
HIV self-testing is a process by which a person who wants to know his or her HIV status collects a specimen, performs a test and interprets the test result in private. It does not provide a definitive diagnosis; instead, it is a screening test for the presence of HIV-1/2 antibodies or the HIV-1 p24 antigen. Any positive HIV result must be confirmed by laboratory-based testing with a venous blood sample.
By providing an opportunity for people to test themselves discreetly and conveniently, HIV self-testing may provide people who are not currently reached by existing HIV voluntary counselling and testing (VCT) services with information about their HIV status.
Sample for HIV self-testing can either be blood or oral fluid. The use of different samples for testing will result in variation in the performance of the test, measured by sensitivity and specificity. The followings serve to give you an idea of different sample collection methods; users should follow the specific instructions given by the manufacturer of the test kit they intend to use.
Globally, there are eight approved HIV self-test kits recommended by World Health Organization. (Information as of July 2018)
Brand name | Manufacturer | Generation | Sample | Sensitivity | Specificity | Approval agency |
---|---|---|---|---|---|---|
atomo HIV Self Test | Atomo Diagnostics, Australia | 3rd | Blood | 99.7% | 99.7% | CE |
autotest VIH | AAZ-LMB, France | 2nd | Blood | 100% | 99.8% | CE |
BioSURE HIV Self Test | BioSURE, United Kingdom | 2nd | Blood | 99.7% | 99.9% | CE |
Exacto Test HIV | Biosynex Group, France | 3rd | Blood | 99.99% | 99.9% | CE |
INSTI HIV Self Test | bioLytical Laboratories, Canada | 2nd | Blood | 100% | 99.8% | CE |
OraQuick In-Home HIV Test | OraSure Technologies, USA | 2nd | Oral fluid | 100% | 99.8% | CE |
OraQuick HIV Self Test | OraSure Technologies, USA | Not available | Oral fluid | 99.4% | 99% | WHO |
SURE CHECK HIV Self Test | Chembio Diagnostic Systems, USA | 2nd | Blood | Not available | Not available | CE |
Source: Market and technology landscape: HIV rapid diagnostic tests for self-testing
In Hong Kong, there is currently no legislation that regulates the manufacture, import, export, sale and use of medical devices (including HIV self-test kits). However, users are able to purchase self-test kits either over-the-counter in pharmacies or through various online platforms. The market price per HIV self-test kit ranges from HK$200 to HK$400.
Some HIV self-test kits may be of poor quality and provide incorrect results. Users should purchase self-test kits, if they choose to do so, from reliable sources; ; and test kits with either CE approval, FDA approval or prequalified by WHO are preferred.
Preparation
Procedures
Testing procedures vary from brand to brand; users should follow strictly the instructions given in the test kit. The followings only serve as a general tip.
Interpretation of result
Result interpretation varies from brand to brand; users should follow strictly the instructions given in the test kit. The followings only serve as a general tip.
In general, there is a Result Reading Panel showing the test result. Right beside the panel are marked with "C" and "T".
First step : Look for the horizontal line at position "C".
The presence of a horizontal line means that the testing fluid has passed through the whole testing paper. The result is valid and ready to be read. Absence of the horizontal line at position "C" means that the result is NOT valid. You should use a new product to repeat the test
Second step : Look for any horizontal line at position "T"
Positive result: the presence of a horizontal line at position "T" means a positive result. A positive result suggests that HIV antibodies are detected, and it is very likely that you have been infected. However, this is only a preliminary result and you need to have further blood test for confirmation.
Negative result: the absence of a horizontal line at position "T" means a negative result. A negative result suggests that HIV antibodies are not detected, and it is likely that you are not infected. However, if the test is done within the window period, you need to re-test 3 months after the last exposure.
If the horizontal line at position T is vague and unclear, or you have any uncertainty about the test result, please call Gay Men HIV Testing Hotline 21171069 or one of the AIDS NGOs to arrange another test.
Linkage to care and follow-up
If you get a positive self-test result:
If you get a negative result, you should continue practicing safer sex to reduce risk of HIV infection. If you have further exposure, regular testing every 6 to 12 months is recommended. The HIV test does not screen for other sexually transmitted infections (STIs), you may consider having other STI screening tests at the Social Hygiene Clinics.