The New York Times reported today that there is a new rapid home testing kit for HIV that went on sale today, October 5, 2012. The kit is called OraQuick, costs $40 and takes 20 minutes to provide results. This is a major breakthrough, as it allows people to quickly determine their HIV status in the privacy of their own homes. It also opens up the potential for sexual partners to test each other before having sexual contact. I’m sure the company that makes the OraQuick test, OraSure Technologies, would love it if many people use this test before having sex. But is this a good idea?
The kit is not perfect. It is almost 100% accurate when it indicates that someone is not infected with HIV, and, in reality is not. But it is only 93% accurate when it says someone is not infected and the person actually does have the virus. This is most likely because there is a period of time after infection before the body is producing antibodies that the test detects.
Should you use this test when considering becoming sexual with a new partner? Consider some very disturbing facts based on two sexual surveys reported in this article. In the first survey, nearly 20% of infected homosexual men reported having unprotected sex with at least one partner without revealing their HIV status.
In the second study, they found that 9% of HIV-positive heterosexual men and women, and 14% of HIV-positive gay or bisexual men reported having recent unprotected sex with someone who they either knew was uninfected, without revealing their own infection! Putting this in real numbers, the authors of this survey estimated that over a year, 34,000 infected gay men and 10,000 infected heterosexual men and women had sex without telling the truth.
This really speaks to the issue of not trusting what people say about sexuality. Too often I hear experts giving the advice to ask your potential partner about their sexual history and their HIV status. Given the results of these two surveys, that seems naïve, foolish and dangerous. People lie about sex. If you are a gay male, it’s reasonable to expect that one in five infected potential partners will lie to you about their HIV status. If you’re a heterosexual, the number drops to a little below 10%. Are those the odds you want to take with your life?
What this really speaks to is the importance both of testing and of safe sex. Since the OraQuick test is only 93% accurate when the person taking it is infected, that means 7% of the time, with an infected person, the test will falsely tell you that they are not infected. So those odds aren’t very good either. So let’s calculate the probability that your new potential sexual partner might be HIV-positive, lying about it, and the OraQuick test would falsely tell you they were HIV negative.
If you are a gay man, then the probability is 20% times 7%, which equals 1.4%. If you are heterosexual the probability is 9% times 7%, which equals 0.69%. So the odds that your deceitful HIV-positive partner would not be identified by the OraQuick test are 1.4% if you are a gay male, and 0.69% if you are a heterosexual man or woman.
So even by using the OraQuick test, you can’t eliminate all risk. That’s why practicing safe sex makes so much sense. At least do so when having casual sexual contact, before you get to know the person well and can figure out whether they are trustworthy or not.
So to summarize, the new OraQuick test allows for quick at home testing of HIV status. Given the facts about how many HIV-positive gay and straight people are not honest about their HIV status, it makes sense to consider using this test. But there is still a risk, since the test is least accurate when used on HIV-positive people. The OraQuick test can improve your odds, but for ultimate safety, practice safe sex!
No joke to end this post, because this is such a serious matter.
Dr. Andrew Gottlieb is a clinical psychologist in Palo Alto, California. His practice serves the greater Silicon Valley area, including the towns of San Jose, Cupertino, Santa Clara, Sunnyvale, Mountain View, Los Altos, Menlo Park, San Carlos, Redwood City, Belmont, and San Mateo. Dr. Gottlieb specializes in treating anxiety, depression, relationship problems, OCD, and other difficulties using evidence-based Cognitive Behavioral Therapy (CBT). CBT is a modern no-drug therapy approach that is targeted, skill-based, and proven effective by many research studies. Visit his website at CambridgeTherapy.com or watch Dr. Gottlieb on YouTube. He can be reached by phone at (650) 324-2666 and email at: Dr. Gottlieb Email.