The Observer (Kampala)

17 May 2012

Uganda: Home-Based Saliva HIV Test Kit Coming

The Food and Drug Administration (FDA) of the United States yesterday approved the worldwide use of a saliva test kit for HIV detection, just days after a panel recommended the use of Truvada in HIV prevention to the same body.

Sheema North Member of Parliament Dr Elioda Tumwesigye, a former chairperson of Parliament's HIV/AIDS Committee of which he is currently a member, says Uganda will soon benefit from the newly invented OraQuick Advance kit.

The kit will allow users to quickly test and know their HIV status in the comfort of their homes, without the need of a health worker or laboratory.

"The test kit uses a mouth swab sample to detect the presence of HIV within 20 minutes. You swab the inside of your mouth between the cheek and gum, pick up cells lining the mouth and test the fluid. After 20 minutes, an indicator will light up if the test detects the presence of HIV-1 or HIV-2 antibodies," Tumwesigye explained.

He says the at-home OraQuick Advance rapid HIV-1/2 antibody test could play a significant role in reducing the spread of HIV.

"These kits could lead to more people knowing whether they have HIV, which could mean earlier treatment of the infection. People afraid or unwilling to take the test, particularly those without any symptoms, may more readily test themselves with a kit they can use privately," he explains.

Tumwesigye is a member of the HIV/AIDS Advisory Group of the Inter-Parliamentary Union (IPU), as well as principal investigator/researcher at Kabwohe Clinical Research Centre (KCRC), one of the international sites at which the study for the kit was conducted.

According to the Uganda AIDS Commission and the ministry of Health, more than two million Ugandans are living with HIV, yet over 70 percent of these do not know they carry the virus.

Tumwesigye adds that the recent recommendation of Truvada was a key breakthrough in the 30-year fight against AIDS, saying there have been no other drugs proven to prevent HIV, and a vaccine is believed to be decades away.

"The world needed to find a non-surgical bio-medical tool that an HIV negative person can use to protect him or herself against sexual transmission without depending on the mercy of the HIV positive spouse," says Tumwesigye.

"This medication gives an alternative means of protection to the HIV negative spouse of an HIV positive person so that he or she doesn't get infected," Tumwesigye adds.

According to recent HIV/AIDS statistics from the ministry of Health, Uganda has a high rate of discordant couples. Between five and six percent of all married couples in Uganda are living in an HIV discordant relationship, and 57 percent of the HIV infected individuals are married or cohabiting with HIV negative spouses.

Uganda registered an unprecedented decline in HIV prevalence between 1992 and 2002, from over 18 percent to about six percent. However, over the last decade (2002-2012), HIV prevalence has not declined. Instead it appears to be increasing, with a current prevalence of about 7.1 percent. Tumwesigye said there is need to scale up HIV testing.

In spite of the medical and scientific breakthroughs, however, Tumwesigye, says no single strategy will work alone.

"There is no single magic bullet; we need to implement multiple integrated, effective biomedical, behavioural and structural interventions," he says, emphasising the continued need for approaches that seek positive behavioural and normative changes in individuals, families and communities.

He cited other biomedical approaches to reduce risk of infection, including condom use, prevention of mother-to-child transmission, male circumcision of HIV-negative heterosexual men, Pre-exposure Prophylaxis (PrEP) for discordant couples, and antiretroviral therapy (ART) for prevention.

A study showed in 2011 that treating an HIV infected individual with ART can reduce risk, by 96 percent, of sexual transmission.

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