In a significant stride towards enhancing public health, Canada is set to introduce the OraQuick HIV self-test, a groundbreaking oral swab test that provides results in as little as 20 minutes. Announced on Tuesday by OraSure Technologies, the test has received approval from Health Canada, marking a pivotal moment in the fight against HIV. While not the first self-testing option to arrive in Canada, the OraQuick test is notable for its non-invasive oral method, requiring no blood samples, thereby offering a more accessible alternative for individuals hesitant about traditional testing methods.
A Much-Needed Solution
The introduction of the OraQuick test comes at a crucial time, as new HIV diagnoses in Canada have been on the rise. Reports indicate an increase from 1,800 cases in 2022 to 2,434 in 2023, though a slight decline was observed in 2024, with new diagnoses dropping to 1,826. Alarmingly, provinces such as Manitoba and Saskatchewan report new HIV rates that are three to four times higher than the national average.
Dr. Sean Rourke, a scientist at the MAP Centre for Urban Health Solutions at St. Michael’s Hospital and the exclusive distributor of the OraQuick test in Canada, expressed cautious optimism about reaching the goal of eliminating HIV as a public health threat by 2030. However, he emphasised that achieving this target hinges on adequate funding for community-based organisations to distribute the tests at no cost.
Community Engagement is Key
In a bid to reach vulnerable populations, Dr. Rourke’s team plans to commence orders for the OraQuick test within weeks, targeting health providers and front-line agencies. “This is the gap that we’ve been missing to reach the people who need it the most,” he remarked, highlighting the importance of engaging communities disproportionately affected by health inequities, including African, Caribbean, and Black communities, as well as Indigenous Peoples and men who have sex with men.
The oral self-test involves swabbing the gums with a flat pad attached to a stick, which detects early HIV antibodies. The swab is then placed in a cartridge for approximately 20 minutes. Research indicates that the accuracy of this oral test is on par with traditional blood tests. Approved in the U.S. in 2012 and recommended by the World Health Organization in 2016, the test is already in use across 60 countries.
Bridging the Trust Gap
One of the key challenges in tackling HIV is overcoming the historical mistrust in communities of colour. Nonty Nkala, research and outreach coordinator at Women’s Health in Women’s Hands, a Toronto-based organisation focused on serving diverse populations, emphasised the necessity of community-led initiatives. “When research is being done by fellow Black people and led by Black people, there’s a level of trust there,” Nkala explained.
Nkala’s organisation has been instrumental in conducting outreach to offer HIV testing in culturally sensitive environments such as churches, shelters, and community festivals. Her efforts aim to dismantle the stigma surrounding HIV, particularly among new immigrants who may find discussing the topic taboo.
The Importance of Accessibility
Despite the promising arrival of the OraQuick test, concerns linger regarding the sustainability of support for HIV self-testing. Following an eight-million-dollar investment by the Canadian government in finger prick tests, funding for wider distribution of self-tests remains uncertain. Some provinces, like Saskatchewan and Nova Scotia, have taken the initiative to fund their own HIV self-testing programmes, but the future of federal support is unclear.
The oral test is expected to retail between £15 to £20, a more affordable alternative compared to the blood test, which can cost around £35. Nkala expressed apprehension about potential cuts to funding for the oral test but acknowledged its critical role in HIV prevention.
Why it Matters
The launch of the OraQuick HIV self-test in Canada represents a crucial advancement in public health policy and accessibility. By providing a less invasive testing option, this initiative not only aims to increase testing rates but also seeks to reduce the stigma associated with HIV. It highlights the importance of community engagement in healthcare and the necessity of targeted funding to reach at-risk populations. As Canada strives towards the ambitious goal of eliminating HIV by 2030, this development is a hopeful sign that progress is being made in addressing health inequities and improving access to vital health services.
