hey barkeep -- gimme a beer and an aids test!

About once a month, James Swire, venue outreach staff at the NO/AIDS Task Force in New Orleans (James Swire neon-
Bars, music clubs, restaurants, souvenir shops and T-
Go through the shirt stand in the legendary French Quarter.
Swire Group brings you the latest HIV
Testing Technology: one finger
Prick test called OraQuick, available-the-
Field results in 20 minutes 99.
6% accuracy.
\"I made flyers and posters to cover the whole building with them,\" he said . \".
The building could be a bourbon bar parade, a good friend bar or a cafe in exile where Tennessee Williams used to drink.
Some of the bar managers even allowed him to do promotional presentations like \"Hey, we\'re doing a quick HIV test upstairs.
Know your results in 20 to 25 minutes.
\"They will come to the test,\" Swire said . \".
Sometimes, \"before we get there, they have lined up and know what happened that day.
\"In the hours before disco, laser and smoke shows took over the second floor during the Bourbon Bar parade, Swire assembled the OraQuick kit at the back bar, where a technician
Swire offers advice at the front bar, ready to greet anyone climbing the stairs, hanging a shower curtain for privacy.
\"I didn\'t force anyone to come up,\" he said . \".
But with the news of the quick test spreading to revelers downstairs in the video bar, \"More people are coming up.
A lot of them would say, \"I \'ve always wanted to be tested and don\'t know where.
Or I don\'t know what to do.
\"Other people may just want to make sure the safe connection for the night.
\"They would say, \'I just met this guy and we wanted to be tested together.
But their safety is a gamble.
As with any HIV test, negative results may not show recent infections.
Explaining these questions is part of the consultation.
Not a couple.
The date will definitely receive the message.
About two years ago, the Food and Drug Administration approved and approved a round of exemptions, extending from hospitals to sex clubs, and oraQuick has brought about significant cultural and psychological changes in HIV testing. With its 20-
Minutes turnaround time, quick test to eliminate nerves
Health experts say a hard wait between the test and the results removes the huge barriers that many people have to take to the test.
But the ease of use, speed, and portability of the technology have brought new dilemmas to clinicians, counselors, and candidates.
First of all, how do you communicate the news that someone is HIV positive or even a preliminary positive (
Positive results need to be confirmed later
Non-quick test)
At a club bar, \"We had a moral debate,\" says Jean Redmann, director of education and prevention at the NO/AIDS Task Force, who works in Swire, New Orleans.
\"Should we do this here? We\'re in pre-
Test consultation: \"What do you feel if all this is back to being positive ? \" My attitude is that these people are adults.
They can choose the way they want to test.
We shouldn\'t say, well, it may not be good for you, so we won\'t let you be tested.
\"At the moment, the boom in rapid testing seems unstoppable.
Given this choice, people prefer to know immediately whether they are positive or negative.
A quick test may eventually go to the next logical step-
People test themselves and get results in a few minutes. -at home.
But is it undeniable that people are really ready to get up in the morning, brush their teeth and test their own rapid hiv test?
Swire says he has a lot to do recentlyof-
Towners from the state and other parts of the country, especially the South, where the outbreak hit hard.
\"Either they just see it here or they don\'t have a quick test where they are.
Different states have different laws.
\"Maybe, although Swire didn\'t say it, I got a lot of people from Mississippi because it was one of the 10 states that didn\'t provide anonymous testing.
\"As far as I know from customers, they feel [if they test]there.
\"The Swire Group also uses OraQuick In the Latino Football League, bathhouse and black churches.
\"Once, even the priest asked me to test him in front of the whole congregation,\" he said . \".
\"So we did this in the church, and the congregation just started testing.
\"He says he is reaching out to people who may be at high risk but may not necessarily seek the organization to be tested, or who may not return the results if he uses the lab --
Need a test based testor two-
Wait a week for results.
He knows because he used to test in this way in the same bar.
\"People are not interested in getting any results,\" he said . \".
\"This is a party town. people are here for one thing ---to party.
They don\'t care after the test.
They are ready for the party and may find someone else to go home together.
Like, \'I don\'t come back. I know I\'m negative.
But that\'s not what Swire found.
\"I don\'t want to say that I have found more positive factors in the community.
\"Other Test professionals support Swire\'s view that OraQuick\'s popularity has increased in the short time before the results are obtained.
\"HIV testing technology, HIV counseling and testing have been changing, probably just a small change,\" said Barbara Adler . \" Project manager for the University of California, San Francisco AIDS health program, the first HIV test nearly 20 years ago.
\"But capturing people in a session is a huge change.
A lot of people say I won\'t test.
The idea of waiting for my results is too difficult. \'\" Charles (a pseudonym), a 44-year-
Old comrades in New York are like this.
\"I was freaking out when this came out because I haven\'t tested it for a while.
I have already started to see someone and I said, I can\'t wait for the exam.
I have some friends and I don\'t even know it\'s positive to get sick around me.
I think everyone is positive if they are positive.
This is really good for you, especially when you start to think back to everything you do.
It drives you crazy.
I postponed the test for so long.
It bites me.
But I\'m not going. . .
In the end, I reached the point where I could no longer deal with the problem.
So I put it on my head and I was about to go to the month-minute test.
If I had to go somewhere for two
Wait a week and I will postpone it for a longer time.
Boom, I went out when I got in. \" In the pre-
FAST test day, others will test but will skip the result--
For fear, stigma, denial, frustration, fear of losing privacy, inconvenience, or any reason not fully understood.
In what has become a regular spell-
Repeated statistics, the Centers for Disease Control and Prevention estimated that 33% of those who tested positive at publicly funded testing sites each year--
Most people test anonymously, so can\'t find it later-
Never come back for their results;
The fourth of the 850,000 to 950,000 people living with HIV in the United States did not even know that they were infected;
41% of the people knew they were infected late in the game. -
Less than a year before the AIDS diagnosis
Facing these data-
And there has been no annual infection rate below 40,000 in the last 15 years, and there are signs that HIV is rising ---
The CDC seized the opportunity of rapid testing to make it a tool behind a new prevention program closely related to technology that uses prevention work and money to identify and serve people who have already been infected with the virus, to prevent them from spreading the virus.
\"I think rapid testing will help reduce the number of infections,\" said Dr . \"
Bernard Branson, head of Laboratory determinants and diagnostics for the cdc aids/HIV prevention department.
\"More people will be tested and tested earlier and receive their results.
At least that\'s our hope.
\"But when the test removes the barrier ---
The anxious week or two-
For some candidates, it will also abandon a buffer.
\"It\'s a delicate balance,\" said Nicholas Shane, a medical anthropologist at the University of California, San Francisco\'s Center for AIDS prevention research.
The quick test eliminates the painful waiting period, but also eliminates the \"safety that people can choose not to come back \". \" No-
Sheon explained that the rate of return was particularly high in the outreach environment, and she planned to conduct a quick test study at the Berkeley bathhouse.
Sometimes it\'s because of a change in position, he says, but \"maybe they\'re being persuaded to take the test through some sort of incentive. . .
They\'re not fully ready yet.
\"But with quick testing, there is no way back.
\"Sometimes we make a client aware that they will get results in 10 to 15 minutes,\" says Joe Mendoza, program manager for prevention and testing at the Los Angeles AIDS Health Foundation.
Since April, the foundation has been rapidly testing mobile vans next to bars and cruising areas in Long Beach, Echo Park, Silver Lake, Sunset Junction and West Hollywood.
\"Maybe it wasn\'t until the consultation meeting that they realized what high risk they had.
Then they realized that we were going to give them this result and they were likely to come back positively.
Maybe it\'s not a good idea, people will say.
\"Counselors must also be prepared for more mentally challenging classes.
\"In the past, they had a little time to prepare for a meeting with their clients.
This is no longer the case.
\"They went in, they saw the results, and the customer was ready for the results,\" Patricia Kumel said . \" David Geffen, director of the Center for HIV prevention and health education, Gay Men\'s Health Crisis in New York.
\"You got the full content of the story,\" said Redmann of the NO/AIDS Task Force . \".
\"They will be back in the last two weeks.
You may not even be in the building.
It\'s a bit far away now.
\"When the results of the quick test are positive, no matter where they test, we will spend 45 minutes to a few hours with that person,\" Redmann said . \".
\"We really tried to get them to follow up. up care.
\"The new fast test has established trend lines that seem destined to continue.
OraQuick is expected to be in more than one-
The test of the expected oral version approved by the FDA in last March entered the market. (
OraSure Technologies, Bethlehem, Pennsylvania.
The manufacturer of OraQuick delayed the release as it was anxious to figure out why an isolated clinical trial produced an unusually high false positive rate. )
However, when the oral version arrived at the test site, Mick Ellis, Whitman\'s former director of HIV counseling and testing, said: \"This will be a huge improvement in HIV testing --
Walker Clinic in Washington
\"You don\'t need all the medical supplies ---
Lanc knife, gauze, bandage, alcohol wipes.
The risk of the consultant will be smaller because they are no longer dealing with the blood.
\"This may not be so disturbing for candidates.
\"People are very scared of blood,\" Kummel said . \".
\"Even a better finger stick than a blood draw can upset people.
\"Once the test has passed the oral test, can the home test be oversoldthe-
OraQuick\'s plastic dipstick device is far behind and looks very similar to the home pregnancy test.
Its core is a synthetic peptide. -
Protein fragments that mimic the structure of HIV.
If HIV antibodies appear in finger-prick in blood or saliva, they bind to these viral proteins, triggering two purple
A pink line with positive results, while a line indicates negative results.
\"This antibody is for the virus it is fighting,\" said Mike Fumika, executive vice president of operations at OraSure . \".
\"Take it as a lock --and-Key arrangements.
\"A few days later, when Drew De Los Reyes, assistant director of the GMHC Geffen Center, put on gloves and showed the concept, the second line appeared, faint, almost within five minutes of the spectrum
\"We waited a full 20 minutes,\" De Los Reyes said . \".
\"Sometimes the line is blurry and sometimes bright.
Its strength does not matter.
Here are all the important things.
\"The government has been OraQuick\'s biggest customer so far.
The CDC purchased 500,000 test packages for $4 million and distributed them free of charge to state, county and municipal health departments and some communities
Based on organization.
The New York City Department of Health has stripped 25,000 free tests from its sexually transmitted diseases clinics, public hospitals and 10 prisons on the island of Rikers.
\"We have been rolling in one place,\" said Susan Blank, assistant commissioner for STD control.
\"Many of our prisoners have left within 72 hours,\" said Robert boding, deputy executive director of prison policy and planning in the city.
\"In the past, those who have tested may not wait for the results later.
This is very important for us.
\"New York has just begun providing rapid HIV testing to single adult men living in shelters.
In August, OraSure reached another agreement with the government to sell $4 million to the Drug Abuse and Mental Health Services Authority (SAMHSA)
For testing of 22,000 substances
Places of abuse and treatment
Fast testing is what people want.
At GMHC, 95% of customers have chosen it, says Kummel.
\"It has been consistent since the day we started offering it more than a year ago.
Kummel said she saw a 35% increase in people under the age of 24 taking the test and more people of color.
\"I don\'t know what the reason is, but a lot of people say this test has greatly reduced their level of anxiety.
\"Redmann saw almost double the number of NO/AIDS Task Forces in the first four months of this year.
\"People want to test quickly. It\'s a one-shot deal.
\"At the STD clinic in New York City, about 80% of people choose to test quickly.
\"Its charm has brought people to the clinic,\" said Assistant Commissioner blank . \".
In New York State, 34% of customers in the CDC survey said they would skip the test altogether if it wasn\'t a quick test.
\"A lot of people do have serious anxiety while they are waiting,\" the doctor said.
Psychiatrist Ewald Horwath who works with AIDS patients.
Rapid testing can help them overcome their difficulties.
Charles, 44year-
The old New Yorker, who has taken three OraQuick exams in the past year and a half, has been unable to get himself on the exam for years.
\"I can\'t stand waiting,\" he said . \".
Brad Heep, 27, did not take the quick test but went through the regular test.
\"I \'ve tested it and I know I may be fine but it\'s still like hell for about two weeks.
Imagine that it will take two weeks for the pregnancy test.
\"In the waiting room of an STD clinic in New York, the speed of the test is 4-hour wait --
The cost of free anonymous testing, apparently--a 37-year-
The old gay designer who claims to be Mike says he hasn\'t tested it for two years.
Between uninterrupted videos on strategies for the Prevention of condyloma acuminatum, herpes, chlamydia and presidential pets ---abstinence --
Mike smiled and recalled how he came here a few months ago and learned for the first time how he felt during a rapid HIV test.
\"I always try to distract myself while waiting.
He said: \"He is back now because his last Test will not cover\" what I did on vacation \"and he refers to\" window period \"or three-
There is a one-month interval between possible exposure to the virus and the production of detectable virus antibodies.
\"I am safe about things and am doing more to make sure.
I will probably test again in three months to assure my new boyfriend.
\"OraQuick is no longer the only quick test in the US. S.
The increasingly brutal market.
In the past year, the FDA has approved two other rapid tests for HIV.
Reveal from MedMira, Canada, provides results in three minutes, but unlike OraQuick, it requires laboratory analysis and is therefore limited to settings that handle more complex tests. Uni-
Gold Recombigen from the Irish Trinity Biotech can get the results in 10 minutes because it doesn\'t need a lab and has become OraQuick\'s closest competitor in the competition, now that the FDA has approved the use of the finger, this competition will only intensify
Blood samples.
Other quick tests from the USS.
Companies such as Calypte and Chembio Diagnostics are also in the pipeline.
\"This is a very price-sensitive and competitive market,\" said Rod Katzer, president of RAK Associates, who analyzes the medical market . \".
\"We hope to see several rapid HIV tests in the United States. S.
Market, \"said Branson of CDC.
\"We hope that there are different tests and there is some competition that will have a positive impact on prices.
\"Competition can also quickly lead to the development of new markets, which is more challenging for consultants.
Use easy-fast, simple, and accurate HIV testingto-
Reading results that require neither a lab nor special equipmentit-
Home test suite sold online or onlinethe-
Wal-Mart, Rite-and other counters in pharmacies and retail chainsAid and CVS.
If the maximum number of people tested is the target, what else can beat the convenience of home testing in addition to the glucose monitoring system, cholesterol tracker, ovulation and pregnancy kit? It allows you to shock your heart at home when your heartbeat stops.
For those who do not want to share the number of sexual partners with strangers over the past three months, what can better protect privacy \"this is an important development,\" said Dr.
Director of microbiology laboratory, Texas Children\'s Hospital, Houston, James Versalovic, assistant professor of pathology, Baylor Medical College.
\"For the first time, it is convenient for people to collect and test separately from the lab.
As far as the actual test is concerned, OraQuick and other tests that may have been developed similarly do pave the way for early home pregnancy tests that anyone can do.
We have effective treatment for HIV, so it\'s not like a genetic test.
The big problem is consultation and support.
Family Care
Located outside Chicago, a year after FDA approval since 1997, years after rejecting the family approach, home exposure HIV tests have been sold online and at large chain stores.
But the Home Access test was only half done: One person poked his finger with a spring
Loaded lancet, collect a blood sample of about a dime on the test card and send it to the lab.
After three to seven days, use a unique 11-
Regardless of state law, customers make toll calls to protect anonymity
Results, consultation and free number for local medical recommendation.
About 50,000 people choose this family every year.
Collection Kit for $45 to $63.
The idea of going home for a quick test runs through the whole route and provides the right results at home, which is not ridiculous.
The CDC recently presented the idea in the recently concluded focus group.
Branson said: \"As we all know, I\'m not good at looking at crystal balls or when to say it, but having a focus group of consumers is the first step in understanding what people think about it.
\"Participants believe that privacy and convenience are the main advantages.
\"A person talks about a situation where he doesn\'t make his family aware of his risk of HIV infection and it can be uncomfortable to go to a family doctor, especially in his small rural community, where it is difficult to keep it secret.
\"As long as I don\'t have to sting myself, the home test is absolutely fine for me,\" said Charles . \".
It\'s worse for me than testing positive.
In my life, I will do this for the convenience and to make sure that I don\'t make it.
I would rather do this than walk to the clinic in Washington Square.
\"Would he need to consult if he showed a positive side ? \"
Not the doctor at that clinic.
We have read books on it.
I have traveled so many times with so many friends. For a 44-year-
Old comrades, like breast cancer. If I were a 19-year-
Hope to have some form of consultation.
\"Mike made a similar mixed reaction to the quick results offered at home. \"I\'d feel OK.
I was educated in this area.
I don\'t need a graph of condoms, but there will always be something new.
I know that HIV is not necessarily a funeral.
The destruction of positive results is not as serious as in the past.
\"Would he need a consultant to stand next to him if he tested positive ? \" He said in a call for testing.
Family rapid testing \"will be an interesting experiment,\" says medical anthropologist Sheon \".
Despite the difficulties around, \"We are a culture that only likes to test and control your health and all of these things.
\"OraSure Technologies has at least considered the possibility of OraQuick returning home.
\"Of course, as a company, we want to work together and will work with CDC to do what we think is right for society,\" Ron Spair said . \", OraSure\'s executive vice president and chief financial officer hesitated on the phone.
\"I don\'t believe this is an imminent matter, though.
Set aside a minute to \"do the right thing for society,\" and gently, home testing will be a small \"growth opportunity\" for young companies like OraSure that are not yet profitable.
Aaron Lindberg, an analyst at Denver, said: \"This will provide a way to drive sales quickly.
Based in William Smith
\"It will be very positive, although it is a bit difficult to predict what the market will look like.
\"But the idea of overtaking the exam --the-
Elliot Cowan, a senior regulatory scientist at the FDA, said counter raised psychological and social issues beyond test performance, agencies with final say on OraQuick or any other potential home HIV rapid testing appear on store shelves.
\"We have to see some additional research.
Consultation is still a very important part of it, but studies have shown that there are ways to make overconsiderationthe-
But we haven\'t arrived yet.
\"While the CDC has not completely dropped the consultation, we are looking for alternative models,\" Branson said.
There\'s a lot of routine.
Information provided in brochures or videos is sufficient for care.
\"But people are still worried that people who test themselves at home alone on the bathroom sink will confuse or misread the results.
Still can\'t grasp the window period.
Or will get a positive result, don\'t understand this is preliminary.
Or commit suicide, or have another catastrophic reaction.
Charles said: \"If you make it too easy, people may use it to gamble. . .
The test is negative. there is unsafe sex when you go out. see if you test positive.
\"Many AIDS advocates and service providers believe that consultation is the most important part of the test.
\"Many of our customers will be happy if we give up consulting altogether,\" said Kummel of GMHC . \".
\"But Consulting is a big thing we do.
It\'s an opportunity for them to think about their behavior if they want to change it.
Personally, I am not sure if I will get positive results alone in the bathroom, or preliminary positive results.
\"There is no doubt that many people will agree with her.
\"People don\'t know a lot of things, they\'re not serious enough,\" said potential home Shipp . \"tester.
\"This is the part you will miss --home test.
\"It\'s not just about whether I\'m positive or negative, it\'s about what constitutes safe or unsafe sex,\" Mike said . \".
But such a country
The licensing survey of practices and partners is also the reason why some people enter the testing site.
\"At the same time, we have said that people should have \'customers\'
They also said that we need to collect all the data about people and their sexual habits ---
\"Did you have sex with that one time this time with a condom,\" Sheon said, \"it didn\'t help with the consultation relationship.
\"Tell a ritual record of becoming a\" violation of your own law. . .
As an unpleasant experience. . .
Sheon wrote in the chapter of HIVInSite that the requirement to obtain a test \"is more similar to the motivation of a confession or police interrogation than a consultation session.
\"We always feel like a carrot is swaying,\" says Adler of the San Francisco AIDS health program . \".
\"I believe many people are reluctant to take advice.
\"For some, the debate about HIV testing in families is similar to the fight about families 25 years ago --Pregnancy check
\"It\'s a very different story to find out you\'re pregnant and you\'re infected with HIV.
However, it seems to me that those who oppose going home --
The access test is a bit exaggerated about the vulnerability of those who have to make decisions about their own bodies, \"said Ronald Bayer, professor of social medicine science at the School of Public Health at the postman at Columbia University, co-author of the recently published \"mortal secrets: lies in the age of truth and AIDS.
\"I think it is important not to short.
Opposition to the home test is playing yesterday\'s script.
This is a legacy of a parental style, and at this stage I would think that style has lost its ability to convince.
\"It may just be a question of rethinking the criteria we have accepted: the bundling of testing and consulting.
\"Sometimes, I think we\'re used to certain things and think they\'re not going to be different,\" Adler said . \". \"We used to [
Give positive results
Not even recommended to anyone.
I remember when the Family Channel came out.
At first, we were just shocked.
How will people get their consultation and what will happen if they get their results and if they get into a crisis? I believe there are a lot of people who should not get HIV testing results at home without anyone around.
For some, however, this may be the best thing in the world.
I can\'t imagine it coming a bit, but we don\'t need to assume that we know what\'s best for everyone.
In such unpredictable places, I have achieved enough positive results.
I gave negative results that were stronger than positive results.
It all depends on what happened to this person.