HIV Self-Testing: a hands-on look

The INSTI HIV self-test kit

The first HIV self-test kit was approved in Canada in late 2020, and will be available in pharmacies soon.  A study conducted by uOttawa and the Ontario HIV Treatment Network is making these  kits available at no cost to people willing to answer questionnaires before and after testing.   We ordered one via the project web site – https://getakit.ca/ottawa/ – to take you through the steps.

NOTE: this is NOT to be considered as a set of instructions!  Please follow the steps in your kit, it includes more details and may have been updated since our trial kit was manufactured. The focus here is on how the process feels so that you may feel more comfortable if you use one of these kits in the future.  If you have ever had a rapid HIV test all this will look familiar, and the process is similar.

If you feel nervous you may want to ask someone to help – particularly if you don’t like the idea of giving up a few drops of blood, or if you are anxious about the test results.  The small bottles could also be hard to handle for some people, so an extra set of hands can help. Take a moment to do whatever calms you – take a deep breath, eat the chocolate you accidently bought earlier, watch cat videos, howl at the moon – whatever works for you, we’re not judging.


Opening the kit, you will find three bottles, about the size of common eye-drop bottles; a square test device in a plastic pouch; a lancet (aka “the stabbing thing”); and a band-aid as well as the instruction sheet.

Inside the kit.

Step 1:  You need the test device, Bottle 1, the lancet, and the band-aid.

Step 1 – the lancet, Bottle 1, and the test device.

It really just takes a few seconds.  The lancet is spring-loaded: uncap it, press it firmly against your finger, and it will quickly stab your finger.  It is very brief and over quickly and it is perfectly ok to yell out, “Ouch! Bad stabby thing, bad!”  You need to add a drop of blood to Bottle 1, not to the test device.  This is a bit awkward, so plan ahead and make sure you don’t stab your smart hand.

At this point the painful bit is over.  Re-cap bottle 1, shake it a few times, and the pour the contents into the square test device and watch the liquid absorb into the central hole. It doesn’t take long but do wait until it all absorbs.

 


Steps 2 and 3:  Now you just need to follow the recipe. Shake bottle 2, pour it into the device, wait until all the liquid absorbs.  Repeat for bottle 3. The only challenge here is to give each time to absorb – we’re just talking seconds here, not minutes, but this is the point where anxiety may cause you to rush.

Add Bottles 1, 2, and 3 waiting until all the liquid is absorbed from each.

Step 4:  Count the dots, but before you do make sure the test device is the right way up!  There is a letter “C” printed the top, and there is a tab at the bottom.  If you had someone help you, it is perfectly ok to ask them to read the results for you.

Test completed. Note the “C” at the top and the tab at the bottom. Make sure you have it the right way up.

One dot at the top means your results are negative.

No dots or dot at the bottom is an invalid result, something went wrong with the process, or the kit was expired.

Two dots mean you are probably HIV-positive – but don’t panic!  A positive result must be confirmed by a doctor who will do a lab test, and remember that treatment options exist.  You can manage this, just take it one step at a time. If you don’t have a family doctor, or do not feel comfortable going to them for an HIV test, see the resources below.

IMPORTANT:

There is a “window period” for HIV tests, a time during which you may in fact be HIV-positive but still test negative.  That window period varies depending on the type of test.  This self-test has a window period from 21 days up to 3 months, so please keep that in mind if you have a negative result but may have been exposed to HIV in the last 90 days.  To be extra-safe, why not have your phone nag you to do another test in three months?  

If the test result is positive, please see a doctor.  It is important to confirm the test, and if you are indeed HIV-positive it is important to start treatment early.  See the resources below.

Congrats, you made it through testing!  You deserve a treat now.  If your test was positive please take a deep breath, give yourself some space, grab a friend for support, and make plans to see a doctor.  There are thousands of people in Ottawa living with HIV, you are not alone and there is support out there.


Resources:

GayZone – Ottawa’s GBTQ2+ Sexual Health Clinic

Sexual Health Clinic

AIDS Information Hotline of the Ontario Ministry of Health  1-800-267-7432

 

More info:

INSTI kit official web site.

How-to Video

CBC News – Test approval

St. Michael’s Hospital news release

Get-a-kit Project

CATIE – CDC study on self-test kits

CATIE – How self-testing can help reach the 90-90-90 targets