W.H.O Pushes For HIV Home Testing Kits: Will India Go For It?

On the eve of World AIDS Day, WHO advocates HIV home testing – but why is India reluctant to adopt the technology?

The first legally approved, World Health Organisation backed, HIV testing kit is available in the market and it works as accurately as a home pregnancy test.

For the first time, the apex health body is pushing countries with a heavy AIDS burden to go for the DIY HIV testing kit; with just a prick it gives results within 15 minutes with 99.7 percent accuracy.

The HIV statistics in India are bleak. We have the third highest number of HIV-infected patients, while four out of ten positive people in Asia can be traced back to India. Yet a device which can diagnose the highly stigmatised disease within minutes with 99.7 percent accuracy is not readily available in India as a part of the government’s HIV prevention programme.

At Least 7 Lakh People Are Unaware About Their HIV Status In India

We have almost 21 lakh positive patients in the country and about seven lakh of them are not aware of their HIV status.

Navreet Singh Kang, Director General National AIDS Control Organisation (NACO)

In 2016 – when the AIDS epidemic is in the third decade – if seven lakh people still don’t know they are infected with the HIV virus and don’t think they are in the high-risk category, then the figures of unknown transmission in India could be huge.

Very little has been done to tackle the issue of late diagnosis. Doctors say, people diagnosed late are 11 times more likely to die in the first year after diagnosis than those who receive early treatment.

In such a scenario, the availability of a legally approved HIV testing kit could be a lifesaver. It’s also a major milestone in HIV research which is mostly focused on developing a preventable vaccine.

FYI, the HIV home testing kits are no ‘morning-after’. If you’ve had a busy night in town, a test the following morning will reveal nothing. Antibodies take four to twelve weeks to multiply and show in a blood test, so regular testing in high-risk groups is recommended.

Also Read: There’s a Daily Pill to Protect Against HIV, Here’s How It Works

Yet, Home Testing Kits Do Not Get the Green Signal In India

NACO, the government’s HIV/AIDS arm, is against allowing finger pricking in the comfort and anonymity of their homes to know their status.

The reason?

HIV testing should be accompanied with pre-testing and post-testing counselling. NACO’s logic is that “people could commit suicide after an incorrect positive status”. They are also afraid that people might use it incorrectly and get a false diagnosis.

Though the risk of self-harm is sort of valid, the argument is flawed at many levels.

Firstly, unlike pregnancy, the home testing kit does not give a straight ‘positive’ or ‘negative’ result but it reads how many antibodies – the proteins the body makes in response to the HIV virus – are present in the blood. The corresponding markers for a ‘reactive self-test’ are mentioned, which implies that one must go to a hospital for specialised HIV diagnosis and a ‘non-reactive self-test’, which would mean that there is no infection. So what’s the harm if a pin-prick speeds up diagnosis?

Lastly, pre and post-test counselling is the ideal way to tackle a highly stigmatised disease like HIV – but does it really happen in India?

We are a country which regularly runs out of HIV testing kits in treatment centres. Last year, there was not a single ART (anti-retroviral) centre in Maharashtra or Karnataka, the two states with very high HIV prevalence, which did not face acute drug shortage for several weeks.

Red tape on international grants, slashing of health budgets, bottleneck in supply and poor co-ordination between Centre and states has endangered patients’ lives.

Or perhaps it is the acute lack of funds that is stopping NACO from adopting this ambitious home-testing kit in its HIV prevention programme.

We know fund shortage is forcing NACO to openly flout the World Health Organisation’s HIV-treatment guidelines which state that ART medication should begin when the patient’s CD4 cell count drops to 500. NACO, on the other hand, does not start free-treatment till the cell count dips to 350 because WHO’s guidelines would mean making nearly twice the number of ART drugs available since millions of extra patients will be eligible for treatment in the initial stages.

Only last year, the HIV-AIDS figures in India have seen a slight decline. Not using available, accurate technology for early diagnosis when we are already buried under the rock of under-reporting could have alarming results.

Could HIV-AIDS go the tuberculosis way in India? The public health fight against TB was abandoned in the last leg of the ‘90s, until it struck back in an incurable, drug-resistant form in the last decade.

Also Read: Will an HIV Vaccine Trial in South Africa End the AIDS Epidemic?