Situations In Which Self
Performance of self-tests is poorer in a number of situations. Results may not be accurate.
- In cases of recent HIV infection, during the tests window period.
- In people with diagnosed HIV who are taking HIV treatment. These tests are not a reliable way to confirm that you still have HIV infection.
- In people who are taking pre-exposure prophylaxis or post-exposure prophylaxis . If they acquire HIV, they may have a delayed antibody response, extending the window period.
- When test instructions have not been correctly followed for example not enough blood has been collected.
Are People Able To Understand Test Instructions And Use Self
A review identified 25 studies in which people used self-tests, with their results compared with those of a healthcare worker testing them at the same time. The original studies were done in a mix of North American, African, European and Asian countries. Fifteen studies used oral fluid-based tests, six used blood-based tests and four used both oral and blood specimens. Of note, several studies were evaluating professional assays that had not been adapted for use as self-tests performance could be better in commercially marketed tests.
The researchers found that most people could reliably and accurately use rapid tests. Using a statistical approach known as Cohens kappa in which 1 represents perfect agreement between the results of a self-tester and a trained health worker and less than 1 represents less than perfect agreement, results were highly concordant. The Cohens kappa was 0.98 in studies in which users first received a demonstration of how to do the self-test or to interpret its result. In studies in which this was not provided, it was 0.97. This means that in only a small minority of cases the self-tester and the healthcare worker got results that were different from each other.
Basic information on testing
Why Its Important To Test
If you have HIV, finding out means you can start treatment, stay healthy and avoid passing the virus onto anyone else. The sooner you start treatment, the less likely you are to become seriously ill. People who are diagnosed early and get on effective treatment can expect to live a normal lifespan.
Once youre on effective treatment and your viral load is undetectable then you can’t pass the virus on to anyone else.
If you wait to test, the virus could do a lot of damage. There is a lot of support available for people who test positive.
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Patients Who Present With A Home Test Result In Hand Require Particular Sensitivity
Until now, we have discussed the situation where the patient inquires prospectively about the purchase of a home HIV test. A more probable scenario is that patients will present after the fact, with the results of a home test in hand. Patients who report a negative result should be reminded that this reveals nothing about very recent exposures and that, if they have been at consistently high risk, negative results probably reflect good fortune more than any immunity from infection. For patients who report histories of particularly high risk-taking, it may also be important to consider the possibility of false-negative results. The OraQuick home test has an estimated 92% sensitivity, meaning that 1 in 12 people who have HIV infection will nevertheless receive a negative test result . When a false-negative result is suspected, a second screeningpreferably one that tests for HIV RNAshould be obtained.
Implications For Possible Hiv Self
In Singapore, HIV self-testing can be operationalized as an extension of the currently available MOH-approved anonymous HIV test sites. Anonymous test sites are an exception to the legal requirement to report all HIV positive tests to a name-based MOH registry. Unlike provider-based anonymous testing, alternative forms of pre and post-test counseling and linkage to care would obviously be necessary for self-testing. As discussed above, phone based counseling is a potential option. In the United States, the commercial company marketing the FDA approved HIV self-test has committed to maintaining a 24-hour toll-free number providing counseling, advice on test conduct, and referral services for care. This strategy could be used in Singapore.
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How Accurate Is A Home Hiv Test Should You Go To A Clinic
The treatment can lead to blood-borne infections if not carried out properly
HIV tests are so important and World AIDS Day 2018 highlights this with the theme know your status. And checking for HIV couldnt be easier with home-testing and home-sampling kits that are easily available, quick and accurate.
Many people question how accurate a home HIV test so if you feel more confident to go to your local clinic, we encourage you to do so. But if youd prefer to test yourself in the comfort of your home, read on.
Although advancements in testing and the introduction of pre-exposure prophylaxis has led to a drop in recent years in the number of gay and bisexual men becoming infected with HIV, the virus is still a huge concern for the gay community.
Gay and bisexual men are the most at risk of catching HIV.
Valerie Delpech, head of HIV surveillance for Public Health England, told the Guardian: Gay, bisexual and other men who have sex with men account for half of all people living with HIV in England.
HIV test results are usually sent back within 2-3 days.
And they raise a wider problem: that in 2016, 42% of HIV diagnoses happened at a late stage of infection.
A home HIV test could help diagnose those living with HIV earlier and help them get the treatment and support they need.
Talking to PinkNews, sexual health consultant Mark Lawson said: The main challenge is getting people diagnosed anything that encourages people to test that otherwise wouldnt is a good thing.
Are Hiv Tests Accurate
Yes. Modern HIV tests are very accurate.
This accuracy has to be considered with the window period.
For example, 4th generation tests will pick up 99% of infections at six week.
Testing earlier, for example after four week, only detects 95% of infections. Testing earlier needs a confirmatory test three months after the risk.
A positive test result is routinely confirmed using a different type of test called western blot. The western blot test looks for immune responses to specific HIV proteins and is 100% accurate as a confirmatory test.
Can anything affect the result of my HIV test?
HIV antibody tests, confirmed by the second test, are not affected by other circumstances.
This includes infections, medications, most vaccinations, putting on weight, eating or drinking anything before the test, use of alcohol or recreational drugs, mouthwash or time of day.
Your test result is accurate even if you had flu or a cold or are using any medication.
You do not need to fast before your test. Food and drink do not affect the results.
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Facts You Should Know About The Rapid Hiv Test
It is now clear from a number of studies that getting treatment as soon as possible after becoming infected with HIV is better than waiting. HIV-infected patients who are treated early have fewer complications from HIV infection and are less likely to infect other people than those who wait to be treated. Studies also show that people who know they are HIV-positive may change their behavior to decrease the risk of infecting others.
The U.S. Centers for Disease Control and Prevention now recommends that all people between the ages of 13 and 64 get tested for HIV regardless of risk.
HIV testing is also recommended at least once a year for those at higher risk of getting HIV infection. These include
- people who use injection drugs and share needles or syringes
- people who have unprotected sex with men who have sex with men , or with people who have sex with multiple partners or anonymous partners
- people who exchange sex for drugs or money
- people who have been diagnosed with hepatitis, tuberculosis , or an STI such as chlamydia, gonorrhea or syphilis and
- people who have unprotected sex with someone with any of the above risk factors.
The Right Test For You
Should you get screened for HIV at a clinic or your doctorâs office, or take the test yourself? And which home test is best for you? The answers to these questions may help you decide:
- How important is it that no one else knows that youâre taking the test or its results?
- How important is accuracy?
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What Are The Rapid Hiv Test Options
In the past, the only way to get tested for HIV was to go to a doctors office, hospital, or community health center. Now there are options for taking an HIV test in the privacy of ones own home.
Some HIV tests, whether taken at home or at a health facility, are even able to deliver results within 30 minutes. These are known as rapid tests.
How Can Someone Test For Other Stds At Home
People can test for other sexually transmitted diseases , such as gonorrhea and chlamydia, using home testing kits. These tests usually consist of taking a urine sample or a swab from the genital area and sending it to a lab facility for testing.
The test should be repeated if a person received negative results, but theyre experiencing STD symptoms.
Another option is to have a healthcare professional order another test to ensure that the results are accurate.
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Where Can People Find More Information About Hiv Testing
There are several resources for people interested about the facts of HIV testing.
- The national HIV, STD, and hepatitis testing site Get Tested helps visitors find free, fast, and confidential testing.
The CDC web site is also an excellent source of information: https://www.cdc.gov/hiv/basics/testing.html.
When You Should Take An Hiv Test
What testing service you should use, and which type of test, depends on when you might have been exposed to HIV. Signs of HIV infection dont show up in the blood right away. It normally happens within four weeks of infection, but can be longer.
If you think you might have been exposed to HIV in the last 72 hours , its possible to take post-exposure prophylaxis to help stop an infection from happening.
If your risk was recent, then your test provider will probably advise you to take a test immediately, followed by a second one a few weeks later. The second test will pick up any infection the first one may have missed.
If your risk was in the last three months, make sure you tell the person testing you, as it may affect the type of test youre given.
A self test is not guaranteed to pick up an infection thats occurred in the previous three months. If you think youve been exposed in the last three months, you should get a test in person.
Very occasionally it can take up to three months for antibodies to appear in the blood, so an HIV negative result is only totally accurate if three months have passed between the test and the last time a risk was taken. However, a negative result four to eight weeks after taking a risk is a very good sign that HIV infection hasnt happened.
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Getting A Result Quickly
Many services offer rapid testing, which means a finger-prick test that will give you a result within minutes.
A self testing kit ordered online and done at home will normally give you a result up to 15 minutes, depending on the kit.
A blood sample taken at a testing centre will be sent to a lab, with results ready within a day or up to a week later.
If you use postal testing, the lab will normally contact you a week or so later with your result.
How Early Can Oraquick Detect Hiv
The OraQuick In-Home HIV Test can give you accurate results 3 months from exposure. Most people will develop antibodies to HIV within this period of time. If you test within 3 months of possible exposure and the result is negative, you may want to repeat the test at least 3 months after the possible exposure.
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What Do I Do If My Results Are Positive
If your home HIV test results are positive, its important to follow up with a doctor as soon as possible. Healthcare professionals usually conduct two tests to confirm that you have HIV, so the results of this test are preliminary. Please call The Miriam Hospital Immunology Center at 401-793-2928 and ask for Dr. Philip A. Chan, or email .
If your second test is positive, your doctor will typically start you on anti-HIV medications right away. While HIV is serious, if you take these medications every day and take care of yourself, you can live a life that is just as full and active as someone who does not have HIV. Visit our page HIV Positive? Get Treated page for more information and resources.
How Soon After Exposure To Hiv Can An Hiv Test Detect If You Are Infected
No HIV test can detect HIV immediately after infection. If you think youve been exposed to HIV, in the last 72 hours, talk to your health care provider about post-exposure prophylaxis , right away.
The time between when a person gets HIV and when a test can accurately detect it is called the window period. The window period varies from person to person and also depends upon the type of HIV test.
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What The Findings Tell Us
From the point of view of specificity, the figures confirmed that the incidence of false positives remains extremely low, even with the earlier generation tests.
The figure only worsened when retesting bloods from the acute stage infections. Of the 58 samples tested, the 3rd generation rapid tests achieved a sensitivity of only 5.2 percent to 25.9 percent, meaning that the majority of such infections would be missed using these rapid, antibody-based tests.
Even the 4th generationDetermine rapid antigen/antibody test was able to identify only half of the acute infections despite having an estimated sensitivity of 96.6 percent and specificity of 100 percent. According to the UCSF researchers, the Determine worked best during acute infection when the patient’s viral load was over 500,000.
Not surprisingly, the lab-based ARCHITECT combination antigen/antibody test performed best. With an estimated specificity of 99.1 percent and a specificity of 100 percent, the tests were able to identify nearly 90 percent of acute infections.
Are The Oraquick Hiv Tests Reliable
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What Does The Test Measure
At-home HIV tests dont look for the virus itself. Instead, they look for either antibodies alone or both antigens and antibodies. If these substances are detected, the test returns a positive result for HIV.
Antibodies are produced by the body in response to HIV infection. At-home tests that look for antibodies alone detect these substances in the blood or oral fluid. It can take several weeks after an HIV infection for the body to produce antibodies, so these tests can detect HIV 12 weeks after infection.
Antigens are substances that the body recognizes as foreign and activate an immune response. Testing for both antigens and antibodies at home requires a blood sample taken from a fingerstick. Because antigens appear before the body produces antibodies, HIV tests that look for both antigens and antibodies can detect an HIV infection within only 2 to 4 weeks of becoming infected.
Home Testing May Play An Appropriate Role In Support Of Responsible Sexual Health Habits
Patients who know their current HIV status and are about to begin a sexual relationship with a new partner may be encouraged to obtain a home HIV test as 1 component of a comprehensive 3-way conversation covering such topics as shared risks, harm reduction, monogamy, birth control, and prevention of other sexually transmitted infections.
The following points may help prepare patients to anticipate and interpret home test results. First, the test does not detect the virus it detects the bodys immune response to that virus. Most people develop detectable antibodies within 6 weeks of infection 97% respond within 3 months . Conservatively speaking, a result obtained today is only a reliable indicator of ones HIV status 3 months ago . Second, a negative result does not imply reduced susceptibility to infection and is certainly not a green light to take greater sexual risks in the future. Third, a positive result requires immediate confirmation using a test that is not available for home use. Patients should contact a health provider immediately present themselves in person call an HIV hotline or use OraSures 24-hours-per-day, 7-days-per-week toll-free customer support center .
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Hiv Testing In A Health Care Setting Or Lab
If you take a test in a health care setting or a lab, a health care provider or lab technician will take your sample . If its a rapid test, you may be able to wait for the results, but if its a laboratory test, it can take several days for your results to be available. Your health care provider or counselor may talk with you about your risk factors, answer any questions you might have, and discuss next steps with you, especially if your result is positive.
- If the test comes back negative, and you havent had an exposure during the window period for the test you took, you can be confident you dont have HIV.
- If your HIV test result is positive, the lab will conduct follow-up testing, usually on the same sample as the first.