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Grab some eggs, milk, pasta, soup and an HIV test
  Sunday, October 23, 2005 Susan Nielsen The Oregonian
I t's time to take HIV tests out of the closet and put them where they belong.
On Aisle 10, next to the toothpaste.
The Food and Drug Administration may soon approve a fast HIV test for people to buy over the counter and take at home, like a pregnancy test. This would represent the biggest revolution in HIV treatment in the United States since scientists developed good anti-retroviral drugs in the 1990s.
It would also lower the stress of getting an HIV test by about 157 percent.
No more cowering in a clinic waiting room. No more telling a stranger about your sex life, knowing that person may be required by law to report positive results to the authorities.
It would be just you and your trusty HIV test, in splendid isolation. Bathroom door locked, sheet of instructions in hand, privacy intact.
The 1980s and 1990s, as some of you crazy cats may remember, were a scary time to have sex with a new partner. HIV, the incurable virus that causes AIDS, was on the move. One wrong step, it seemed, would send you to the hospital ward and the grave.
But getting an HIV test was almost scarier.
It was like a sex tribunal.
You'd go to some clinic and testify about your sins. They'd take your blood as evidence, then you'd slink back two weeks later to receive the verdict.
You'd imagine a siren going off, signaling your transformation from a person into a public health emergency. You'd picture being led down a dim hallway and stuffed into a government database with fellow untouchables.
It didn't matter how nice the clinic workers were, or how confidential the results. The suspense and fear were still awful -- or at least, um, that's what my friends told me.
"People were quite concerned then, and rightfully so," says Dr. Sean Schafer, an epidemiologist in the Oregon Office of Disease Prevention and Epidemiology.
A handy little at-home HIV test might've put a few million minds at ease. In fact, one company sought FDA approval for an at-home test in the late 1980s. But the idea seemed preposterous then, like stocking the health-and-beauty aisle with a test for the bubonic plague.
Federal regulators also worried about the accuracy of the tests and the biohazards involved. Mostly, they worried about people killing themselves after they got bad news at home, alone.
Times have changed.
Magic Johnson is still alive, for one thing. HIV is less deadly, now that better drugs can keep the virus in check for years. The public's hysteria about HIV has wilted into weary concern.
Tests have changed, too.
One test, called OraQuick, delivers results in 20 minutes and measures antibodies in saliva, not blood. The FDA approved it for clinic use last year, and an FDA advisory committee will begin studying it in November for over-the-counter sale.
The FDA says the test, which originated in Oregon, is more than 99 percent accurate. You simply swab your gums, stick the swab in the holder and wait for the results to appear.
One stripe means hallelujah.
Two stripes mean pray.

Michael Anderson-Nathe, manager for men's prevention and wellness at the Cascade AIDS Project, says he's intrigued by the idea. He's waiting to see how the FDA will urge people to seek counseling and get help with voluntary partner notification. He also hopes the FDA will warn people about the delay, of up to several months, between catching the virus and testing positive for it.
But overall, he's optimistic. "Any time people have access to getting tested," he says, "it's a good thing."
People in Oregon took about 90,000 HIV tests last year. Only 0.3 percent of those tests were positive. Even among people at high risk for HIV, such as gay men and injection drug users, the positive rate was only 2-3 percent.
The odds of having HIV are low. The odds of putting off the dreaded appointment, however, remain high.
As Schafer points out, the typical man doesn't exactly love going to the doctor anyway. And recent public-health research suggests that many people remain as reluctant to take an HIV test in front of a stranger now as they were in the 1990s.
A fast, at-home HIV test could be the perfect way for people, finally, to get answers on their own terms.
On Aisle 10.
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