HIV Home Test Kit: Debate Today

[epepke]

If there is no way to produce a home test which doesn't produce a false positive then we are left with testing people in clinics and doctors offices. Doctors and therapists tell people that they have terminal illnesses all the time.

The point that you are not getting is that doctors (not sure about therapists) will do several different tests with higher and higher degrees of specificity before telling people that they likely have a rare terminal illness.

For a home test to work, you have to figure out a way to provide something similar for the home user. I even suggested one (apparently without any effect on the brains of people here, but I'm used to that).

 

[epepke]

If worse comes to worst and some fool kills himself over a false positive, what of it? That's just poor judgment on his part.

Well, what of it? What of it is that the relatives of the victim sue, and your wunnerful home test is gone from the marketplace real quick.

I suppose that one can approach practical matters by having a stalwart idealist opinion, but I think it's kind of dopey.

 

[Rolfe]

Interesting paradox. You suggest that a false "positive" is totally unacceptable, for some very good reasons. However, what if there was no such thing as a "positive" result reported? If the result was instead reported as "suspect" or "possible", with the instruction to get to a proper testing centre for a definitive result? Do you think that would be just as undesirable, in that people would jump to the conclusion that "suspect" meant positive anyway?

The reason I ask is that I tend to view sensitivity as more important in screening tests in general. Because, if the negatives are entirely reliable, then you have very significantly reduced the number of patients that need to be put through the professional testing system. And the patients who are presented include the ones who need attention.

Conversely, if it's the negatives that aren't wholly reliable, have you gained much? If all the negatives have to proceed to further testing, then you probably haven't cut down the professional lab workload by much. Plus, the people you don't see (the positives) are exactly the people you really want to get into the system.

Having said that, though, the sensitivity and specificity figures quoted about for this test were very impressive. There were indeed no false positives being reported, and the percentage of false negatives was so small that it's likely very very few infected patients would be missed.

So in this case it really does seem to be a sociological and psychological argument.

Rolfe.

 

[Luke T.]

Do you seriously think that proposal even deserves consideration? Why test people who walk into a doctor's office? Won't that just make people less likely to see a doctor? Why not just force everyone to get a test? And then we can force everyone who tests positive to list every sexual partner (right before being shipped off to a quarantined island, that is).

Don't drink the Kool-Aid.

A central dilemma of the AIDS hysteria has been a systematic effort by homosexual and civil rights advocacy groups to prevent the application of disease control measures to HIV infection. Since no health departments have seriously considered restricting HIV carriers, the major focus has been on preventing the mandatory reporting of HIV infection and limiting the notification of persons who have been exposed to the disease. Homosexual activists have resisted reporting and contact tracing because they fear that the health department
records will be used to persecute homosexual men.

The tragedy is that since these groups have not be able to make a valid scientific argument against the reporting of HIV infection, they have instead chosen to attack the integrity of public health officials. Despite evidence that public health departments have an
essentially unblemished record in protecting patient information, homosexual advocacy groups have convinced most state legislatures that health departments cannot be trusted with information on the spread of HIV. This attack on the integrity of public health has been made with the tacit support of many public health officers. These public health officers have become captives of the rhetoric of patient autonomy. They speak of protecting the patient's right to privacy, rather than the patient's right to life. The legacy of this schizophrenic view of the role of public health officials has been the unnecessary death of tens of thousands of people, primarily homosexual men.

http://biotech.law.lsu.edu/cphl/articles/CO_HIV.pdf

ETA:

Colorado requires that the physician attending a pregnant woman
test the woman for syphilis within ten days of her first patient
visit. If the woman is attended by a midwife or faith healer who is
not permitted to draw blood, then the woman must be sent to a
physician to have a blood sample drawn for testing.1

This idea is not unprecedented. Earlier in the century when syphillis was out of control, it was standard practice to test people for syphillis for common doctor visits to get the epidemic under control.

 

[Melendwyr]

Well, what of it? What of it is that the relatives of the victim sue, and your wunnerful home test is gone from the marketplace real quick.

Only if the legal system is staffed entirely with idiots.

 

[luchog]

Only if the legal system is staffed entirely with idiots.

"McDonald's Coffee."
"Twinkie Defense." (Yes, i know, that one isn't quite what the media made it out to be. It was still asinine.)

 

[Melendwyr]

"McDonald's Coffee."

The woman actually had a very good case. McDonald's had been serving coffee at boiling temperatures for far too long, and had been repeatedly warned about doing so. In addition, the woman received very severe burns. I know everyone holds that up as an example of legal absurdity, but it wasn't at all.

"Twinkie Defense." (Yes, i know, that one isn't quite what the media made it out to be. It was still asinine.)

Yes, that was ridiculous.