Can the HIV home test promote access to care? Lessons learned from the in-home pregnancy test.

Adolescents and young adults are the fastest growing age group of human immunodeficiency virus (HIV) positive individuals in the US, and many who are infected do not know their HIV status. The HIV home test has the potential to help curb the HIV epidemic by improving detection of persons living with HIV and enabling them to seek follow-up care but it has not yet been evaluated in adolescents. Analogous to the home pregnancy test, which was met with much resistance and only successfully marketed during a time of social change, the HIV home test has been met with resistance since its FDA approval. This commentary summarizes the need to systematically evaluate positive and untoward/unanticipated effects of HIV home testing, particularly in young adults. The overall incidence of HIV has been declining in the US, yet it continues to grow at alarming rates for adolescents and young adults [1]. Almost 40 % of new HIV infections in the US are in this age group [2]. Further, many HIV infected adolescents and young adults are unaware of their infection. Nationwide, only 22.6 % of sexually active high school students have ever been tested for HIV [3]. While advances in drug regimens have transformed HIV into a chronic disease, infected individuals need to be identified and subsequently engaged in care [4].