. The CDC explains it well:
“Most people will develop detectable antibodies within 2 to 8 weeks (the average is 25 days). Even so, there is a chance that some individuals will take longer to develop detectable antibodies. Therefore, if the initial negative HIV test was conducted within the first 3 months after possible exposure, repeat testing should be considered >3 months after the exposure occurred to account for the possibility of a false-negative result. Ninety-seven percent of persons will develop antibodies in the first 3 months following the time of their infection. In very rare cases, it can take up to 6 months to develop antibodies to HIV.”
To simplify matters: If you are worried about exposure to HIV, testing right away will give you a baseline only. You have to wait about 3 months before a test will be accurate, so keep that in mind.
3) A reactive test is not a necessarily a positive test. There are two types of results when using the OraQuick: non-reactive, and reactive. A non-reactive test means that no anti-bodies were found, and is considered a negative test. Reactive is a preliminary positive, meaning that a confirmatory test must be done at a lab before it can be said for sure that you have the virus. Take my advice: do not take this test at night or on a weekend, when you cannot do anything about a positive result. Do it in the morning on a weekday, so that if you have a positive result you can go straight to your doctor or your local Planned Parenthood for a confirmatory test.
Caption: On the left is a reactive test, on the right is a non-reactive test. These are pictures of the OraQuick currently used in health facilities; the at-home test may or may not be the same.
4) Have support ready. When you take your test, have a friend with you or, if you want total privacy, at least have some phone numbers on hand. You can find your local Planned Parenthood here, your local health department here, or you can use your personal doctor, friends, or family. Don’t go through this alone!
If you want an HIV test and don’t want to wait until October, come to your local Planned Parenthood where we have rapid testing with trained educators available.
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