$1 chip tests for HIV in 15 minutes, fits in your wallet

http://www.fastcompany.com/1770850/the-10-cent-plastic-chip-that-quickly-detect-hiv-syphilis

by d0ne • 15 years ago

214 124 15 years ago

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?

d0ne4• 15 years ago

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.

corin_2• 15 years ago

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.

d0ne4• 15 years ago

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.

thestranger2• 15 years ago

Are you involved in the project?

araneae11• 15 years ago

We don't need a cheap ELISA test here- it's already pretty cheap.

What we need is a cheap molecular test, which can detect HIV during early stage infection, when people who are HIV positive are 40 times more likely to transmit the disease.

rcfox• 15 years ago

Maybe a $5/$10 price tag North America could help keep the price around $1 in Africa.

Shenglong4• 15 years ago

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.

raganwald4• 15 years ago

I speculate it would do more harm than good. Safe sex practices are important even if you have a means of lowering the risk of HIV.

wisty• 15 years ago

It's a risk. But the same could be said for condoms in nightclubs.

Generally, the best public safety campaigns work are "defense in depth". You discourage sex in general, discourage unsafe sex, discourage casual sex, discourage polygamy, provide condoms, and encourage tests. It all generally works, as long as you don't treat any of it as a magic bullet.

It's the extremists who either think a) abstinence is the only protection; or b) causal sex is fine as long as you take precautions; who cause problems, as they tend to discourage defense in depth.

So ideally, they would have an ambiguously enthusiastic "Over 90% accurate!" blurb, and be packaged with a condom or two.

mike-cardwell3• 15 years ago

Isn't this the same line of reasoning that the Catholic church uses to try to prevent the spread of condoms in certain parts of the World?

smiler• 15 years ago

Except this does not test for all kinds of other STIs.

Robin_Message6• 15 years ago

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• 15 years ago

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

Shenglong4• 15 years ago

I don't think anyone who will go to the trouble of testing their potential partners with this will forego using traditional methods as well. It's a lot more troublesome, after all.

hugh3• 15 years ago

Realistically, in the first world it's gay men who most need to worry about HIV, due both to the greater likelihood of it being transmitted by anal sex and the much greater preexisting incidence among gay men.

http://www.cdc.gov/hiv/topics/msm/index.htm

"A recent CDC study found that in 2008 one in five (19%) MSM in 21 major US cities were infected with HIV, and nearly half (44%) were unaware of their infection." -- eep

Heterosexual college-town hookups? Likely to give you all sorts of things, but probably not AIDS. But expect to see these quick AIDS tests in West Hollywood and the Castro real soon now.

burgerbrain11• 15 years ago

That's like opposing seatbelt adoption because you think it will increase the rate of fender-benders.

AlexC04• 15 years ago

That was my first thought actually. Problem is, do you want to be the company who holds the liability of a false negative?

How do you manage that risk? Otherwise, yes a wallet STD test would be a fantastic little thing to have available in "hook up spots"

araneae11• 15 years ago

No, no no!

Already up to 1/2 of new HIV infections are from people who would test negative in this test; early stage infections. This is because people who have been newly infected are about 4,000% more likely to transmit infection than those who are in late stage infection.

If condom usage dropped even a small amount as a result of this test, it could considerably worsen the epidemic.

From a public health perspective this could be a terrible, terrible disaster.

Estragon• 15 years ago

  ...1/2 of new HIV infections are from people who would test
  negative in this test...

I'm curious what the article means when it says "Researchers at Columbia University claim the mChip has a 100 percent detection rate." Are you sure the test is working the way you think it works? Could it be DNA-based rather than antibody-based?

Shenglong4• 15 years ago

I am -NOT- purposing this as a mutually exclusive alternative. This should be an addition to what's already happening. No one who goes through the trouble of using this is going to say "well she doesn't have HIV, so what the hell, no condom!"

If you're already practicing to be safe, you still worry about the possibility of something going wrong, and you contracting the infection anyway. With this, you can be more certain that nothing will go wrong. You would still use a condom just in case.

Your argument is like saying people engaging in random sexual activity should close their eyes because not seeing warts will lead them to believe the partner doesn't have warts - which may lower then chance they use a condom. This would offer more information, and if it turns out that person is HIV positive by the test, you'd be eliminating your chances of contraction altogether.

beej71• 15 years ago

I hear you, but you're arguing that less information is better, and I have a hard time with that. Especially when you're saying that half of new HIV infections could possibly be prevented by this test! I'm not ready to chuck that out with the bathwater.

The problem is one of information interpretation. If the test results were given as either "Positive" or "Unknown", this would solve the issue, yes?

eru• 15 years ago

Prepare for some lawsuits, if your tests says someone's OK but then transmits HIV.

AgentConundrum• 15 years ago

This segues nicely into an idea that occurred to me the other day.

I was knocking around the idea of a website where you sign up with just an email and are issued a unique id, potentially with the ability to generate new ones on the fly. When you hook up with someone, you load an app on your phone or a website, and it generates a QR code. Each partner scans each others code and the website logs the encounter.

At some point, someone is going to get an STD/STI. When this happens, the infected parter can go to the website and with just a few clicks, you can send a notification to your recent (for some medical definition of recent), and they'll be notified to get themselves checked.

Now, the whole HIPAA compliance thing (or compliance in general, since the US isn't the only government affected here) would be a bitch and a half, and getting user adoption would be hard ("you use website.com? slut!"), but if it was safe and caught on, I could see it having a real effect on infection rates.

Some really common infections (chlamydia, gonorrhea) show no symptoms in a lot of cases, so just getting that easy notification could really help people identify that they have the disease, and so they could get quicker treatment.

I just wish I had the skill and finances to try it. Maybe some kid that wants to take a run at YC funding could use this as their idea?

Robin_Message6• 15 years ago

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.

d0ne4• 15 years ago

If you do some searching around you will find 3% to 5% false positive for blood test is not uncommon.

raganwald4• 15 years ago

This is true of most tests. When he likelihood of a false positive is significant in relation to the expected incidence, you need corroboration such as symptoms developing before choosing to run the tests.

Sidebar: This is misunderstood by people criticizing doctors who refuse to run tests without corroborating evidence. It's not just the money/scarce resources, it's the problem of false positives dominating actual positives.

jcoder• 15 years ago

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.

carbocation4• 15 years ago

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.

gus_massa2• 15 years ago

Wikipedia says that the false positive rate of the standard ELISA test is only 1.5% (thats < 6%) http://en.wikipedia.org/wiki/HIV_test#Accuracy_of_HIV_testin...

and a "positive" result should be confirmed by a Western Blot test. http://en.wikipedia.org/wiki/HIV_test#Interpreting_antibody_...

dstein2• 15 years ago

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

ceejayoz• 15 years ago

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.

corin_2• 15 years ago

While his exact point was rather moronic, you could lessen the idea and have a good plan.

Sure, testing everybody in Africa wouldn't get rid of HIV, it would do far more good than just offering them for $1, and it would be a huge step towards eradication - though definitely not the final step.

dstein2• 15 years ago

7 Billion people, $7 Billion dollars to identify everyone with HIV (* plus administration costs). Sure, it won't immediately cure eliminate HIV overnight but it would be a start.

com• 15 years ago

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)

gus_massa2• 15 years ago

And after that, remember to solve the problem of transmission between the intravenous drug users.

pbhjpbhj5• 15 years ago

I think you'd need to tattoo their foreheads.

[Hmm this'll be an interesting one to watch the votes on].

alexholehouse4• 15 years ago

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.

araneae11• 15 years ago

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.

ikarous4• 15 years ago

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.

mrspandex• 15 years ago

>> While I'm sure that everyone on HN understands the seroconversion window period...

I don't. Care to explain?

wrl2• 15 years ago

Usually, an HIV test doesn't test for presence of the virus itself; it tests for the antibodies your immune system develops in response to infection. The "window period" is the span of time between contracting the virus and the presence of detectable antibodies, which can be up to 6 months in some cases (though it's usually shorter). During this period, a person will test negative for HIV even though he or she is infected with the virus (and, worse, is contagious).

Newer tests have been developed that test for presence of the virus's RNA, shortening the window period to about 21 days (if I recall correctly), but they are more expensive and much, much less widespread.

carbocation4• 15 years ago

It's not good public health to deny information to everyone because some people will misuse said information.

While the linked rag's piece is sensationalized, the Nature Medicine article on this device is more useful. http://www.nature.com/nm/journal/vaop/ncurrent/full/nm.2408....

ikarous4• 15 years ago

I am not at all opposed to providing information! I merely want the test to come with very easy to understand instructions so that people know what results really mean.

araneae11• 15 years ago

It actually is a public health issue. Officials often make decisions on what treatments are available to what groups based on their effects on public health. For instance, vaccination or lack there of of certain demographics, when to begin mammograms, etc.

These tests absolutely fall under the FDAs jurisdiction; after all, pregnancy tests do! If research was done that found that people would ignorantly use these tests in lieu of condoms, that would worsen the HIV epidemic considerably, and the FDA would likely not approve them for off the counter usage.

I'm libertarian minded, so my feelings about this are more complicated from that. But you brought up public health, and from a public health standpoint there absolutely is an interest in denying people access to technology that would worsen an epidemic!

alexholehouse4• 15 years ago

Couldn't agree more (hence my post) - although nutrition may play a role in the antibody response. Malnourished individuals (especially those with low protein diets) tend to show slower antibody responses, so may have a longer seronconversion window period

orc2• 15 years ago

"Researchers at Columbia University claim the mChip has a 100 percent detection rate, although there's a four to six percent chance of getting a false positive"

That sounds like a negative result DOES mean you don't have it, but a positive result DOESNT mean you do.

Edit: I guess this is just misleading and you actually can get false negatives.

alexholehouse4• 15 years ago

A negative result DOES mean there are not detectable levels of antibodies. However, while obviously highly linked this is NOT the same as saying you don't have it.

They're correct to say it has a 100% detection rate (assuming it does, but we have no reason to suspect otherwise), but I think this is quite misleading - it's detecting HIV-specific antibodies, not the virus itself.

wrl2• 15 years ago

Better false positives than false negatives. Generally, after testing positive for HIV, there are follow-up tests done to verify the result (usually with a different test from the first) and to check for t-cell count (to determine how damaged the immune system is).

abeppu• 15 years ago

Does anyone here know anything about what goes into creating a test with a 0% false negative rate? That sounds impressive (even with the noted caveats that it's detecting the antibodies and not the virus).

alexholehouse4• 15 years ago

All this said, I think it's role is a not to be a "check if someone is clean for sexytime" test (incidentally, probably not a good tagline).

Instead, it's a cheap, easy and effective way to test people (especially pregnant women) so they can begin a medical regime, rather than not having any realistic means to test and risk further spread and health damage.

pbhjpbhj5• 15 years ago

Your comment sounds like someone saying at the advent of the pill that it was not about enabling promiscuity but about allowing wives to manage their family planning better.

araneae11• 15 years ago

Thanks for playing this role on HN. I've responding to people on engadget to this effect; it really worries me that there are so many comments like "no more condoms for me!"

The irony is that such a technology could easily worse the epidemic in the U.S. because of such ignorance.

Alex39172• 15 years ago

"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• 15 years ago

--------------- 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.

stanmancan• 15 years ago

Where I live in Canada we have clinics where people can get clean needles / properly dispose of used ones.

joegaudet• 15 years ago

Vancouver (where I live right now) has several needle exchanges, as well as, safe injection sites.

I was reading yesterday that coastal health is releasing a free crack pipe + cleaner kit.

Granted we are likely a bit more progressive then the rest of the country.

pbhjpbhj5• 15 years ago

>if you're a heroin user then you can literally get put in jail for trying to use clean needles.

// You know what's not illegal. Stopping injecting yourself with dirty needles.

fungi• 15 years ago

Australia (and particularly NSW) has a long running and very successful needle exchange program. The anti exchange (largely conservative christian) lobby has been basically silenced by its undoubted effectiveness.

badclient• 15 years ago

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

gegegege• 15 years ago

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.

jdietrich• 15 years ago

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• 15 years ago

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.

$1 chip tests for HIV in 15 minutes, fits in your wallet

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