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ASHM Report Back
Clinical posts from members and guests of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) from various international medical and scientific conferences on HIV, AIDS, viral hepatitis, and sexual health.
In the session on ‘Initiation, testing and diagnosis’, Dr Mark Bloch spoke of a new device that could be used for rapid HIV self-testing. The concept of rapid HIV testing has been around for some time, however it is not yet readily available in Australia. Mark spoke of the many benefits self testing could provide: possibly increasing uptake of testing and thus diagnosis – particularly for those in hard to reach communities (there is predicted 10% undiagnosed people living with HIV in Australia), as well as increased convenience, confidentiality and sense of autonomy. Of course it is not without risk – the potential for inaccurate results, ethical risks, and potential psychological danger in the event of a positive result in an environment without clinicians readily available to answer questions.
Mark’s study looked at the usability and performance of a new device – Atomo Galileo HIV self-test. In 521 individuals, concordance of the self-test was assessed with the conventional laboratory testing, and usability was assessed by assessing accurate performance of 6 critical steps. In this study, concordance of the self-test with lab testing was essentially 100% (99.8% - the 1 discrepancy was attributed to a false positive from the lab test). There was high usability scores demonstrated by close to 90% of all individuals performing all 6 critical steps.
The device itself looked simple and intuitive. It was not too dissimilar from a glucometer or a pregnancy test – with a lancet to prick the finger and chamber to collect blood (in the same device). A single band appeared in the event of a positive result alongside a control band. The test reportedly takes approximately 15 minutes to obtain a result.
This device has potential for use in difficult to access communities and resource limited settings, and removes additional barriers to testing and diagnosis. It remains to be seen what impact HIV self-testing will have in engagement with clinics and whether this would impact adherence to regular screening guidelines for other STIs.
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Mark directs us to his website ‘HIVST.org’ for further information on HIV self-testing.