The Benefits Of Introducing At Home Testing For Hiv In Indonesia

2674 words - 11 pages

The growth of HIV cases in Indonesia is one of the most rapid ones among the countries in Asia (UNAIDS 2013). Indonesia’s Ministry of Health estimates that more than 500.000 people in Indonesia will become infected with HIV in 2014 unless there is an acceleration of HIV prevention programs (UNICEF Indonesia 2012). In Indonesia, the testing of HIV currently is done in voluntary counseling and testing (VCT) clinics in selected hospitals. The patients are required to visit the clinic to do the testing and counseling. VCT has been shown to have a role in both HIV prevention and as an entry point to treatment (UNAIDS 2000). This program has been one of the most important parts of national strategic plan to prevent and control HIV in Indonesia (Afriandi et al 2009). However, there has been an idea for at-home HIV testing for a long time (Whellams 2008; Wright et al. 2006). At-home testing for HIV is supposed to reduce the number of individuals which are unaware that they are infected with HIV. In July 2012, the US Food and Drug Administration (FDA) approved the sale of the first rapid home testing kit in the USA (Food and Drug Administration 2012). Interestingly, there have been many pros and cons about this testing (Arnold 2012; Whellams 2008; Wright and Katz 2006; Sibbald 2000). This paper will analyze the advantages and disadvantages of the introduction of an HIV home testing kit in Indonesia and argue that such a kit would be beneficial for high risk populations in Indonesia.

The main objection for allowing at home HIV testing to be sold in Indonesia concerns the lack of counseling part in self testing. It is feared by some experts that there would be some detrimental effects caused by the absence of direct counseling before and after testing in self testing for HIV (Arnold 2012). When a positive result is elicited without any counseling, it is feared that the person could not cope with it. However, there is evidence that the suicide risk for HIV patients appears not to be associated with the announcement of HIV infection but instead with the start of the disease manifestation (Starace 1993). Indeed, Wright and Katz (2006) announced that the amounts of suicide cases in the USA were not increased after the approval of home testing kits by FDA in 1996. On the other hand, some people feared that notification of negative result in home testing would diminish the chances to educate at risk individuals to understand their risky behavior. Meanwhile, in VCT setting there are less concerns about this problem because it has face-to-face counseling for patients with any results. However, it is believed that direct counseling services currently provided in clinic based testing are ineffective because they are too brief and inadequate (Harris 2005). Moreover, according to a study that interviewed at-risk individuals, most of them supported the argument that current face-to face counseling services were not necessarily optimal and also supported the...

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