Instant at-home HIV tests

[graygo98]

This has been a really interesting thread. I have to admit that Lawguy's suggestion is rational. But it still bothered me, and I didn't quite know why. And then goodtimes nailed it, at least from my perspective.

Originally Posted by good times

and the fact that, at least for me, anyone that paranoid about it wouldn't be attractive to me as a play partner in the first place.

[curiousagain]

Originally Posted by Lawguy

First a response to curiousagain. Umm, will flunking a 100 question psychological profile kill you? Probably not. Will flunking an HIV test kill you; probably could. Can't see the difference? Hmm. I'll move on.

I'll go back to it for a sec. You failing that psychological profile may keep either one of us from getting killed. I've been stalked to the point that the police and guns were involved and I've been outed so to speak. I obviously have had more problems from people's psych than STDs so, forgive me if I'm more concerned with that.

I have to agree with good times on the spreading of good vs bad news. I had an associate get a false positive on an HIV test while obtaining some life insurance and have seen first hand what a CF that is in the best of circumstances. And, I've had to give patients and their spouse the news that one of them had tested HIV positive so forgive me if I realize just how bad it can be all around in the best of enviroments much less the one you propose.

And as a final thought, HIV may be what you are most afraid of but Hep C is not much better and is as or more easily transmitted. If you are that fearful, then might I suggest you stay home.

edit: The more I think about it, the more unsavory it is. So, a couple agrees to take the test and it shows positive. You say "Wow, that's some shit, see ya" and leave them standing there?

[LOL_OMG]

Doesn't the Red Cross check for aids? Just make em show you their pin from the last time they gave blood

[sereneiders]

Originally Posted by LOL_OMG

Doesn't the Red Cross check for aids? Just make em show you their pin from the last time they gave blood

I bet the Red Cross would give you your pin wheter you're a valid donnor or not, because:

1) They want to reward the solidary attitude you had, just by taking your time to go there to offer your blood, beyond the actual usedullness of your act.

2) They wouldn't want to discourage people from being solidary just because they may fear they won't get that pin should they're invalid donnors, for watever reason (even a temporary disease), allowing third ones to know they attempted to donate unsucessfully and suspect the worst scenario.

[curiousagain]

You get a pin, shirt, whatever for donating. If your blood is found to be unusable during it's testing (days later) you are notified. So, nothing found wrong with your blood, no notification, ergo no proof.

[LOL_OMG]

OKAY....or,

working on it...need thinking

[Lawguy]

Originally Posted by curiousagain

I'll go back to it for a sec. You failing that psychological profile may keep either one of us from getting killed. I've been stalked to the point that the police and guns were involved and I've been outed so to speak. I obviously have had more problems from people's psych than STDs so, forgive me if I'm more concerned with that.

I have to agree with good times on the spreading of good vs bad news. I had an associate get a false positive on an HIV test while obtaining some life insurance and have seen first hand what a CF that is in the best of circumstances. And, I've had to give patients and their spouse the news that one of them had tested HIV positive so forgive me if I realize just how bad it can be all around in the best of enviroments much less the one you propose.

And as a final thought, HIV may be what you are most afraid of but Hep C is not much better and is as or more easily transmitted. If you are that fearful, then might I suggest you stay home.

edit: The more I think about it, the more unsavory it is. So, a couple agrees to take the test and it shows positive. You say "Wow, that's some shit, see ya" and leave them standing there?

Goodtimes' club experience is noteworthy, but the false positive argument still does not fly with me because whether it occurs in a hotel room or at a doctor's office, it hits just as hard, IMHO. Curiousagain, you may be a health care provider (hard to believe because I deal with doctors on a daily basis, and cannot imagine this argument with my acquaintences), but in my own profession, I deal in human nature--and I know that there's not too much difference in the locale of the results. Indeed, you might argue that if there was a positive result in a hotel room, there would much less of an emotional impact as, most assuredly, the test would not be believed and an appointment would be set the next morning with a local lab. A positive result in the physician's office, however, will more likely be accepted as fact, giving a greater, not lesser, impact emotionally.

As for curiousagain's analogy, I just feel your analogy is not apt. There are so many remedies for a psychotic: law enforcement, restraining orders, or Smith & Wesson (okay, so I threw that last one in there). Being from Texas, I guess if I ever thought a stalker was going to be a threat to my life--I'd take 'em out first. Seriously, however, there is really NO remedy for AIDS: period. Goodtimes seems to believe that having a fear of AIDS is too paranoid to play with. Hmm, but why is testing to see if a person might infect you with a deadly disease paranoid, especially if A) you really don't know them, and B) they are about to engage in sex with you? Yes, there are other threats in the world, but when swapping, sex is obviously one of the major ones. On the other hand, other posters keep giving me other "what ifs" as if they undermine my cautious approach. Yeah, I guess a couple could try to blackmail you and ruin your career (seen this on the internet before). Yeah, I guess a couple could rob you at gun point while you are naked in your hotel room (heard about that too before). Yeah, a couple you meet at the club, just might--just might--be aliens who want to suck your brains out for their nefarious experiments. But faaaaar more likely is that the couple you are rendezvous-ing with, has had multiple sex partners and that's a CDC-factor for HIV risk. That not MY analysis, that's the CDC's analysis. So it just doesn't seem paranoid to ask for a few minutes to test someone's saliva and check their status--that's safety, not paranoia in my opinion.

In sum, those of you all who disagree simply believe that HIV infection is an acceptable risk of the lifestyle and do not think that there's a need to test a potential partner.

Arguments that the tests give false positives or that it takes months to turn serum-positive following infection, are all arguments which undermine the confidence in the test, but they do not in the least, discredit the tests--they are still highly accurate. As I wrote earlier, if you think about it, it's really not a point of debate: if you think I'm paranoid, you won't want to sleep with me. And, if you think I'm paranoid, then I don't want to sleep with you either. No harm; no foul for either of us. Two different perspectives. (BTW, this whole thread is working under the assumption that these 5-minute tests are available to the public which they are not).

[Merric]

Reliable Home HIV Test
Public Health & Education | OraSure Preparing To Seek FDA Approval for Nonprescription Sales of OraQuick Oral Rapid HIV Test
[Apr 05, 2007]

Bethlehem, Pa.-based OraSure Technologies during the past year has been preparing to seek FDA approval for nonprescription sales of its OraQuick Advance Rapid HIV 1/2 Antibody Test, the Allentown Morning Call reports. OraSure on Monday announced it has hired Durham, N.C.-based Constella Group to design a consumer counseling and referral system to accompany nonprescription sales of the test (Kennedy, Allentown Morning Call, 4/3). The OraQuick test requires users to swab their gums and then place the swab in a holder. After 20 minutes, one line appears on the strip if the test result is negative and the person is HIV-negative and two appear if the result is positive and the person is HIV-positive. Positive results require a follow-up test with a medical professional for confirmation (Kaiser Daily HIV/AIDS Report, 9/29/06). According to the Morning Call, the counseling and referral system will be a critical component FDA considers when deciding whether to approve OraQuick for nonprescription sales. The test currently is approved only for use by hospitals, physician offices and clinics (Allentown Morning Call, 4/3). The FDA Blood Products Advisory Committee at a March 2006 hearing told OraSure it needs to devise a clinical study to test the accuracy and safety of OraQuick before moving forward with the approval process for nonprescription sales. The committee recommended a multiple-phase experiment of at-home HIV tests that explores whether people could perform the test correctly and what psychological risks exist for those who test HIV-positive (Kaiser Daily HIV/AIDS Report, 9/29/06). OraSure in response to the FDA recommendation has conducted laboratory and label comprehension studies. The company plans to apply for FDA approval for nonprescription sales after additional clinical studies scheduled through 2008 are completed. The cost of the clinical studies is expected to be about $10 million, according to OraSure CEO Douglas Michels. According to the Morning Call, terms of the deal with Constella, which since 2002 has operated a nationwide HIV/AIDS call center for CDC, were not disclosed. Chris LeGrand, president of Constella's public sector business, said the company is "committed to helping individuals both understand their HIV test results and receive immediate information on accessing lifesaving treatment and care services" (Allentown Morning Call, 4/3).

Now there’re many things to consider.

1. The HIV tests done in doctor’s offices as a rule are 99% accurate so it’s a pretty sure bet this home test will be fairly precise as the doctors if not as precise.

2. I’ve found the percentage of false positives from these tests is greater than 0.1% (swingers board) I found nothing for false negatives so this is still an admirably accurate test. Certainly better than nothing at all.

The only problem I see with it is:

1. Window periods and limitations of STD testing STD testing requires some time between when a person is infected and when the test can be expected to identify the infection. These are called window periods or incubation periods. They vary from a few days to 6 months. During incubation or window periods, an infected person can transmit the disease to someone else. The window period if you are doing a blood test tends to be longer than for other tests, as they are for the most part testing the person's immune response rather than for the "bug" itself. Remember with STD testing that you can still develop the infection after the tests are taken. A person could, therefore, have received recent negative test results yet still have an infection that could be transmitted to others. Also, while tests are mostly accurate they can be falsely negative and very occasionally, falsely positive.

2. This in home test doesn’t cover the multitude of other STDs, some
which are potentially as lethal as HIV. And again since this test is for
HIV if you in fact have it and the test is taken during this “Window
Period” it’ll show negative and mislead you.

3. Specific STD Window Periods

4. Gonorrhea--The incubation period for Gonorrhea is usually 2 to 7
days.

5. Chlamydia--The incubation period for Chlamydia is usually 2 to 6
weeks, but can be longer.

6. Syphilis--The incubation period for Syphilis is usually 10 to 90
days.

7. HIV--The window period for HIV is usually 2 weeks to 3 months,
butcould be up to 6 months. (In my researches I’ve also found HIV
Windows lasting up to 10 years. See following.) Types of HIV Infections
(AIDS) for the first few years of the AIDS epidemic, it appeared that
some HIV-infected people sickened and died quickly while others stayed
healthy indefinitely or slowly progressed into sickness. Now it appears
the greater majority of HIV-infected will gradually become very sick and
eventually die. There are reports of long-term survivors of HIV infection;
but, they seem to be the exception rather than the rule.The average
(the mean) incubation time for HIV infection is 10 years. Incubation time
means the time from initial infection until the development of "full-blown
AIDS," The average is a bell curve, with 10 years at the center. Some
individuals develop illness sooner than 10 years and some later than 10
years.

8. Hepatitis A--The incubation period for Hepatitis A is 15 to 50
days.

9. Hepatitis B--The incubation period for Hepatitis B is usually
45-180 days, with an average of 60 to 90 days.

10. Hepatitis C--The incubation period for Hepatitis C ranges from 2
weeks to 6 months - commonly, 6 to 9 weeks.

So even if you take a test for all these diseases if the test happens to fall on these window periods if you’re infected seeing how the test can show negative there’s every chance you could unknowingly be passing an infection on to someone else during unprotected sexual intercourse. However considering my permanent thread sign off. (See below.) Aside from total absence or dedicated condom use concerning sex to help assure a certainty or measure of not contracting a disease, I also have to agree with Lawguy that some foresight and any precaution available for use is better than just playing Russian roulette or trusting to crap shoots when it comes to sex and the possibility of STDs. However that’s just my opinion and I respect any and all opinions here since one man’s opinion is equally valid as the next. I also want to thank you all for this thread since it spurred my curiosity to further look into the subject so Thanks.

[sereneiders]

Let's suppose we already have this test available for nonprescription sales. You can get it anywhere, as you can get pregnancy tests (and I am pretty sure, it'd be easy to have those tests for many other diseases like the ones you mention).

Why would you threaten your privacy right taking the test in front of others?

Notice the chances for a false positive are, for the sake of my question, a worst scenario than having chances for false negatives. Since there exist an incubation window, no one would (nor should) relinkish safe sex on whatever test's grounds. False negatives falls into the "incubation window" scenario for what matters to us here, while false positive will be treated like true ones: people will be facing rejection, the gossips, and "the news" to be spread beyond their control.

So, it'd be great to have the chance to take the test in your home privacy, and you wouldn't dare to take it at someone's else's place. Should this test were sold out, the most likely scenario would be like this:

Host: "folks, before playing with you, we'd like you to take the test in front of us".

Guests: "come on, we bought the test set by dozens, we're used to take it once a week at home, and you'd have to take our word for it. We won't take it in front of other people for obvious reasons. If we were infected, it'd be our choice to let you know, and believe me, we're responsible enough, and we wouldn't be even here should we were positive"
Host: "Then, you shouldn't have any problem to take it again, right here, right?"

Guest: "Well, you know, tests could give us a false positive, and we'd rather preffer to deal with a false positive privatelly. In the other hand, should you take it and turn to be negative, we'd be using condoms anyway, cause of the incubation window. Either case, we still require to behave the same way regarding safety measures, while we risk exposing ourselves to the missuse of possibly wrong information that could damage us... we all have way more to lose than to win here, soe we already took the test privatelly, and as I said, we wouldn't be here should it turned to be positive... unless you're telling me I am lying to you... take my word for it or leave it, it is your choice"

Host: "Mmmm no, we want you to take the test."

Guest: "Ok. Nice to meet you, guys... good bye."

For the sake of this discussion, having the chance to buy the test to take it privatelly doesn't make it available to be used in public, if you have common sense about the risks of disclose this kind of information to unknown people, you wounldn't take the test in front of others anyway.

And let's suppose we're dealing with liars here, I mean, people who already know they are positive and are up to swing without telling you about it. What would be the difference for you, since you'd also find people that, even when responsible enough, they still are legitimally concerned about their privacy? You don't have an "honesty test" to tell the difference, so you cannot rely on people's words... as it happens today, without an unreciped test available.

There is another concern, about people with denyal attitudes who, today are forced to rely on a physician to take a test while they still doesn't know wheter they're infected or not. Once knowing they're positive, they could refuse to take any test because of this attitude. This transfer the responsibility of dealing with positive cases to the individual, instead of the public healthy system, which could prevent the later from gathering vital information for research/statistical purposes, nor to take measures. How odd this case could be? Not so uncommon, let's suppose a teenager concerned more of being socially outed, and inmature enough to understand the consecuences. The kid takes the test, just for fun, finds out it turned positive, and start doing everithing he/she can to hide this from others.

For the sake of our concerns as swingers, this test availability could lead us to a more dangerous scenario than the one we face today. People misslead bout the test effectiveness, unaware of the incubation window, could relinkish to take safety measures, increasing their exposure to infections and the exposure of others. The test availability could lead to attempts to impose it to others, under the assumption that it's fair to do it, and that the information it provides is meaningfull enough. Even if you're not concerned about privacy and you take the test, once it's negative, it's very likely that the safety measures to use would be weakened, because of our human nature and the unconscious pursue to enhance the pleasure (for example, avoiding condoms for certain activities like oral sex). Uninformed, non professional people, with this test at hand, could boost the epidemy.

It doesn't matter if each one of us believes we're informed and responsible enough. For the one who are really informed, the test shouldn't change their current safety concerns nor ther prevetive behavior: given a 10 years incubation window for HIV, many of the people with negative results have the same chances to infect you than serum positive ones. For the ones who are less informed, it would help increase the risk of exposure for everyone involved, while limiting the chances for the proffesionals to educate people and provide us all with the right information.

The problem here is our fears, and how our fears are able to misslead us into the illusion of safety by taken certain measures that aren't as effective as our intuition allows us to believe.

[MoonLightKiss]

Originally Posted by sereneiders

Why would you threaten your privacy right taking the test in front of others?

This is the question that makes me say we would not take one of these tests in front of potential playmates. I have a divine right to privacy that no one has the right to trample on. I get tested regularly by my family doctor, and I give blood regularly as well. My obgyn also runs the standard tests when I do my yearly pap. So between all of these, I probably get tested 4-6 times a year. Should any type of symptom arise, I would go to my doctor immediately for a check up as well. The difference between you and my doctor...he is bound by reasonable confidentiality, YOU are not.

I have another question though. What is the difference between taking you with me to my doctor to get the results and taking the test in front of you? I can't see the difference. And frankly, I would never take a potential playmate to the doctor with me. Why? Because I have that pesky little right to privacy, and while the doctor is bound by confidentiality, again YOU are not. I don't care if its the flu, pnumonia, a cold, or HIV. I don't want my business spread unless I choose to share it.

In all honesty though, swinging is a lifestyle that contains risk. You have to decide for yourself if the risks are worth it. If you are concerned with HIV or any other disease the choices are simple. Use a condom, or don't play. I wouldn't play with anyone so paranoid that they carried tests in their pockets. And if you are that concerned, then VegasLee has said it best in several posts I have read of his...Swinging is not for everyone. There is no shame in saying its not for you either.

[good times]

Why do I think that someone that would require me to take an HIV test before playing with me is paranoid? Because I know that in the demographic group that we play with, even if I use the most pessimistic statistics available to determine my risk, I am still more likely to be abducted by aliens from the planet Beetlegiese than I am to get AIDS from one of my play partners.

[rpu3]

Originally Posted by Lawguy

In sum, those of you all who disagree simply believe that HIV infection is an acceptable risk of the lifestyle and do not think that there's a need to test a potential partner.

I don't think you can really lump those who dissent with your ideology/thoughts/beliefs altogether with your statement.

In sum, I don't "simply believe HIV is an acceptable risk..." There's nothing simple about this topic - nor our choices regarding this topic. Those choices and the reasoning behind those choices are as diverse and personal as there are members of this board.

Rebecca
Still not being sarcastic.

[curiousagain]

Originally Posted by Lawguy

(hard to believe because I deal with doctors on a daily basis, and cannot imagine this argument with my acquaintences), but in my own profession, I deal in human nature--and I know that there's not too much difference in the locale of the results. Indeed, you might argue that if there was a positive result in a hotel room, there would much less of an emotional impact as, most assuredly, the test would not be believed and an appointment would be set the next morning with a local lab. A positive result in the physician's office, however, will more likely be accepted as fact, giving a greater, not lesser, impact emotionally.

Then have the argument with them and see what they say. The argument that it would be less traumatic in a hotel room is BS. I think this thread shows your lack of knowledge of human nature irregardless of how much you deal with it. Until you’ve had to deliver that test result I’ll continue to believe I know much more about it than you do. A positive result in a physicians office would be ran again and arrangements made for support before the patient was informed. My associate had a false positive at a test clinic and was informed by phone by her insurance agent (pre HIV politics days) and I imagine watching the test turn positive in a hotel room in front of people you figure are going to spread the word like wildfire would be more traumatic. But then, I've only got a few degrees, years of education and training and 14 years of on the job experience and an active swinger, what the Hell do I know? I'm sure your imagination and theories are much, much, more realistic.

Originally Posted by Lawguy

As for curiousagain's analogy, I just feel your analogy is not apt. There are so many remedies for a psychotic: law enforcement, restraining orders, or Smith & Wesson (okay, so I threw that last one in there). Being from Texas, I guess if I ever thought a stalker was going to be a threat to my life--I'd take 'em out first. Seriously, however, there is really NO remedy for AIDS: period.

It wasn’t an analogy. Have you ever dealt with psychotic people? I’ve been stalked for two years including threats to burn my house down at night with my family in it. I’ve had the police watching my house and monitoring my phones, I’ve been in a couple of gunfights and I’ve got a scar from a knife. Back when I had a job that involved carrying money, I stopped three robbery attempts with my pistol, one with a fire extinguisher, and one with a truck door. I’ve had to wrestle psychotic patients down and restrain them before they hurt themselves or others. Including one who had a gun. I’ve “seen the elephant”, have you? If you take someone out who is not an immediate threat, that’s murder. Trust me, as far as a stalker, I’d do it that way if I had it to do over and just do the jail time, as my stalker only stopped when I tried to shoot him but he realized it before I got a clear shot (innocent people around) and fled for good, but then, wouldn’t it be better to avoid the whole shebang if possible? But, I'm not from Texas.
Just an FYI, a restraining order isn't worth shit against a real psycho, but again, WTF do I know?

Which brings me back to a point that several have made. If you are that concerned with it, just forego swinging. It isn’t for everybody. Everybody has some things they will or won’t do. I drive a motorcycle at 150 mph with a huge grin on my face. A friend of mine won’t sit on one with the motor turned off. However, he has skydived for years. I have started to do that a few times and always chickened out. I love to fly and skydiving intrigues me, but it’s just not for me as motorcycles are not for him. Maybe swinging is the “shebang” you need to avoid.

We all have our comfort zones. I sleep with a .45 (I'm a Colt man, myself), a mag light, and a cell phone on my nightstand in a house with an alarm system and a dog that barks at everything sleeps in the same bed. Some would call that paranoid and I just call it being careful. Some call your test hypothesis paranoid and you just call it being careful. We all have our own opinion. Ain't America great?

I hope you find your comfort zone and enjoy it. I've found mine and am enjoying it.

[sereneiders]

Originally Posted by good times

Why do I think that someone that would require me to take an HIV test before playing with me is paranoid? Because I know that in the demographic group that we play with, even if I use the most pessimistic statistics available to determine my risk, I am still more likely to be abducted by aliens from the planet Beetlegiese than I am to get AIDS from one of my play partners.

I wouldn't say "is paranoid", however, to some extent it is pointless to rely on tests (public or preivate).

Why would you want me to take the test in front of you as to be an elegible playmate? It isn't about what you know once having a result, but about what you still doesn't know, even with the result. So, the question isn't so trivial as it looks. Once having this "information" (the quotes are mines, and I will explain this)... what would you do about this? Would you current behavior change? If the answer to this question were "yes", then beware! You could be testing someone already infected and within the 10 years window before the symptoms. 10 years! And the test would provide you a false sense confidence. If the answer to this question were "no", then we don't have anything to discuss here.

Now, I quoted the word information because information isn't just a piece of data, or the gathering of data. It is the data peged to your purpose. It depends on the purpose the data value, and the word information refers to this value. "I am a tall guy"... this piece of data isn't information unless it becomes meaningull for someone's purpose. Meawhile you could say "you're tall? who cares!?".

So, let's revert the situation. You come to my place bringing your testing kit, and without being asked, nor ask me to do it, your just take the test in front of me, I'd say... "what do I care?". Should the test be negative, you could be already infected during the incubation window, so I will take the same measures I was about to take without knowing the test result. Of course, should the test turn to be positive, for sure I will refuse to play with you... even when we all know there are false positive results (thus, the data is unacurate). But, it is very unlikely that you didn't took the test privatelly before oferring me to take it again in front of me, and if you did and you already know it is positive, you wouldn't offer to take the test in front of me in the first place. So, your chances to make a "public" test on someone who is positive are very odd, should it turn to be positive inmediatelly after a negative result (from let say, a couple of days before, wich means you were lucky enougn to meet the guy rignt after the incubation window), it's very likely that you'd be having a false positive result.

So, the test you just made, disregarding the result, isn't that usefull to me as it seems at the first glance, it's a piece of data deprived of it value IN THIS SCENARIO (which differs from the one at you're doctor's practice), it isn't information, and even if it were, the value is so dimished that it doesn't justify the other "social" problems it use FOR THIS PURPOSE, could bring to us all.

You may claim "well, the idea that I'd be willing to make the test on my own and disregarding your oppinion is stretched". The fact is, if using this test turns into a widespread prescreening method to decide wheter to have sex with someone, people wouldn't wait for you to ask them to do it, because it'd be ill seen of they does.

For the laboratory wanting this test to be sold without recipes this would be an excellent business, they will swim in money. People, and not only swingers, will use it as a prescreening method, even for casual vanilla sex, without bothering about any educative measure. Even if swingers were able to properly use the kit and properly lead with the results, a lot of people would not, for example, getting overconfident and weakening the preventive measures that they previously used to take. IMO, again, this could boost the epidemy... and turn into a vicious cicle, as the epidemy grows (increasing the risk for swingers), more people would freak out and (miss)use the test, feeding the lab's pockets.

As far as I know, you don't have many unreciped tests for infectious diseases. IMO this is on purpose, because the only way the State and the healthy organizations are able to deal with an epidemy is by means of ensureing people will meet a doctor to be diagnosed, giving them the oportunity to deal with most of the cases, and track back other possible infected people. This "wonderfull" test risks to make them lose the control for the disease.

Here, the only winners will be the lab owners, and I am afraid, at the price of many people's lives.

[VegasLee]

I have been thinking about this from a Club Hosts view since this thread started.

As a host I don't think I would allow you to ask people to take the tests at our club.

Since it will only take a matter of minutes before everyone in the place knew that you will only play with people that take your test and the test is negative then people are going to have to assume that anyone you talk to but did not play with either would not take the test or that it came back positive.

I can see this causing a great deal of drama in a club or house party.

I am thinking that if you only want to play with people that you personally see the test results of in person that the best way is going to be hook ups in bars or online explaining this is your requirement. I don't think that to many party hosts or club owners are going to let this testing happen at their parties.