Thu, Dec 01, 2005 page9

• HIV test may lead to a new sexual trend

  While a rapid at-home HIV test would allow a couple to jump into bed fster than they might have before, the device could also stem the spread of the AIDS pandemic

  • By Gardiner Harris / NY TIMES NEWS SERVICE
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  he two young single women, attractive and confident, were sitting at the bar of a popular Washington after-hours spot when they were asked how a relatively quick do-it-yourself HIV test might affect their dating life.

  One of them, Julie Powers, 23, laughed.

  "I would definitely make someone take it," she said, "hopefully before the sex."

  

  And she would not be embarrassed, she said, to insist that a man submit to the test.

  "I really think we've got what they want. And if they want it, they can have it on our terms," she explained.

  Her friend, Victoria Maulhardt, 25, nodded and added, "Especially if you're getting serious with someone."

  Their comments were not idle speculation: A rapid at-home HIV test could be available on pharmacy shelves within the next year or so. Encouraged by a federal drug advisory committee last month, OraSure Technologies in Bethlehem, Pennsylvania, is expected to apply to the US Food and Drug Administration soon for permission to start selling its HIV test over the counter. Now it's available only in clinics.

  Taking the test involves a simple swab of the gums. Results appear within 20 minutes.

  And if the results are negative, certain inhibitions may disappear.

  "I think there would be a lot more unprotected sex if there was a 20-minute test that people could take," said Michael Mathews, 40.

  Mathews was sitting in another Washington nightspot, this one with frosted windows and a clientele that was almost uniformly male.

  "We're all sick of hearing about condoms and prevention and safe sex," Mathews said.

  If a test could allow gay men to skip such prevention efforts, many would, he said.

  Ken Deckinger, co-founder and chief executive of the dating service HurryDate, said that an easily available AIDS test could quickly reassure a dater of a prospective partner's health, allowing a couple to jump into bed faster than they might have before.

  The test, he wrote in an e-mail exchange, will "speed up the natural relationship evolution process."

  "This, of course, will most likely lead to more casual encounters," he wrote.

  Helen Friedman, a clinical psychologist in private practice in St. Louis, Missouri, said she could envision daters "bonding over this and saying, `Let's take this test together,'" and then, safely reassured, going from there.

  The test is part of a growing stable of medical products that people can use at home to address their sexual behavior; for example, self-administered pregnancy tests and the morning-after pill.

  The HIV test also addresses an issue that more and more singles face: knowing next to nothing about their next date. The popularity of Internet dating and group set-ups has led more and more singles to participate in blind dates, no references included.

  But while technology has helped foster the trend, it is also helping singles cope with it. Google can provide screenfuls of information about a prospective match. Other Web sites offer criminal background checks and lists of real estate holdings. So perhaps it's no surprise that coming soon to a drug store near you is a quick way to tell if a would-be Mr. or Ms. Right has an infection that could kill.

  And perhaps soon to fade from the popular imagination will be scenes like the one from Sex and the City in which the sexually ravenous Samantha is asked by a prospective partner to get tested for HIV (she becomes so nervous, she passes out at the clinic).

  Friedman said she expected the tests to be taken by people who routinely get anxious, often for very little reason, about their partners or their past. She has clients who take at-home pregnancy tests repeatedly and then, for good measure, go to a doctor for another test, she said.

  Members of a Food and Drug Administration advisory committee suggested in a meeting this month that the people most likely to take the test are college students recovering from an uncharacteristically wild night. But the test is no hangover cure.

  An HIV infection will take anywhere from two weeks to three months to become detectable, so the test can offer no assurances about a partner's most recent sexual history -- or fidelity.

  Still, Arthur Aron, a professor of psychology at the State University of New York at Stony Brook, said surreptitious testing of bodily fluids was bound to happen once the test becomes widely available.

  "In the context of jealousy, people do amazing things," Aron said.

  Maulhardt, on the other hand, nursing a drink at the Washington bar, dismissed the idea.

  "I wouldn't want to do it behind someone's back," she said.

  Besides giving daters more chances to have quickie sex and then be horrible to each other, a rapid at-home HIV test could of course help stem a stubbornly high rate of HIV infections in the US, particularly among blacks, homosexuals and drug users. More than a million people in the US have been infected with HIV, almost two-thirds through male-to-male sex. The rate of infection among blacks is more than eight times that of whites.

  Last year 38,685 more Americans were found to be infected with HIV, and studies have shown that 40 percent to 45 percent of new cases develop into AIDS within a year of diagnosis. AIDS takes nearly a decade to develop after an HIV infection, so the seemingly rapid onset of AIDS in these cases means that many Americans -- at least 250,000, studies estimate -- carry the virus for years without knowing it, perhaps infecting others.

  That is why so many public health officials are eager to put OraSure's test on pharmacy shelves. Getting that quarter-million people to shed their ignorance and get screened could be the key to reducing the epidemic's toll in the US. But persuading some daters to make use of the test may still be difficult.

  "I could not envision saying, `Gee, this has been really great, but before we go any further, here's a box for you with a little bow on it,'" said Amy Drummond, a single woman from Alexandria, Virginia.

  Matthew Montroi, a 23-year-old single from Washington, said he could imagine a woman asking him to take the test as they became more intimate and moved from using condoms to using birth control pills.

  "But I'd probably never ask her to take one unless we were sitting at dinner and she just happened to mention that she'd had 50 partners before. I'd probably leave at that point anyway," Montroi said.

  Then he paused.

  "Well," he said, "if she was really hot, I might stay and ask her to take the test."
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