Use of a home-use test to diagnose HIV infection in a sex partner: a case report

BACKGROUND: Home-use HIV tests have the potential to increase testing and may be used by sex partners to inform sexual decision-making. To our knowledge, this is the first report of an individual diagnosed with HIV using a home-use test with a sex partner. CASE PRESENTATION: We are conducting a randomized controlled trial of home self-testing for HIV using the OraQuick ADVANCE(®) HIV-1/2 Antibody Test on oral fluids. In 2011, a 27-year-old, homeless, Latino man who has sex with men not enrolled in the trial (the case) reported receiving a reactive result from a diverted study kit. When interviewed by study staff, the case reported that, 11 months prior, he had unprotected anal sex with a trial subject without discussing HIV status. Afterwards, the subject asked the case if he would like to test, performed the test, and disclosed the reactive result. The case reported altering his behavior to decrease the risk of HIV transmission to subsequent partners and sought care two months later. CONCLUSIONS: This case demonstrates that home-use HIV tests will be used by sex partners to learn and disclose HIV status and inform sexual decision-making. It also highlights concerns regarding the absence of counseling and the potential for delayed entry into HIV care. Additional research must be done to determine under what circumstances home-use tests can be used to increase awareness of HIV status, how they impact linkage to care among persons newly diagnosed with HIV, and whether they can be safely used to increase the accuracy of serosorting.