Wed 9 Feb 2011 In: Health and HIV View at Wayback View at NDHA
The Head Start Testing homepage Head Start Testing makes bold and emotive claims for the new home test HIV kits it has started promoting in New Zealand. Even the pious tag line attached to the company name in its promotional material states the company is all about "Enhancing and saving lives through medical testing." Professional health and HIV organisations see it quite differently. The NZ AIDS Foundation yesterday publicly accused Head Start, which has yet to respond to GayNZ.com's questions or the NZAF criticism, of preying on vulnerable people and of lying about its test kits, which are similar in style to kits which the distributor promoted then withdrew after a hail of criticism a year ago. By making up front claims for the kits such as "Medsafe approved" and "They have accuracy of >99% and detect both the HIV 1 Eamonn Smythe Eamonn Smythe, the NZAF's Director Positive Health Service, pulls no punches when advised that the test kits are for sale online and being promoted to retailers. "First of all, a rapid HIV test is considered a 'medical testing device' and is therefore not even regulated by Med Safe, which is the Government agency with responsibility for medications!" he says. "Their statement that this test is "Medsafe approved" is blatantly untrue." It's not the first time such misrepresentation has angered the Foundation. "When this issue came up in November 2009 one of the websites selling these kits said that the NZAF used the tests they were flogging. That was also untrue." THE PERILS OF GOING IT ALONE But, more importantly, the primary concern of the NZAF staff is not the efficacy of the test, although that is clearly a worry. Its the lack of pre- and post-test counselling for these tests that has them steamed. "There is ample research, anecdotal evidence and the personal experience of every person living with HIV that proves that a positive test for HIV is a shocking, life-changing and often deeply traumatic experience." Smythe says the NZAF is committed to providing free, professional pre- and post-test counselling and psychotherapy because effective and professional testing and services can achieve a variety of important goals. He lists those goals as reducing the further spread of HIV and "limiting the potential trauma that a positive diagnosis may cause, assisting any person with a predictive positive result through the confirmation process, and educating anyone taking an HIV test, regardless of a positive or negative outcome, about the relative risks of different sexual activities and safe sexual behaviour." Another important goal Smythe lists is "providing more information and education to any client with a positive result in order not only to prevent further spread, but also to facilitate the empowerment of the client." A fourth goal is encouraging the provision of follow-up support and "enabling a person living with HIV to explore the options available and support them through events such as disclosing their HIV status to their partners, family, friends and employers." Dealing with difficult lifestyle factors is the fifth goal. It's important, says Smythe, to be able to refer clients to other professional services as needed, such as mental health services or drug and alcohol service providers." TO HOME TEST OR NOT TO HOME TEST? Is home testing for HIV ever appropriate or effective? "It wasn't in 2009 and it isn't any more appropriate or effective in 2011," declares Smythe. "Everyone will react in a different way to a positive diagnosis and research shows that without professional pre- and post-test counselling or psychotherapy a positive HIV test might result in depression, self harm to a greater or lesser extent, and harm to others whom they think may have infected them." Then, he says, there's the danger of further transmission of HIV "due to a lack of sufficient knowledge about HIV or correct use of condoms and lube." The Miller Report on HIV services last year highlighted the public and personal stigma faced by people with HIV. Smythe says there are significant dangers in "non-premeditated disclosure of HIV status to others, possibly resulting in stigma and discrimination, and/or depression and isolation. Not to mention the dangers inherent in "lack of, or inappropriate, disclosure to previous partners who may have been exposed to HIV." And further on the issue of disclosure, there are many thorny issues surrounding disclosure to "support networks such as partners, friends and family" for which a person newly diagnosed with HIV may need some solid guidance. FALSE NEGATIVES But at the core of concerns is the tricky issue of the "window period during which a person may have contracted HIV but not test positive. Whilst Head Start acknowledged that issue in it FAQs it's far from certain that someone taking a test will read or understand that detail, or that someone asked to take a test "now" by a prospective partner - a concern raised by HIV people's peer support group Body Positive last evening - will even have the information available. Despite Head Start's promotional claim that their kits "detect both the HIV 1 and 2 and subtype virus, "this test is actually an antibody test," explains Smythe. After a person has contracted the HIV virus, "that person’s body first needs to develop the antibodies that produce a positive result. This takes the human body time to develop and will be identifiable in 80% of people in 3 months." So, for months after contracting HIV and all the time being able to pass it on, a negative test result is possible, even probable? "Negative results during this period are common and it is important that any risk event is discussed with a health professional so that they can give appropriate advice about when a repeat test will be needed." In short, urges Smythe, "this test cannot, and will not, be able to reliably tell you if you or your partner have HIV." A DANGEROUS WASTE OF MONEY Cutting to the chase, Smythe says the kits are a dangerous waste of money. The NZAF "sees no value in these tests and considers them to be a desperate attempt to make money." He encourages anyone who thinks they have been at risk of contracting HIV "to get a free test from a professional rather than paying a dodgy online supplier $25 for one." And strangely, a site identical in almost every way to Head Start's online sales site, has the same product on sale for a whopping $39.95! LACK OF PROFESSIONAL INPUT It's no secret that having an HIV test can be both stressful and frightening. "People are entitled to professional support both before and after their test and that is not available through suppliers like this, or from retailers who may choose to stock the tests." Smythe is disdainful of the back-up information provided on the Head Start sales site. "Their supporting material in the ‘About HIV’ section has been copied verbatim from www.experts123.com!" he observes Was the NZAF, considered to be a world-rated expert on HIV, consulted by Head Start regarding distribution of the kits or for information relevant to the epidemic in New Zealand? "No, not at all." That lack of consultation doesn't surprise Smythe. "The NZAF has staff who can be expected to notice completely false claims such as 'Medsafe approved' and who would take action about misleading the general public, and anxious or vulnerable people in particular. Additionally, the position of the NZAF in regard to DIY HIV testing is very clear and has been stated repeatedly in the media." TODAY'S SPECIAL: HIV TEST KITS? Will the future see HIV test kits on sale in adult shops or even service stations and dairies? Clearly the NZAF and Body Positive - who last night also voiced their opposition to the sale of the kits - hope not. "We believe that most retailers, online outlets, sex on site venues and adult shops in New Zealand are responsible," says Smythe, "and we strongly recommend that they do not stock these testing kits." His message for people who have bought a kit, or are thinking of buying one, or are asked to submit to one is simple. "This test does not provide you or your partner with protection against HIV – using condoms and lube for anal sex does. Reliable HIV testing is available in a non-judgemental, pro-sexual, professional setting. The HIV testing provided by the NZAF is free, anonymous, simple, fast and available to anyone who is concerned about HIV. A do it yourself HIV test cannot be relied on to provided an accurate result, appropriate support or prevention in the future." "We urge people not to support this irresponsible and unprofessional initiative that preys on people who may be vulnerable, worried and at risk," Smythe says. Almost all HIV infections in New Zealand occur due to unprotected sex between between men who have sex with men. Professional, confidential HIV testing and counseling is provided by the NZAF's Regional Centres and contracted counsellors, local sexual health services including Body Positive in Auckland, and by GPs. Testing at the NZAF, Body Positive and sexual health clinics is free. Jay Bennie - 9th February 2011