The Food and Drug Administration (FDA) made the right call at the right time by allowing over-the-counter sales of HIV home test kits in Thailand.
While the number of people living with HIV/Aids in Thailand has been declining over the past two decades, the country is still faced with the challenge of preventing the spread of the disease in certain demographic groups.
Back in 2015, there were about 6,900 new cases of HIV infection, which is roughly equal to 19 new infections per day. In 2017, the number of new infections dropped to about 5,500 cases, which works out at about 15 new infections per day.
Indeed, the rate of new infections seems to have risen among Thai youths, as well as men who have sex with men (MSM). Recent figures released by the Department of Disease Control said 50 percent of new patients identify as MSM, and that about 55 percent of new patients are less than 25 years old.
Nevertheless, the figures may not reflect the actual situation, as there are many high-risk individuals out there who have no access to HIV testing. Some avoid getting tested out of fear of being stigmatised by the community, while others forego testing because of their lack of awareness of the disease and how it is transmitted.
As such, despite the availability of anti-retroviral treatment for patients with HIV/Aids – which is covered by Thailand’s universal health coverage and social security schemes – many of them remain undetected and untreated, because to gain access the treatment, one has to know his or her HIV status.
Thailand’s HIV testing method has not changed significantly over the years, in that it has to be done under the care of doctors or medical professionals, who will also provide information on prevention and/or treatment. Therefore, allowing the sale of over-the-counter home test kits can help the government identify undiagnosed HIV patients who might have been reluctant to visit a hospital. It can help curb the spread of HIV by directing patients towards the appropriate treatment.
However, there are several concerns about the availability of home test kits.
Self-testing without a sufficient understanding about the virus, and limitations of the test kits, could prove to be just as dangerous. Not all users are aware that a positive result on the kit has to be confirmed by medical professional.
In addition, users of the test kits also need to understand the “window period” of HIV infection – that it may take up to three months from the time of infection for traces of HIV to show up in tests. As such, a test conducted during the three-month window period could result in “false negatives”.
Unsupervised, HIV self-testing could have a major impact on users who are not aware that HIV-positive individuals can live normal lives, if they get the proper treatment in a timely manner.
A positive result on the home test kit could even lead a person to behave irrationally and possibly, in the worst cases, attempt suicide.
Now that HIV home test kits can be purchased over-the-counter, the Public Health Ministry along with other state agencies and campaigners should improve their public awareness programmes to ensure that people understand the benefits of the home test kit, as well as its limitations. Authorities should also provide pre- and post-testing counselling for those who choose to use the home kit.