OraSure can make HIV testing quick, safe, and accurate

Only a drop of blood, a loop of wire and a 20-minute wait stands between 900,000 Americans… Only a drop of blood, a loop of wire and a 20-minute wait stands between 900,000 Americans and the truth.

On Thursday, the Food and Drug Administration gave its approval for a rapid HIV test that would cut the initial waiting period from 90 to 20 minutes. Subsequently, Secretary of Health and Human Services Tommy Thompson asked the company manufacturing these tests to apply for a waiver so that people with minimal medical training – like social workers or clinic counselors – could administrate it.

OraSure Technologies, a Bethlehem, Pa.-based company, agreed to sign the waiver. Rapid tests, probably available by January, could be administered at any public health facility. These breakthroughs prove crucial in battling the spread of HIV. For instance, the 900,000 mentioned are unaware of their HIV-positive status.

The accessibility of quick HIV tests should expand beyond clinics to target those under 25, with free testing offered in high school and college.

At Pitt, Student Health provides HIV testing. But for kids in high school, the options are limited. Most, being under 18, see pediatricians, with whom they may not feel comfortable discussing sex. Others do not have health care and must rely on costly emergency services.

In both cases, medical care is routed through parents. No matter how close or estranged the parent-child relationship might be, they do not always discuss sex readily.

If such testing were available, high school nurses qualified to administer these tests could tell kids their HIV status and direct them to a guidance counselor or psychologist – one of which most school systems require schools to have. Results would have to be confirmed by labs, since the initial test only detects the presence of HIV antibodies – proteins the human body manufactures in response to that specific pathogen – rather than the virus itself.

Schools have become some students’ first source for medical and social aid. HIV testing would be in the best interest of both the student population and public health.

Of course, legal issues would arise. Nonemancipated minors are their parent’s wards. In order for schools to perform treatments, kids need a permission slip signed by their parents. But HIV testing is not a treatment; it is a diagnostic test, one which technology has made easy.

Testing is after the fact. By making the distant possibility of disease immediate, kids would experience the anxiety of an HIV scare in a controlled atmosphere. Mortality and HIV become terribly close, part of the dangerous and tangible reality of high-risk behavior.

Many kids choose adult activities – sex, smoking and credit card spending, for instance – before they come of age. Schools should acknowledge this and serve kids accordingly.

HIV testing should not be as controversial as other safe sex programs, such as condom giveaways, which many see as giving kids a carte blanche to have sex. People can contract HIV through means other than sex, including sharing drug syringes or tattoo needles.

Schools could monitor and address risky behavior as it arises. Testing programs would simplify collecting health statistics. Because minors comprise an underreported population, public health services would benefit from the availability of such numbers.

Last year, one of my fellow columnists described the process of getting an HIV test – going to a clinic, having blood drawn and waiting a week with breath held and nails bitten for the result. He described the experience as a, “seven-day limbo … wondering whether or not [his] blood is poisonous.”

Other options for testing exist currently. People over 17 years old can donate blood to the Red Cross – another way of getting a free HIV test, since the organization examines all its donations for sexually transmitted infections and other diseases. But because of the sheer quantities of blood the Red Cross collects, this analysis can take more than a month.

Home HIV tests, sold on the Internet and available at some stores, can be prohibitively expensive and time-consuming. Aids.com lists two FDA-approved tests that cost between $40 and $60, take between three days and one week and are about as accurate as the OraSure system.

Clearly, the OraSure tests reduce the waiting period and expense of testing. Kids could wait as little as 20 minutes for a 99.6 percent accurate test. Having tests at the prick of their fingertips would alleviate the fear of having poisoned blood and numbered days.

Columnist Sydney Bergman can be reached at sbergman@pittnews.com.