Ask The Experts About Hiv
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How accurate is a negative HIV test after 40 days of possible HIV exposure? Currently, it has been over 8 weeks since my possible HIV exposure. I dont have any symptoms. Should I keep testing for HIV until the six month window is over or was the HIV-1 RNA PCR result at 40 days enough?
It sounds like youve had two different kinds of HIV tests. The first kind, the one used by most clinics as a screening test, looks for antibodies produced by the immune system against the virus. Detectable antibody levels to HIV usually develop within two to eight weeks , but it sometimes takes longer. This test will almost always be reliable three months after exposure, so to be on the safe side, we recommend a second HIV antibody test if the first was done before 90 days after exposure.
The second test you mentioned is the HIV 1 RNA PCR. This is an additional test sometimes performed for people with a high-risk exposure and symptoms of acute HIV disease. An exposure would be considered high-risk, for example, if the partner was known to be HIV positive. If this test was negative at 40 days after exposure, you did not become infected from the exposure you mentioned.
J. Dennis Fortenberry, MD, MS
Versie Johnson-Mallard, PhD, RN, APRN, WHNP-BC
Will Wong, MD
Sexual Health Resource Center Staff
Asymptomatic Stds Are Common
It’s essential to keep in mind, though, that symptoms aren’t always a good measure of determining whether you or your partner have an STD. Many sexually transmitted diseases can remain asymptomatic for years. In other words, there are no noticeable signs of infection.
Furthermore, someone can have no STD symptoms at all and still be contagious. Examples of asymptomatic contagious STDs include:
- Gonorrhea
Screening For Hiv In Pregnancy
If you’re pregnant, you’ll be offered a blood test to check if you have HIV as part of routine antenatal screening.
If untreated, HIV can be passed to your baby during pregnancy, birth or breastfeeding. Treatment in pregnancy greatly reduces the risk of passing HIV on to the baby.
Page last reviewed: 22 April 2021 Next review due: 22 April 2024
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What Is Usually The First Sign Of Hiv
The initial presentation of an HIV infection is a flu-like illness which includes:
- Rash
- Swollen lymph nodes: Lymph nodes are a part of the bodys immune system that helps get rid of bacteria and viruses. An HIV infection, like many other infections, can cause the inflammation of lymph nodes, which can be felt as round or nodular swellings in the armpit, groin, and neck. The swelling is often associated with aches and pains in these areas.
How Soon Can I Take An Hiv Test
This question usually refers to how soon after exposure can someone test for HIV.
This used to involve waiting 3 to 4 weeks before taking an HIV test .
However, 2020 UK guidelines now recommend waiting 6 weeks.
This is because 4th generation HIV tests will detect 99% of infections at 6 weeks compared to 95% of infections 4 weeks after exposure.
A negative test after four weeks needs to be confirmed with a second test three months after the risk. This is to cover the small chance that you take longer than four weeks to generate an antibody response.
Extending this to 6 weeks means the confirmatory test is no longer needed.
In high risk exposures, especially if symptoms occur, viral load testing is sometimes used after one week. This includes after a sexual assault or after a needlestick injury to a healthcare worker.
In these cases a viral load test can exclude an infection when there are symptoms.
Viral load tests are not approved to diagnose HIV. A negative result still needs to be confirmed by an antibody test three months after the risk.
Figure 6: Recommended time from exposure to HIV test *
* This diagram needs to be updated to show the six-week window.
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Types Of Condomless Sex And Risk Of Hiv
During condomless sex, HIV in the bodily fluids of one person may be transmitted to the body of another person through the mucous membranes of the penis, vagina, and anus. In very rare cases, HIV could potentially be transmitted through a cut or sore in the mouth during oral sex.
Out of all types of condomless sex, HIV can most easily be transmitted during anal sex. This is because the lining of the anus is delicate and prone to damage, which may provide entry points for HIV.
Receptive anal sex, often called bottoming, poses more risk for contracting HIV than insertive anal sex, or topping.
HIV can also be transmitted during vaginal sex without a condom, although the vaginal lining is not as susceptible to rips and tears as the anus.
The risk of acquiring HIV from oral sex without using a condom or dental dam is very low. It would be possible for HIV to be transmitted if the person giving oral sex has mouth sores or bleeding gums, or if the person receiving oral sex has recently contracted HIV.
In addition to HIV, anal, vaginal, or oral sex without a condom or dental dam can also lead to transmission of other STIs.
Where Can Someone Find Resources For A Person Just Diagnosed With Hiv
The following are resources to share with someone with newly diagnosed HIV:
- How to Find HIV Treatment Services, a fact sheet listing HIV-related resources, including resources to help find a health care provider and get help paying for HIV medicines, from HIVinfo.
- Telling Others, a webpage with information on how to share an HIV diagnosis with others, from the Centers for Disease Control and Prevention.
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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.
Feasibility And Validation Of Procedures For Removal/ Inactivation Of The Infectious Agent
Validation of the various removal and inactivation steps must be carried out following the actual production processes using HIV . HIV can be propagated to sufficient amounts in cell culture, enabling the spiking of the different source materials under laboratory conditions. Individual steps have to be investigated mimicking the different production processes with regard to their virus removal or inactivation capacity by determining the infectious titres at the start and the end of each production step. Because HIV-1 and HIV-2 are considered to have identical inactivation characteristics, it is sufficient to use HIV-1 for the validation of an inactivation method. Although HIV-1 and SIVmac239 2) show similar properties in inactivation experiments , the use of SIV is not accepted.
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What Is Hiv Testing
Human immunodeficiency virus is the virus that causes acquired immune deficiency syndrome . HIV destroys the body’s immune system and eventually leads to AIDS. People with AIDS develop many diseases and “opportunistic” infections that may ultimately lead to death. Prevention is critical. There is no cure for HIV/AIDS, but currently, there are effective treatments that can drastically slow the disease process and prevent illness and HIV transmission. If you have been exposed to the HIV virus in any number of ways, you can very easily be tested to determine whether or not you have been infected with the virus.
- How HIV is transmitted
- The HIV virus can be transmitted by unprotected sexual contact , sharing needles, by transfused blood products, from mother to newborn, and by occupational needle-stick exposures.
- Higher risk of HIV transmission is associated with penile anal intercourse and sharing needles to inject drugs.
- Higher risk of HIV transmission is associated with a higher number of sexual partners.
Soon after the HIV virus enters the body, it begins replicating at a rate of 10 billion new viral particles per day. In fact, it is during this early burst of viral replication, within the first month of contracting HIV, when many patients are asymptomatic , that the virus is high in numbers and more likely to be spread from one person to another.
Hiv Transmission In Australia
In Australia, HIV is commonly transmitted through:
- Unprotected anal or vaginal sex .
- Sharing any needles, syringes, or other injecting equipment.
- From mother to child during pregnancy, childbirth, or breastfeeding This can occur when the mother doesnt know she is HIV-positive, or is not on effective treatment.
- Tattooing or other procedures that involve unsterile or reused equipment.
- Needle stick injuries.
HIV is not transmitted by:
- kissing, hugging, massaging, mutual masturbation and other body contact
- social interaction
- sharing food, dishes, utensils, drinking glasses
- air, breath, or being coughed or sneezed on
- mosquito, insect or animal bites
- use of communal facilities .
It is perfectly safe to consume food and drinks prepared by someone who is HIV-positive even if theyre not receiving treatment.
People with HIV who are on treatment and achieve and maintain an undetectable HIV viral load cannot transmit HIV sexually.
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What Are The Tests For Detecting Hiv
Various tests may be used for HIV detection:
- HIV antibody test: This test detects the antibodies produced in the body in response to HIV.
- Antigen test: This test can be done at an earlier stage than an HIV antibody test. It measures a protein called p24 antigen, present in the virus and produced in high amounts after the infection.
- Nucleic acid test : It is also called an RNA test. It is a very specific test that looks for the virus itself and can detect HIV as early as about 10 days of infections.
- In-home test kits: Although less accurate than the laboratory-based tests, home-based kits have the advantage of testing in the privacy and comfort of the home. Only FDA approved home-based kits should be used.
- Viral culture: This involves using the patients sample and growing the virus in the lab. It takes longer to get the results and is not the most preferred test for HIV.
Does Hiv Viral Load Affect Getting Or Transmitting Hiv
Yes. Viral load is the amount of HIV in the blood of someone who has HIV. Taking HIV medicine daily as prescribed can make the viral load very lowso low that a test cant detect it .
People with HIV who take HIV medicine daily as prescribed and get and keep an undetectable viral load have effectively no risk of transmitting HIV to an HIV-negative partner through sex.
HIV medicine is a powerful tool for preventing sexual transmission of HIV. But it works only as long as the HIV-positive partner gets and keeps an undetectable viral load. Not everyone taking HIV medicine has an undetectable viral load. To stay undetectable, people with HIV must take HIV medicine every day as prescribed and visit their healthcare provider regularly to get a viral load test. Learn more.
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If My Test Is Negative Do I Need Get Tested Again
Talk to your doctor or the counselor or social worker at the testing site to see if you need to get tested again.
Some reasons to get tested again include if you:
- have sex without a condom
- are a guy who has sex with other guys
- have had sex with more than three partners in the past year
- get an STD
- are a woman and are pregnant
After Testing Positive For Hiv What Can A Person Expect During Their First Visit With A Health Care Provider
After testing positive for HIV, a persons first visit with a health care provider includes a review of the persons health and medical history, a physical exam, and several lab tests. The health care provider also explains the benefits of HIV treatment and discusses ways to reduce the risk of passing HIV to others.
The information collected during a persons initial visit is used to make decisions about HIV treatment.
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Infection And Infectious Diseases
HIV is able to enter the body via intact mucous membranes, eczematous or injured skin or mucosa and by parenteral inoculation. When transmitted by sexual contact, HIV attaches first to dendritic cells or macrophages/monocytes HIV using CCR-5 as a co-receptor is then preferentially replicated . HIV is taken up by macrophages and replicated as shown for M cells in the mucosa . HIV exposure to blood cells can result in the direct infection of T helper cells and the transmission of R5 and X4 viruses . As mentioned above, 1 HID is equivalent to approximately 500-1,000 HIV particles, with a higher dose required for infection via mucous membranes compared to infection via the bloodstream, e.g. by needle stick injury. The majority of new HIV infections are still transmitted sexually. Another epidemiologically relevant route is parenteral administration of drugs and also snorting of drugs with epistaxis.
Transmission of HIV via blood or transplanted organs, including bone, is possible from about days 5-6 after infection of the donor. Mother-to-child transmission has been demonstrated from the 12th week of gestation, but transmission occurs predominantly in the final trimester and particularly shortly before or during birth . HIV can be transmitted via breast milk .
Severity And Course Of The Disease
The course of an HIV infection is always chronic, ending fatally without antiretroviral therapy. CD4 cell disintegration and clinical symptoms can be decelerated or suppressed by antiretroviral therapy for decades . In untreated HIV-1 infections, AIDS-defining symptoms appear after a mean of about 10 years, with a range of 2-25 years. HIV-2-induced AIDS becomes apparent after a mean of approximately 15 years . With antiviral therapy it is possible to extend the phase without or with only slight symptoms for many years .
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How Long Does Hiv Take To Test Positive
In the event that PEP has been taken for a period of time, most modern HIV tests can detect HIV within four weeks of exposure. It depends on the type of test you are offered and when your risk was, as well as the type of test you were offered, whether you will be asked to return for more tests and a follow-up.
When Should I Have An Hiv Test
Testing is highly recommended for anyone who feels like they have been exposed to the virus or is at high risk of being infected. High-risk activities include non-monogamous sex, unprotected sex, and injectable drug use.
If you know the moment you may have come into contact with HIV, get a test three months later after that date. Getting tested three months after exposure gives a 99% accurate test result.
Testing for HIV is available at a hospital, clinic, pharmacy, community clinic, family planning clinic, youth center, mobile sites, or with a take-home test. To find a testing site near you, use the online locator offered by the U.S. Department of Health and Human Services. Many of the sites offer walk-in testing. Some require an appointment.
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What Does The Hiv Test Involve
The Centers for Disease Control and Prevention recommend that all people between the ages of 13 and 64 be tested at least once for HIV. People with known risk factors should be tested yearly, or more frequently.
HIV tests are very accurate, but no test can detect the virus immediately after transmission. How soon a test can detect HIV depends on what the test is looking forantibodies, antigens, or the virus itself.
HIV testing uses a blood draw, a finger stick, or an oral swab. The type of sample used depends on the test.
These three types of diagnostic tests are used to detect HIV:
Antibody and antigen/antibody tests are typically used first because they are less expensive and easier to administer. They may also detect signs of HIV sooner. A NAT test may be used to confirm a positive result on an antibody or antigen/antibody test, or if these tests are negative and there is a strong suspicion for new HIV infection.
Where To Get Tested For Hiv
Getting an HIV test is easy. Tests for HIV and other STIs are confidential and available from your local doctor , or a sexual and reproductive health clinic.
It is a good idea to have some pre-test counselling. Before the test, talk with your doctor, nurse, or peer tester about any concerns, your level of risk, whether you are likely to be HIV-positive and what a positive result may mean.
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Hiv Testing And Your Rights
Testing for HIV is voluntary and can only be done with your informed consent, except in exceptional circumstances.
Before you are tested, you will be provided with information about what is involved. what the results might mean for you, and how to prevent HIV transmission in the future. All people who request an HIV test must receive this information from the test provider.
Under Australian and Victorian law, it is unlawful to discriminate against anyone who has HIV. Test results, and details on whether someone has been tested are strictly confidential. It is illegal for any information about a person being tested or a person with HIV to be disclosed without their permission.