HIV Home Tests Debated in Iowa Legislature
Des Moines, Iowa (Feb. 27, 1997)-- A study bill under consideration by the Iowa Senate Human Resources Committee would allow the Department of Public Health to define the terms by which home HIV test kits are evaluated for sale in stores. Home HIV test kits are illegal under current Iowa law.
Senate Study Bill 186 was introduced in the committee Tuesday; the bill is co-sponsored by the Department of Public Health and the Pharmacy Examiners Board. These two entities would like to legalize the sale of the two FDA-approved home HIV tests: Confide, which was approved in May, and Home Access, which received approval in July.
The current law regarding home HIV test kits passed into the Iowa code in 1988 to prevent the sale of unreliable kits. The task the Department of Public Health will face if its legislation passes is the definition of test kits versus collection kits.
"Neither of those terms is currently defined in Iowa law, so therefore the law is rather ambiguous," said Terry Witkowski, administrative assistant at the Pharmacy Examiners Board. "Essentially, the argument is that these are home collection kits because you don't get the results in your home."
Mark Schoeberl, legislative liaison for the Department of Public Health, said, "We believe Confide and Home Access are home collection kits."
Because of the current law's ambiguity, some stores have been reluctant to stock the test kits. Wal-Mart pharmacies carry Confide, but Iowa Walgreen's stores carry neither test.
Marty Dunn, pharmacist at Methodist Plaza Pharmacy, 1212 Pleasant St., said, "I didn't even know there was a law on the books." He chose to begin stocking Confide two months ago.
Dunn expressed surprise that HIV tests were singled out for such legislation. "What's the difference between that and blood-glucose monitoring [for diabetics]?" he asked.
Witkowski said the Pharmacy Examiners Board has agreed to pursue no legal action against businesses selling the kits because of the law's ambiguity and the board's stance that the kits are home collection rather than test kits. However, the attorney general and county attorneys also have the power to pursue such cases.
"Anyone who wants to market those kits is doing so at their own risk," Witkowski said.
Schoeberl is confident that it is only a matter of time before the current law is clarified.
"For the most part, it should be a pretty noncontroversial issue," Schoeberl said. "We don't anticipate significant opposition because all we're doing is clarifying."
The biggest hurdle may be how fast the study bill can make it out of committee. According to the legislative timetable, Friday, March 14, is the last day for Senate bills to be introduced out of committee.
"I think that will not be a problem," Schoeberl said.
Should the study bill leave committee and pass into law during this legislative session, Schoeberl said the clarification would then be made by the Board of Pharmacy Examiners within approximately 90 days.
What effect that law could have remains to be seen. Iowa residents can order home HIV test kits directly from the manufacturers through toll-free hotlines even if they aren't on pharmacy shelves.
Home Access Express is marketed by the Home Access Health Corp. for $49.90 through its toll-free number, 1-800-HIV-TEST. Confide can also be purchased by phone for $49 at 1-800-THE-TEST. The kits sell in stores for between $30 and $40.
The tests use a simple process to assure anonymity and provide results to clients. A finger-prick blood sample is placed on a card, identified by an anonymous four-digit code, and mailed in protective packaging to the laboratory for evaluation. In seven days the person can call back and receive results from a professional counselor by specifying the test code number. Home Access also requires a pre-test phone call that can include counseling and further test instructions.
Deanna Acrea, client advocate at the AIDS Project of Central Iowa, was skeptical about the quality of patient counseling with these home test kits until an HIV negative staff member and an HIV positive client tested Confide in the office. The staff member received his negative results from a recording, which also gave him numbers that he could call for more information or assistance. The client got her positive results from a live person.
"He was pretty concerned about her," Acrea said. "I would say she was on the phone with him half an hour to 45 minutes." Acrea said the counselor was able to give the client names and numbers of local counseling programs.
"It was really pretty enlightening," Acrea said. "All of us felt much better about recommending those" test kits.
It is unclear how large the demand in Iowa is for these tests.
Rosa Crooks, department manager at Wal-Mart, 5102 S.E. 14th St., said, "We've got six in the store. We haven't sold any since January." The store has been selling the kits since October.
Deana Yazel, pharmacy technician at the Windsor Heights Wal-Mart, 1001 73rd St., said, "We've only sold about five."
Dunn said he has not sold any of the kits he has in stock at Methodist Plaza.
© 1997 CyberPress Communications, School of Journalism and Mass Communications, Drake University 50311.
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