According to Masango, a May 2015 decision by the council effectively removed the ban on pharmacist sales of HIV self-testing kits.
The decision came almost a year after the council gazetted a draft plan to remove the ban. The proposed lifting of the ban was warmly received by the public, he said.
“Most pharmacists and the public felt that a pharmacist was better placed to deal with the sale of such tests, given the sensitivity and the professionalism required in dealing with the condition,” said Masango, who explained that after another year of deliberation, the council has now green-lighted the sale of do-it-yourself tests.
“The council in October 2014 had decided not to publish the minimum standard for implementation until such time that a standard for selling of HIV tests kits had been designed,” he added.
“In May 2015, the council finally resolved that the minimum standards – which effectively removed the ban for pharmacists to sell the HIV test kits that were approved in October 2014 – were sufficient and that there was no requirement to formulate further standards for selling HIV test kits.
“Pharmacists are in a position to sell these kits at this point in time,” said Masango, who added the council would now be looking to release a set of minimum standards to assure the quality of HIV self-tests.
The Southern African HIV Clinicians Society has previously voiced its support for home-testing, although the society’s President, Francesca Conradie, has said that guaranteeing test quality will be important.
“There are many people who want to test and who do not want to interface with the healthcare system. We believe the more people testing, the better,” Conradie said. “Let’s get as many people to test as possible.”
In 2010, the South African Medical Association issued statement warning that self-testing in the absence of trained counsellors could be risky for newly diagnosed people living with HIV.
“Whilst rapid testing may assist in facilitating the diagnosis of HIV infection… tests have important implications for the individual, especially in respect of HIV counselling,” said the association in a statement.
“There is also the danger of people committing suicide after being informed of their HIV-positive status, or even following misinterpretation of the results of the home test-kit.”
Lydia Lesala, a counsellor at Lehlohonolo Adams Clinic said she shares the association’s previously stated concerns.
“Anything can happen if you test yourself,” she said from Douglas in the Northern Cape. “You might accuse people wrongly of infecting you and some people may even commit suicide.”
Lesala also had concerns about whether people who tested HIV positive at home would report to their local clinics for other crucial tests needed to determine whether they should start HIV treatment. Pharmacist Rachel Strydom said that pharmacists may also need to provide pre-test counselling when they sell the take-home tests.
But some like Douglas resident Maria de Vos said that finding out your test results in your home has its advantages.
“You always hear on the streets about those private conversations between patients and counsellors. I’d rather find out in the privacy of my home and not have everyone on the streets know my business,” she said.
Conradie also cautioned that concerns about what people may do if diagnosed in the privacy of their homes might be exaggerated.
“People do home testing for a variety of other things, such as pregnancy and drug tests,” she said. “We feel the notion that people will [engage in] self-harm if they find out alone that they are HIV positive is a bit paternalistic.
HIV self-tests are already available in some pharmacies for about R35.