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Can HIV self-tests help counter Canada’s rising transmission rates?

From the article in Xtra:

…The INSTI HIV self-test may look familiar to anyone who’s done a rapid HIV test at a clinic in the last 15 years, largely because it’s the same test.

“bioLytical’s test had been licensed in Canada for more than a decade, but they hadn’t yet brought forward a self-test version,” says Dr. Sean Rourke, a scientist at MAP Centre for Urban Health Solutions at Toronto’s St. Michael’s Hospital. “So we helped the company bring forward an application to allow the test to be done by everyone.”

Rourke’s mission to get at least one HIV self-test on the market began five years ago, when he published a white paper on the issue and tried to get the federal government to sign on, with little success. “There was no traction, it was just striking to me. Where was the leadership?”

Tired of waiting for a government mandate, Rourke and his colleagues formed REACH Nexus, a collective dedicated to ending Canada’s HIV epidemic by 2025 using tactics like self-testing. Their first step was to get the INSTI test approved for use by non-medical professionals, which they did by giving self-tests to more than 700 people from higher risk demographics—like men who have sex with men, injection drug users, Indigenous folks and immigrants from countries where the virus is prevalent.

The goal: Prove that people could be trusted to reliably take the test and interpret the result. By the study’s conclusion, more than 95 percent of participants said they’d use the self-test again and would recommend it to sexual partners, friends and others.

If proving that Canadians could follow self-test instructions sounds like a somewhat low-bar, that’s because it is. “There’s an element of paternalism—that health systems and doctors know better,” says Rourke.

For instance, HIV tests used to be accompanied by hour-long counselling sessions. However, now that so much more is known about the virus—and that treatments allow people to live long, healthy lives—the “looking over the shoulder” approach from health care practitioners isn’t needed, says Rourke. “These antiquated policies shouldn’t be there anymore.”

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