Getting people around the world to test themselves for HIV could help bring the HIV/AIDS epidemic under control, by finding infected patients earlier before they infect others, a new study suggests.

The study, led by the Research Institute of the McGill University Health Centre, looked at how willing people are to use home-based HIV self-tests over going to a clinic for a test – or not getting tested at all.

They reviewed 21 studies from around the world and found that most people liked the idea of home-based self-testing. The studies also revealed that the tests had high acceptability, meaning most people offered the tests in the studies actually went ahead and performed them. As well, most preferred oral tests to those using a finger pinprick of blood.

The oral tests are easy to do and non-invasive and simply involve swabbing the inside of the mouth and then testing the swab. The tests ensure confidentiality and can provide results within 20 minutes.

The full results of the study appear in PLoS Medicine.

The director of the McGill University AIDS Centre, Dr. Mark Wainberg, says it’s gratifying to see that home-based tests are so well-accepted because many people are reluctant to get screened for HIV due to worries about stigma and discrimination.

“What it means is that if we can get people to test themselves and go to see their doctors as early as possible, they’ll go on treatment and they’ll become less infectious to other people,” Wainberg told CTV’s Canada AM Wednesday from Montreal.

“And that will allow for diminished numbers of new infections, which is what this game is all about.”

Wainberg says there might have once been a time when people who were worried they might have contracted HIV would have been reticent to get tested, either at a clinic or at home. But he says that HIV medications mean an HIV diagnosis is no longer a death sentence. Instead, patients can live into their 80s if they stick with the medications, he said.

“Now there’s no reason for anybody to feel helpless,” he said. “…The progress has been so dramatic over the last 20 years that this kind of testing makes absolutely good sense.”

According to UNAIDS, 50 per cent of people living with HIV worldwide are unaware of their condition. Study author Dr. Nitika Pant Pai, a clinical researcher at the RI-MUHC, said in a statement that she believes access to an HIV self-test will help expand access to screening.

Most of the studies were carried out in high-income settings including the United States, Canada, Spain and the Netherlands, as well as Kenya, Singapore, Malawi and India. It’s not clear how acceptable self-testing would be in lower-income areas or in areas with poor literacy where people might have trouble following the test’s directions.

While a quick oral test is available in the U.S. for under $20, the test is not available in Canada.

Wainberg says authorities have likely not made the test available in Canada because they prefer a system in which those getting tested are counselled beforehand on what a positive test result can mean.

“I think Canadian regulatory authorities have wanted to wait a little bit, perhaps to see how these tests do in other jurisdictions,” he said.

“One of the concerns has been that when these tests are available without much regulation, somebody who finds out they’re positive in the absence of proper counselling might become despondent,” he said, noting that some people have even committed suicide if they weren’t told about the excellent treatment that are available.

The study was supported by a Stars in Global Health award from Grand Challenges Canada, which is funded by the federal government.