Ban on home HIV tests 'outdated'

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Banning home HIV testing kits is unwarranted and a breach of patient autonomy, a UK health expert argues.

The tests were made illegal in 1992 amid the concern, among others, that a person could discover they had HIV without ready access to counselling.

In The Lancet, Lucy Frith of Liverpool University claims none of the arguments are strong enough to continue the ban and argues on behalf of patient choice.

HIV experts were divided over whether lifting the ban would do harm or good.

The Department of Health said it was taking advice from an expert advisory group on whether to review the legislation.

Illegal

A home HIV test recently went on sale in the UK by exploiting a loophole in the current law.

The individual sends in a saliva sample to a laboratory, and, if negative for HIV, they receive the results via e-mail.

But DIY kits where all stages of the test take part in the home, in the same way as a pregnancy test, are illegal.

Lucy Frith, from the university's division of primary care, says if the UK were to lift the ban more people might get tested.

People should be allowed to choose where, when and how they are tested for HIV Lucy Frith

She argues that the current requirement of pre-test face-to-face counselling deters some from coming forward to be tested.

An estimated 31% of UK people are unaware of their HIV status.

Early diagnosis is important not only to maximise treatment but also to reduce the risk of transmitting the virus to others.

Ms Frith says self-testing would also enhance patients' choice.

"If practitioners truly believe in patient autonomy, people should be allowed to choose where, when and how they are tested for HIV, where the technology exists," she explained.

Time for change

She said technology had moved on enough to ensure the tests were reliable, accurate and easy to use.

And there are ways to offer counselling and support after a home test - via a telephone helpline, for example - she said.

You can't have people dealing on their own with the news that they are HIV positive Annabel Kannabus of HIV charity AVERT

"Counselling would also be available when people sought a confirmatory test," she added.

But Annabel Kannabus of HIV charity AVERT maintained self-testing could not be allowed to go ahead, mainly because of the lack of "face to face" counselling and indeed information when someone learns their test result.

"You can't have people dealing on their own with the news that they are HIV positive.

"Most people initially are going to panic and think that they are going to die."

Instead, she said it would be much better to have more walk-in clinics, at places like supermarkets, where people could get a rapid test without too many questions being asked but with advice readily available.

However, Lisa Power of the Terrence Higgins Trust said: "It's time that home testing for HIV was legalised and regulated in the UK.

"High quality, easy-to-use testing kits are being developed and it is vital that we offer greater choice for people who want to know their HIV status."

The Department of Health spokesman said the existing HIV testing system provided the best service to those concerned about their HIV status.