Where To Access Testing Services
Standard HIV testing can generally be accessed through any health provider across the country. Each province is responsible for licensing the laboratories that provide HIV screening and confirmatory testing in its jurisdiction. In general, all provincial Public Health Laboratories provide both screening and confirmatory testing. Reference and specialized services, when required, are provided by the National HIV Reference Serology Laboratory after consultation with the provincial laboratory. It is advisable to contact your testing laboratory to confirm the specimen collection details.
Anonymous or POC testing locations can be found by calling a local HIV/AIDS hotline .
What Are The Treatments For Hiv/aids
Currently, there is no cure for HIV infection or AIDS. However, early diagnosis allows for treatment with antiretroviral therapy that can help to suppress levels of virus in your body and greatly improve your long-term health. The U.S. Department of Health and Human Services as well as the World Health Organization recommend that all individuals diagnosed with HIV infection receive treatment as soon as possible, including pregnant women. With advances in treatment, individuals with HIV infection are living longer, healthier lives.
People typically take at least three drugs from two different classes in order to prevent or minimize virus replication and the emergence of drug-resistant strains. Combinations of three or more antiretroviral drugs are referred to as highly active antiretroviral therapy or HAART. Read the Treatment section of the article on HIV Infection and AIDS for additional details.
How Can I Get Tested
To get tested, you can:
- Ask your doctor to test you.
- Go to a local clinic or community health center.
- Go to National HIV and STD Testing Resources to find a testing center near you.
- Buy a test at a pharmacy and do the test at home.
Many testing centers will do an HIV test for free. Ask if there is a fee before you go for testing. In most states you do not need a parent’s permission to get tested for HIV. And you can buy the test at the pharmacy without a parent.
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Appendix D: Natural History Of Hiv Infection
Human immunodeficiency virus is a retrovirus that infects the cells of the immune system. It is transmitted via exposure to body fluids that contain lymphocytes or free infectious viral particles . The routes of infection are: unprotected sexual intercourse, sharing of injection-drug use equipment and from an HIV-infected mother to her unborn child. Although rare, HIV can also be transmitted through an occupational exposure such as a needlestick injury or other event where blood to blood exposure could occur. All blood and blood products used in Canadian healthcare settings now undergo extensive screening for HIV prior to use, so new infections related to their use have been virtually eliminated .
The virus can enter the body through unprotected mucous membranes where cells may become infected with HIV . The presence of a sexually transmitted infection can enhance HIV transmission because of lesions and/or an increased number of lymphocytes. Using a needle contaminated with HIV-infected blood deposits the virus directly into the blood system, where infection of lymphocytes will occur. Transmission from mother to child can take place in utero, during delivery through exposure to the mother’s blood or vaginal secretions, and through breast milk . Seroconversion occurs when an individual changes from being HIV antibody negative to HIV antibody positive.
Hiv Testing Types And Lab Technologies
This chapter provides information regarding available testing technologies, approaches to testing and interpretation of results. There are many different types of HIV screening tests that are licensed for use in Canada and can vary by jurisdiction. For questions or information specific to your province or territory please contact your local Public Health laboratory.
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Next Steps Following Test Results
Although a negative result from a home test can be comforting, these tests are only the first step.
As false positives and false negatives do occur, it is important to get a follow-up test from a healthcare professional.
In particular, anyone who receives a negative result from the OraQuick In-Home HIV Test should not presume that they do not have HIV. Further testing is a requirement, especially if the person has symptoms of HIV or knows that they have had exposure to the virus.
If further testing shows no signs of HIV, it is usually safe for a person to conclude that they do not have the infection. If the test result is positive, their doctor will advise them on what to do next.
Although HIV is a serious condition, scientists have done a lot of research to create the best possible treatments. As one
Appendix C: Hiv Transmission Risk
This appendix is condensed from a more detailed technical report, HIV Transmission Risk: A Summary of the EvidenceFootnote 3 which synthesises the scientific evidence on the risk of HIV transmission through sexual activities, injection and other drug use, and mother-to-child transmission. Over 200 references formed the basis of the review, based on a search of the literature for the period between 2001 and March 2012 Footnote 4. The findings from this large body of evidence demonstrated the difficulties inherent in quantifying the risk of HIV transmission, in part due to the role of behavioural and biological co-factors, including viral load and the presence of co-infections, in increasing or decreasing the risk of transmission.
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How An Hiv Test Works
An HIV test is a blood test. It does not detect HIV itself, but looks for a protein found in an HIV cell, or an antibody made by the body to fight HIV.
HIV tests in the UK are very reliable. They can occasionally produce a positive result which is then found to be negative when tested again. This is called a false positive and is rare, occurring in less than 1 in 1000 cases.
Who Will Know The Results Of My Testing
It depends on where you get your testing. Testing sites have different privacy rules. Ask about privacy rules at your testing site so you understand whether anyone else will know you got tested or see your results.
If you go to an anonymous test site, only you know the results. No written record of the test result is kept.
If you go to a confidential test site, the results will go in your medical record. Positive results are sent to the state or local health department. Your insurance company will have access to your results. Depending on the state you live in, your parent or guardian may be contacted.
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What Is It Used For
An HIV test is used to find out if you have been infected with HIV. HIV is the virus that causes AIDS . Most people with HIV don’t have AIDS. People with AIDS have an extremely low number of immune cells and are at risk for life-threatening illnesses, including dangerous infections, a severe type of pneumonia, and certain cancers, including Kaposi sarcoma.
If HIV is found early, you can get medicines to protect your immune system. HIV medicines may prevent you from getting AIDS.
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How Much Does The Test Cost
The cost of an HIV test is usually covered by insurance without a copay, although specific costs depend on a persons insurance coverage and where the test is performed. Check with your health plan and health care provider for specific cost details.
At-home HIV tests cost below $50. Health departments and community-based organizations may provide HIV self-test kits for free or at a reduced cost.
Testing Recommendations And Requirements
The U.S. Centers for Disease Control and Prevention recommends routine HIV screening in health-care settings for all adults, aged 13-64, and repeat screening at least annually for those at higher risk.26,27 Per the CDC individuals who may benefit from at least annual screening include:28
- sexually active gay or bisexual men
- individuals who have had sex with an HIV-positive partner
- individuals who have had more than one partner since their last HIV test
- those who have shared needles or works to inject drugs
- people who have exchanged sex for drugs or money
- individuals who have another sexually transmitted disease, hepatitis, or tuberculosis
- those who have had sex with someone who has participated in any of the above activities or with someone with an unknown sexual history
Certain factors are known to reduce the risk of HIV transmission including condom use, antiretroviral treatment leading to durable viral load suppression among those with HIV, which prevents further transmission, and the use of pre-exposure prophylaxis among those at increased risk for HIV.29
Additionally, HIV testing is recommended for all pregnant women and for any newborn whose mothers HIV status is unknown.30 Treatment provided to pregnant HIV-positive women and to their infants for 4-6 weeks after delivery can reduce the risk of transmitting HIV to 1% or less.31 HIV testing is also recommended for anyone who has been sexually assaulted.
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Can I Take The Test At Home
At-home HIV tests are a convenient way to take an HIV test in a private location. Testing for HIV at home is a form of HIV screening that requires additional follow-up if preliminary results are positive. At-home HIV tests can be obtained online, at a pharmacy, or at health departments and community-based organizations.
Challenges In Hiv Testing
4.3.1 HIV Testing in the “window period”
The window period is the time after acquisition of HIV infection when the individual is highly infectious but tests negative on HIV antibody screening because antibodies are not immediately produced. As shown in Figure 4, the timelines associated with the window period have changed with the evolution of more sensitive antibody screening tests. While 1st generation tests detected HIV antibody an average of 60 days following exposure the 4th generation combination tests permit detection of acute HIV infection during the viremic phase. This reduces the window period to approximately 15 to 20 days. Making the diagnosis as early as possible can help prevent onward transmission of the virus, since the person is most infectious during this period. Some jurisdictions provide NAAT testing for high-risk clients , in an effort to identify very early HIV infection.
4.3.2 Indeterminate results during the window period
4.3.3 Confirmatory Testing
The Western Blot assay is not as sensitive as the 3rd and 4th generation screening tests and may yield indeterminate results during the window period. New algorithms employing NAAT as a confirmatory test are currently being evaluated.
Figure 5: Antigen/Antibody detection periods
Figure 5 is a detailed diagram showing the days elapsed, from zero to 360, since the start of HIV infection. The diagram is divided into a sliding scale of four time periods:
4.3.4 Genetic diversity of HIV
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Introduction And Guiding Principles
A request was made by the Federal/Provincial/Territorial Committee on AIDS for the Public Health Agency of Canada to develop guidelines on HIV testing that reflect the realities facing care providers and their clients, as well as advances in HIV testing policy and practice. To inform the development of this guide, the Agency commissioned a literature review and consultations with key stakeholders, including people living with HIV/AIDS and other affected populations, academics, nurses, physicians, professional associations, non-governmental organizations, policy-makers, community workers, and legal and ethical experts. As a result, the recommendations outlined in the guide are based on the most up-to-date evidence and expert opinion.
Hiv Rna Test Compared To Other Tests
The HIV RNA test is a type of nucleic acid test . NATs are blood tests used to detect the genetic material of viruses and bacteria in your blood. Theyre sometimes used to screen blood donations for HIV and other conditions, such as hepatitis B.
The HIV RNA test is also called the HIV viral load test, since it can identify the viral load, or how much genetic material from HIV is in your blood. This sets it apart from other HIV tests.
According to the , there are two other types of HIV tests:
- HIV antibody tests. These tests look for antibodies created by your body in response to HIV.
- HIV antigen/antibody tests. These tests look for antibodies, but they also look for antibodies and an HIV protein called p24.
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Types Of Hiv Tests And Their Window Periods
- Nucleic Acid Test A NAT can usually tell you if you have HIV infection 10 to 33 days after exposure
- Antigen/Antibody TestAn antigen/antibody test performed by a laboratory on blood from a vein can usually detect HIV infection 18 to 45 days after exposure. Antigen/antibody tests done with blood from a finger prick take longer to detect HIV .
- Antibody TestAn antibody test can take 23 to 90 days to detect HIV infection after an exposure. Most rapid tests and self-tests are antibody tests. In general, antibody tests that use blood from a vein detect HIV sooner after infection than tests done with blood from a finger prick or with oral fluid.
Ask your health care provider or test counselor about the window period for the test youre taking and whether you will need a follow-up test to confirm the results. If youre using a self-test, you can get that information from the materials included in the tests package.
If you get an HIV test after a potential HIV exposure and the result is negative, get tested again after the window period. Remember, you can only be sure you are HIV-negative if:.
- Your most recent test is after the window period
- You havent had a potential HIV exposure during the window period. If you do have an exposure, then you will need to be retested.
How Can I Get Tested For Hiv
There are a few different ways you can get access to HIV screening:
- A blood or saliva sample can be collected in a healthcare practitioner’s office or a local clinic and sent to a laboratory for testing. Certain testing centers provide either anonymous or confidential HIV testing and counseling. You can also contact your state or local health department to find out where testing may be available. To find a testing site near you, visit the National HIV and STD Testing Resources webpage.
- In these same settings, there may be a rapid test available, with results that are generated in 20 minutes or less.
- There is a home test for HIV that has been approved by the U.S. Food and Drug Administration . It uses a saliva sample and results are available in about 20 minutes.
The home test has two limitations:
1. The saliva test is less sensitive than a blood test, so the home test may miss some cases of HIV that a blood test would detect.2. The home test is not as accurate when it is performed at home by a lay person compared to when it is performed by a trained healthcare professional. However, the convenience of home testing might encourage some people who might otherwise be reluctant to go to a healthcare practitioner or clinic to learn their HIV status.
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If You Have A Negative Test Result Does That Mean That Your Partner Is Hiv
No. Your HIV test result reveals only your HIV status.
HIV is not necessarily transmitted every time you have sex. Therefore, taking an HIV test is not a way to find out if your partner is infected.
It’s important to be open with your partner and ask them to tell you their HIV status. But keep in mind that your partner may not know or may be wrong about their status, and some may not tell you if they have HIV even if they know they’re infected. Consider getting tested together so you can both know your HIV status and take steps to keep yourselves healthy.
Situations In Which Rapid Tests May Not Be Accurate
Performance of rapid 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 you acquire HIV, you may have a delayed antibody response, extending the window period.
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The Accuracy Of Different Rapid Tests
A wide range of point-of-care tests have been manufactured in many countries, but only a few of them have been subject to rigorous, independent evaluations, and even fewer are marketed in the UK. Research on HIV tests is only occasionally published in medical journals. Informally, laboratory professionals may have insights into which tests perform best.
It is important to verify that any test used is CE marked. This should mean that the test conforms to European health and safety legislation, although it does not necessarily mean that test performance has been independently evaluated.
There are variations in accuracy from one test to another, with some older tests that are not usually marketed in the UK having a sub-optimal sensitivity and specificity. However, evaluations by the World Health Organization of several rapid diagnostic tests that either have CE marks or are approved by the US Food and Drug Administration , indicate that most are extremely accurate. The key measures of accuracy are sensitivity and specificity .
Of note, in the World Health Organization data below, the tests were performed with samples of plasma or serum. However, the tests are less sensitive when testing whole blood sampled from a finger prick. Moreover, the blood was taken from people who had chronic HIV infection, but the tests are less accurate in cases of recent infection.
“All HIV tests need to have reactive results confirmed with further tests.”