
$1 chip tests for HIV in 15 minutes, fits in your wallet - d0ne
http://www.fastcompany.com/1770850/the-10-cent-plastic-chip-that-quickly-detect-hiv-syphilis
======
ikarous
I really doubt the "no human interpretation" part of the Engadget article.
I've been involved in HIV education as part of the gay community, and this
sort of kit worries me greatly. If the test is an antibody based test, then it
could do far more harm than good by giving uneducated users a false sense of
security: a negative result does _not_ mean that you don't have HIV.

While I'm sure that everyone on HN understands the seroconversion window
period, this is simply not the case in the larger community. Ignorance about
HIV is widespread. I cannot even begin to count the number of people who
believe that pulling out before ejaculating affords some sort of magical
protection from the virus. These are the same people who upon seeing a
negative result would assume that they're safe without condoms.

The CDC states that the window period for detectable HIV antibody formation is
three months; however, this figure is based on first generation HIV tests and
is considered somewhat conservative. Public health experts like H. Hunter
Handsfield state that detectable antibodies usually form in four to six weeks.

Whatever figure you choose to believe, it's a pretty significant time period.
And it's a _deadly_ one. It's during the window period that an HIV infected
person is most infectious. Their viral loads are off the chart and they can
unknowingly infect multiple people in a short period of time.

The "cure" for HIV is the same as it has always been: education and safer sex
practices. HIV is largely a preventable disease. I would be okay with personal
test kits if they were bundled with extremely clear educational packets
printed in multiple languages. But this particular kit is advertised too much
like a silver bullet to assure me that the manufacturers are anywhere near
that responsible.

~~~
Alex3917
"HIV is largely a preventable disease."

Except when the government is responsible for spreading the disease. 50% of
all new infections come from intravenous drug use, and an even larger
percentage are secondary to drug users. If you're gay then it's not illegal to
use condoms, but if you're a heroin user then you can literally get put in
jail for trying to use clean needles.

What's more, many black communities in the US have higher HIV rates than sub-
Saharan Africa. Why? Because so many black males are in prison that it
completely changes the sexual dynamics for everyone left on the outside. And
further, many of those in prison contract the virus and then end up spreading
it throughout the larger community once they get released.

~~~
rkalla
\--------------- but if you're a heroin user then you can literally get put in
jail for trying to use clean needles. \---------------

Many pharmacies have programs for drug users to buy clean needles, no-
questions-asked for exactly this reason.

I am not negating what you said, I'm am sure there are elements of the program
(or accessibility) that make it a less-than-perfect solution, but it does
exist.

~~~
VladRussian
>Many pharmacies have programs for drug users to buy clean needles, no-
questions-asked for exactly this reason.

unfortunately, not being a drug user i couldn't benefit from it. Once i needed
to buy a syringe, and when i'd ask for it (it was here in Bay Area), they
would make big eyes and refuse. Surprised, i tried a couple other places - the
same. Until, at another place, they sold it to me and made sure that it packed
so when i'm walking to the car, it wouldn't be visible.

------
Shenglong
You know what would be a _fantastic_ sub-market for this? Bars and clubs in
college towns. Regardless of whether you believe 1-nighters are moral or not,
they're going to keep happening. Might as well promote safety and reduce the
spread of STIs.

Edit: I don't mean this should be an _alternative_ to traditional protection.
It just adds another layer of certainty.

~~~
Robin_Message
I really don't think that is a good idea. If people believe they won't get
AIDS, which is the scariest STI, they'll be less likely to use protection,
which will increase the spread of things like chlamydia (which has only minor
side effects, like possible infertility) . Also, I bet the error rate goes up
to a scary level once you have it being self-administered by drunk people.

~~~
neutronicus
As a recent college student, take your paternalism and shove it. I want this.

~~~
Robin_Message
As a current university student, it's not my paternalism. It kind of sucks,
doesn't it?

But it's like lots of things in life: sometimes we can't have nice things
because other people, who are much less mature and sensible than you, will
misuse them, so nobody is allowed them.

Also, "paternalism" is an irritating dog whistle. We are talking about "public
health policy", which also means such sensible things as that you can't have
plastic surgery done in a car garage or buy cola sweetened with lead acetate
or Cyclamate.

~~~
burgerbrain
Condoms won't slow the spread of crabs, scabies, or the common cold. Maybe we
should ban those too under your logic.

~~~
Robin_Message
I oppose making a less safe substitute available and I think how people
actually act is fair game to consider.

Condoms don't substitute for something equivalent that is safer (some people
try to make out that they substitute for abstinence, but that is obviously not
true since abstinence is obviously not equivalent).

This device could equivalently substitute for condoms (actually, it's probably
cheaper and more fun than condoms as long as you don't mind a small pinprick),
but it's less safe. Thus my opposition.

~~~
burgerbrain
Surely then you are opposed to The Pill and other contraceptives that do not
hinder the spread of STDs. A major, _if not the primary_ , reason people use
condoms under usual circumstances is to prevent unwanted pregnancies.

This device is _not_ a substitute, nor will anyone with a conscience and a
brain present it that way. It is something to be used _in addition_ to
existing technologies and sensibilities. It is about _increasing_ available
information so that people are able to make _more informed_ decisions.

------
alexholehouse
I think it's worth pointing out that while this is great tech, it's still
relying on antibody detection, and the incubation period between infection and
antibody production can be anywhere from 6 weeks to 6 months. However, you
yourself become infectious from a couple of days after infection, and in fact
there's often a really high viral load in these early few weeks/months before
antibodies start being produced.

Long story short, for the 2-6 months after you first become infected the test
would return negative, but you'd still be highly infectious.

~~~
araneae
40 TIMES more infectious. To emphasize how important this is.

Some researchers estimate up to 1/2 of new infections are from people who
would test negative in this test.

------
Robin_Message
A 6% false positive rate? You don't want anyone taking this without probable
cause then, else you're going to get a metric crap-ton of people going to
their doctor's and having to have a full workup done.

Edit to clarify: My point was that just because it was cheap doesn't mean
it'll ever be sold to the public. Apart from anything else, consider the
psychological impact of discovering you (may) have HIV from a test kit you
picked up from next to the Oreos on a whim.

~~~
jcoder
Of course at $1/15m/test, a battery of tests is practically built in to the
price. If the instructions are to "take three cards and put a drop of blood on
each," and that it isn't a positive result unless all three agree, you've
solved that problem.

~~~
carbocation
Works for medical professionals, but I think to sell this to the general
public, those three cards should be baked in together to avoid confusion.

~~~
danvet
Highly unlikely that three runs of the same test are fully independant, i.e.
they might match all on the same antibody which is similar to an HIV one but
not due to a HIV. You likely only prevent operation goof-ups like "oops,
spilled a bit of blood from the needle of my bro here ..." (or something less
fancy and more likely).

Which is why in practice you run a different test to confirm results.

------
jdietrich
Statistical note: With a 4-6% false positive rate, this device is only useful
where there is a very high probability of infection. In much of the developed
world where HIV infection rates are a fraction of one percent, this would mean
that the overwhelming majority of positive tests are false positives.

~~~
nazgulnarsil
the article claims a 0% false negative rate. This is a MUCH more important
claim. False positives are fine, if scary, you go and get a proper test the
next day.

------
corin_
The title in the nature.com report includes "in the developing world", so I
wonder if this will be one of those products that doesn't really get targetted
towards US/EU - where, while we may not have HIV problems anywhere near as bad
as in Africa, but a $1 15 minute test would still be insanely useful.

~~~
d0ne
Even if they don't intend to market this to the US I will do whatever I can to
see that it is easily available here.

~~~
thestranger
Are you involved in the project?

~~~
d0ne
No.

Innovation in practical use medical technologies is one of my personal
passions and frequently on the receiving end of my philanthropy.

~~~
thestranger
Well kudos to you, good sir.

------
gapanalysis
I wonder how this will come to market and how privacy will be protected. I
know purchasing a test chip is not the same as confirming HIV positive but it
is a data point, just as pregnancy tests are. If it's OTC do you have to
consider how easy it is to track?

~~~
d0ne
I could foresee these items being purchased in bulk by individuals. At the $1
price point Bachelors and Bachelorettes around the world might purchase these
as frequently as Condoms.

------
gegegege
These will never be available over the counter because they would lead to a
rash of suicides by people who test positive and are infected as well as the
false positives. HIV testing is generally done in conjunction with
professional support and not something that should be done at home.

------
badclient
As someone who had a false positive not long ago, I am _not_ gonna be using
this anytime soon.

------
dstein
At this price, countries should just purchase a test for everyone, and
eradicate HIV.

~~~
ceejayoz
How would testing everyone eradicate HIV? You'd need to remove the genitals of
anyone who tested positive, which I'd imagine would be a little difficult to
get through most democratic legislatures.

~~~
com
Just like most other disease control campaigns, you appeal to people to change
their behaviour, you use social control to support their choice to comply and
ultimately you use laws and the iron fist of the state (see smoking or leprosy
as good examples).

Seriously, in campaigns to minimise HIV transmission in much of the rich
world, they generally use self-interest, people's feelings about their loved
ones and the broader sense of social concern as drivers, and above all, non-
judgemental honest information - that has worked pretty well in many places
(although concern about rapid infection growth in some communities amongst
young men-who-have-sex-with-men has been growing recently).

Fear-based campaigning hasn't had a particularly good track record in public
health campaigning, at least as far as I recall (just one statistical analysis
of road-safety campaigns: <http://eprints.qut.edu.au/1839/1/1839.pdf>)

