Mr. Peter Foley:

I thank the committee for the opportunity to speak. I will focus on home testing and how it fits in as another component of making testing in general more accessible. The key differential from other methods is the testing itself is taken away from the clinical setting and is conducted by the user in an environment of his or her choosing. Home testing and remote testing targets two areas specifically. In the first instance are people who are asymptomatic who do not present any clinical symptoms, which is quite a large proportion of the population. Before and after seroconversion people with HIV are generally asymptomatic. A total of 80% of women with chlamydia are asymptomatic all of the time. Home testing also removes many of the traditional barriers and encourages people to engage emotionally. People may be afraid of the testing process or going to a clinic in the first instance, or might have geographical restrictions by way of time or where they are located, such as in rural Ireland are various parts of the country. It is about giving them access and ensuring they are provided with a solution.
Letsgetchecked.comis a technology platform that facilitates the dissemination of testing It sends testing equipment to a person in a secure fashion. It also disseminates results after testing has taken place. I will try to keep my explanation of how the process works as simple as possible. Someone visits the online site and orders a test kit from a laboratory. The laboratory dispatches the kit in discreet packaging to the address designated. The testing or self sampling is conducted, for HIV it is a finger prick of blood dispensed into a vial, and returned to the laboratory for analysis. The laboratory then runs the test and uploads the results directly to the user's profile. This can all be conducted through a mobile telephone, tablet or desktop device and is accessible and convenient. Anyone can do it at any point in time.
There is an issue with people who test positive for HIV. It is not appropriate that such results are just send to someone's phone. The project could have gone live much sooner than it did, but we engaged the public health system by way of Saint James's Hospital and private health centres. If someone tests positive he or she is contacted by a nurse over the phone. By way of a three-way conference facility the nurse puts the patient directly through to a clinic at either Saint James's Hospital or a private clinic in Dublin run by Professor Fiona Mulcahy, at which point our nurse will drop off the phone and the person is directly put into care.
People who are infected also need to be provided with actionable information which allows them make sensible decisions on how they receive treatment or care and how they act socially, whereby they have the knowledge to act responsibly by way of treatment and interaction.