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
How To Prevent Hiv From Progressing
The most effective way is to take antiretroviral medication as soon as possible and to do so consistently as prescribed.
Antiretroviral therapy keeps the immune system healthy and reduces the risk of transmitting the virus to virtually zero.
The sooner a person receives a diagnosis, the sooner they can begin treatment. Early treatment can improve the persons outlook and lower the risk of the virus passing on to others.
What Are The Signs And Symptoms Of Hiv
No two people with HIV will have the same symptoms, and some may not have any at all. But the infection can cause some common changes over time.
In the first few weeks: These first, flu-like symptoms happen because your body is reacting to HIV. Your immune system is trying to fight it off. The symptoms at this stage can include:
- Aches and pains in muscles and joints
Keep in mind that even if you have these symptoms, that doesnât automatically mean you are HIV-positive. Many different illnesses can cause these problems. Talk to a doctor or an HIV testing facility if you think you might be infected.
At this early stage of HIV infection, itâs important to know that you may not get accurate results from an HIV test. It can take 3-12 weeks for enough signs of the virus to show up on routine tests for the infection, which measure antibodies against HIV. A new kind of screening, called a nucleic acid test, can detect the virus itself during this early stage, but itâs expensive and not usually used for routine HIV testing.
Let the testing site or your doctor know if you think you might be recently infected. Also, be sure to use a condom every time you have sex, and take other steps to prevent spreading the virus.
After years with untreated HIV, youâre likely to get infections caused by bacteria, viruses, or fungi that your body is no longer strong enough to fight off. They can be a sign that your infection has gone from HIV to AIDS. You might have:
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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.
How Is Life Expectancy Calculated
Life expectancy is the average number of years that a person can expect to live.
More precisely, it is the average number of years an individual of a given age is expected to live if current mortality rates continue to apply. It is an estimate that is calculated by looking at the current situation of a group of people and projecting that into the future.
However, HIV is a relatively new disease and HIV treatment is a rapidly changing area of medicine. It is therefore hard to know whether our current experience will be an accurate guide to the future.
At the moment, there are large numbers of people living with HIV in their twenties, thirties, forties, fifties and sixties. Current death rates are very low, resulting in encouraging figures for future life expectancy. But we have very little experience of people living with HIV in their seventies or eighties, so we know less about the impact HIV may have later in life.
Also, health care for people with HIV is likely to get better in the future. People living with HIV will benefit from improved anti-HIV medications that have fewer side effects, are easier to take and are more effective in suppressing HIV. Doctors understanding of how best to prevent and treat heart disease, diabetes, cancers and other conditions in people with HIV is improving. This could mean that people actually live longer than our current estimates suggest.
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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
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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Who Should Get Tested For Hiv
The Centers for Disease Control and Prevention recommends that everyone 13 to 64 years of age get tested for HIV at least once as part of routine health care. As a general rule, people at higher risk for HIV should get tested each year. Sexually active gay and bisexual men may benefit from getting tested more often, such as every 3 to 6 months. If you are over 64 years of age and at risk, your health care provider may recommend HIV testing.
Factors that increase the risk of HIV include:
- Having vaginal or anal sex with someone who is HIV positive or whose HIV status you do not know
- Injecting drugs and sharing needles, syringes, or other drug equipment with others
- Exchanging sex for money or drugs
- Having a sexually transmitted disease , such as syphilis
- Having sex with anyone who has any of the HIV risk factors listed above
Talk to your health care provider about your risk for HIV and how often you should get tested for HIV.
Making Hiv Testing Routine
You might want to test more regularly than this, for example, if you are having sex with a new partner or feel you are more at risk. Groups who are more at risk are recommended to test more regularly. Testing every 3-6 months is often advised for men who have sex with men.
Testing regularly helps keep your mind at rest, and if you test positive, it means you can start treatment quickly, protecting your health.
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Should I Wait To Test For Hiv
They will be able to talk to you about your situation and help you decide what to do next. If you visit a healthcare professional within 72 hours of when you think you were exposed to HIV, you may be offered PEP . This is a course of emergency HIV treatment that can prevent HIV infection. It must be started within 72 hours and be taken properly.
Unfortunately, PEP isnt always available and healthcare providers may only give it to you if they feel youre at a high risk of HIV. If you take PEP youll need to test before and after to ensure it has worked.
If the time to take PEP has passed, then most modern HIV tests are now able to detect HIV from around four weeks after exposure. Depending on the type of test you are offered and when your risk was, your doctor may ask you to come back for further tests and a follow-up to check your results.
If you think you have been exposed to HIV, it is in this early stage of infection that you are most likely to pass HIV on to others. Be extra careful during this time use condoms and dont share injecting equipment.
What Is The Life Expectancy For People Living With Hiv In The Uk
A study published in 2014 looked at the outcomes of over 20,000 adults who started HIV treatment in the UK, between 2000 and 2010. The analysis didnt include people who inject drugs, who tend to have poorer outcomes than other people, but otherwise included a wide range of adults living with HIV.
The key finding was that people who had a good initial response to HIV treatment had a better life expectancy than people in the general population.
Specifically, a 35-year-old man who had a CD4 cell count over 350 and an undetectable viral load one year after starting HIV treatment could expect to live to the age of 81. A 50-year-old man with the same results after one year of treatment was predicted to live to the age of 83. In the general population at this time, men in these age groups were expected to live to 77 and 78 years.
A 35-year-old woman and a 50-year-old woman with the same results could expect to live to 83 and 85 years. This compares to 82 and 83 years in the general population.
“A person living with HIV has a similar life expectancy to an HIV-negative person providing they are diagnosed in good time, have good access to medical care, and are able to adhere to their HIV treatment.”
A 35-year-old man with any of those results could expect to live to 70-72 years. A 50-year-old man was predicted to live to 75-77 years. Women of the same ages could expect to live around two years longer than the men.
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Reasons To Get Tested
It’s also worth noting that concerns about STD incubation periods aren’t just for people who have unprotected sex. Although practicing safer sex can drastically reduce your stress levels and risk, it isn’t foolproof protection.
Condoms and other barriers can reduce the risk of diseases, but they can’t entirely prevent them. That’s why it’s a good idea to talk about testing and risk potential with new partners before you have sex.
What Happens During An Hiv Test
You will either get a blood test in a lab, or do your own test at home.
For a blood test in a lab:
- A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
For at home test, you will need to get a sample of saliva from your mouth or a drop of blood from your fingertip.
- The test kit will provide instructions on how to get your sample, package it, and send it to a lab.
- For a saliva test, you will use special spatula-like tool to take a swab from your mouth.
- For a fingertip antibody blood test, you will use a special tool to prick your finger and collect a sample of blood.
For more information on at-home testing, talk to your health care provider.
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Stages Of Hiv Infection
The stages of infection from person to person vary slightly, both in severity and the speed of progression. These stages map the depletion of immune cells as the body’s defenses further and further degrade.
With each progression, the risk of opportunistic infections increases until the immune system is said to be fully compromised. It is at this stage that the risk of illness and death is particularly high.
The stages of infection can be roughly classified as follows:
Hiv Testing Outside Of A Health Care Setting Or Lab
If you are tested outside of a health care setting or lab you will likely receive a rapid HIV test
- If the test comes back negative, and you havent had a possible exposure during the previous 3 months, you can be confident you dont have HIV.
- If your test result is positive, you should go to a health care provider to get follow-up testing. Counselors providing the test should be able to answer questions and provide referrals for follow-up testing as well. You can use the HIV.gov locator to find a provider near you.
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Why Do I Need An Hiv Test
The Centers for Disease Control and Prevention recommends that everyone between the ages of 13 and 64 get tested for HIV at least once as part of routine health care. You may also need an HIV test if you are at higher risk for infection. HIV is mainly spread through sexual contact and blood, so you may be at a higher risk for HIV if you:
- Are a man that has had sex with another man
- Have had sex with an HIV-infected partner
- Have had multiple sex partners
- Have injected drugs, such as heroin, or shared drug needles with someone else
HIV can spread from mother to child during birth and through breast milk, so if you are pregnant your doctor may order an HIV test. There are medicines you can take during pregnancy and delivery to greatly reduce your risk of spreading the disease to your baby.
Can You Have Hiv For 20 Years And Not Know
While its common for people with HIV to experience symptoms similar to the flu after a few weeks of the initial infection, some people may experience no symptoms at all during the early stages of HIV.
If a person with HIV goes undiagnosed and the virus develops into stage 2, HIV will continue to develop and may last for 10-15 years without the appropriate HIV testing and treatment . Its important to note that this stage can also bring with it little to no symptoms and people may not even feel sick.
The only way to know your HIV status is to get tested. This can be done by visiting your local HIV testing centre, your local doctor, or from home with an at-home lab test. Early detection is crucial to getting prompt treatment and going on to lead both a happy and healthy life.
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Understanding A Negative Result
What does a negative test result mean?
A negative result doesnt necessarily mean that you dont have HIV. This is due to the window period.
If you test again after the window period, have no possible HIV exposure during the window period, and the result comes back negative, you do not have HIV.
If you have certain risk factors, you should continue getting tested at least once a year. Learn more about who is at risk for HIV and why they should be tested more often.
If I have a negative result, does that mean my partner is HIV-negative also?
No. Your HIV test result reveals only your HIV status.
HIV is not necessarily transmitted every time you have sex or share needles, syringes, or other drug injection equipment. And the risk of getting HIV varies depending on the type of exposure or behavior. It is important to remember that taking an HIV test is not a way to find out if your partner has HIV.
Its important to be open with your partners and ask them to tell you their HIV status. But keep in mind that your partners may not know or may be wrong about their status, and some may not tell you if they have HIV even if they are aware of their status. Consider getting tested together so you can both know your HIV status and take steps to keep yourselves healthy.
Days To 20 Years After Exposure
The chronic stage of infection occurs once the immune system brings the virus under control. During this phase, HIV will go into hiding, where it resides in various cells and tissues throughout the body in a dormant state known as latency. HIV latency can persist without symptoms for 10 years or more, although some people may experience signs within a year or two.
During the early chronic phase, lymphadenopathy may be the only notable sign of an HIV infection. In some cases, the glands may be visibly enlarged and reach up to an inch or more in size. If the condition persists for more than three months, its referred to as persistent generalized lymphadenopathy .
Even during latency, the virus will multiple imperceptibly and gradually deplete immune cells known as CD4 T-cells. As immune deficiency develops, a number of nonspecific symptoms are likely to appear, including:
- Oral candidiasis , a fungal infection that causes the formation of creamy, white lesions on the sides of the tongue and lining of the mouth
- Unexplained fevers and drenching night sweats that soak through bedsheets and nightclothes
- Severe, uncontrolled diarrhea that lasts for more than three days
Each of these symptoms is commonly seen in persons with immune deficiency. They may, in some cases, be caused by HIV itself or by an infection that has yet to be diagnosed.
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