We reported previously on the “4th Generation HIV testing” that is being promoted by an outfit known as Pro-Health Community Care. They want to convince the the adult production community to abandon PCR-RNA (viral load) testing in favor of the combo antigen/antibody test offered by them.
This is from one of their press releases, announcing a pitch scheduled for tomorrow afternoon in Chatsworth, CA:
FREE Information meeting about Pro-Health’s 4th generation HIV 1 & 2 COMBO Antigen/antibody test which can detect HIV within a few days of exposure.
Approved by the FDA, please consider this new test and our other STD testing panels.
. . .
WHY DOESN’T FREEDOM [sic] OF SPEECH COALITION want you to know about this BETTER, more accurate test? It can save your life — your business — and keep your clients safe and working.
-Joyce?Joyce L. Thomas, MHA, CPM, Administrator
Pro-Health Community Care
16101 Ventura Blvd. Suite #343
Encino, CA 91436
Now, that reads like one of those scam flyers you find at a mini-mall laundromat, but performer testing is an important issue, so let’s dig a little deeper. What do we know about the relative merits of “4th generation combo” testing?
A 2009 study published by the American Society for Microbiology in its Journal of Clinical Microbiology assessed the 4th generation HIV Ag/Ab Combo test (interestingly, Jeffrey D. Klausner of UCLA, a friend of AHF and a Measure B supporter, was one of the study’s authors):
The performance of the 4th generation test “was evaluated on specimens from 64 recently infected individuals (tested in San Francisco, CA) identified based on an HIV-1 RNA testing algorithm (all specimens were HIV-1 RNA positive).”
Meaning: the study’s authors recognized RNA viral load testing as definitive. That’s how they determined they actually had HIV positive samples in hand to compare the “combo” test’s sensitivity.
The 4th generation test “was found to be capable of detecting the majority (89%) of infections, including 80% of those considered acute infections based on the presence of HIV RNA and the lack of detectable antibody to HIV.”
That means 20% of acute infections which WERE DETECTED BY RNA testing WERE MISSED BY THE 4th GEN TEST. TWENTY PERCENT! The detection of acute (new) infections is the main purpose of adult industry testing!
“57 of the 64 specimens from recently infected individuals were found to be reactive in the HIV [Ag/Ab] Combo assay,” the study reported.
These findings match what we reported previously on TRPWL, that the 4th generation HIV combo Ag/Ab EIA test may reduce the diagnostic window when compared to an 3rd generation screening assay, but the adult industry DOES NOT EMPLOY 3RD GENERATION TESTING. It uses PCR viral load testing.
It’s irrelevant that 4th generation testing is better than 3rd generation. A better version of the wrong test is still the wrong test.
4th generation tests detect 95% or more of infections or more at four weeks after exposure.
PCR viral load tests detect 95% or more of infections or more at 10 days after exposure.
The study in the Journal of Clinical Microbiology found the 4th generation test was a less-expensive, easy substitute to RNA testing because RNA-based tests are “expensive, laborious” and in many cases it can take 1 to 2 weeks for test results to come back.
Well, adult industry (PASS-approved) RNA test results are received back the next day in most cases, so that’s not relevant, and as for cost — aren’t the lives of adult performers worth the added expense?
We think they are.
Pro-Health Community Care’s “4th Generation Combo Testing” is a dangerous scam – one which we’ll be exploring in more detail very soon.