Results Reporting Critical Findings
Once HIV is diagnosed, it is essential to link patients who are HIV-positive to the care they need. The CDC uses the HIV care continuum to explain that only 30% of the 1 million adults living with HIV in the United States are in treatment, adhering to medication therapy, and achieving viral control. Data from 2011 shows that only 86% of HIV-positive adults are diagnosed, 40% are linked to a provider, 37% are prescribed antiretroviral therapy, and 30% adhere to the medications to achieve viral suppression. The care continuum is a motivating tool for healthcare providers to intervene at every level of HIV care to improve outcomes. HIV can be treated in a variety of settings including primary care, infectious disease specialty offices, federally qualified health centers, and specific HIV care centers. Every practice that screens for HIV should develop a relationship with a treating office and follow up with patients concerning their linkage to care.
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
Hiv Tests For Screening And Diagnosis
HIV tests are very accurate, but no test can detect the virus immediately after infection. How soon a test can detect HIV depends upon different factors, including the type of test being used. There are three types of HIV diagnostic tests: nucleic acid tests , antigen/antibody tests, and antibody tests.
An initial HIV test usually will either be an antigen/antibody test or an antibody test. If the initial HIV test is a rapid test or a self-test and it is positive, the individual should go to a health care provider to get follow-up testing. If the initial HIV test is a laboratory test and it is positive, the laboratory will usually conduct follow-up testing on the same blood sample as the initial test. Although HIV tests are generally very accurate, follow-up testing allows the health care provider to be sure the diagnosis is right.
Resources for FDA-approved laboratory tests, self-tests, and testing of self-collected samples are available. Learn more about testing in nonclinical settings and screening in clinical settings.
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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 any type 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 getting 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.
Who Should Be Tested For Hiv And How Frequently
It is recommended that the consideration of HIV testing be made a component of routine care. In general, care providers should take an active approach to HIV testing, offering HIV testing to clients whether or not clients have asked for a test. In the provision of routine medical care, and in discussion with the client, care providers should consider whether there is a benefit to an HIV test.
HIV testing is associated with several advantages:
- a negative test result is an opportunity for clients to take an active role in remaining HIV negative
- the early detection of HIV, especially at the acute stage, can improve outcomes for individuals and prevent further transmission of HIV
- detection at any stage of the disease, prior to wasting and dementia, is an opportunity to initiate lifesaving treatment and other related healthcare services
- opportunities arise for conversations with clients about risk-reduction strategies
2.1.1 Testing recommendations
An in-depth comprehensive HIV behavioural risk assessment is not a requirement for offering an HIV test. An assessment that the client understands how HIV is transmitted, the implications of testing , and how to interpret the test results is sufficient.
For occasions when clients may not be able to accurately estimate their risk, the guide includes more detailed guidance in Appendix B for conducting rapid risk assessments and a more detailed technical review of HIV transmission risks can be found in Appendix C.
2.1.2 Couples testing
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Reducing The Risk Of Hiv Transmission
The most effective way to prevent HIV transmission during sex is to use a condom. Get a condom ready before any sexual contact occurs, since HIV can be transmitted through pre-ejaculate, vaginal fluid, and from the anus.
Lubricants can also help reduce the risk of HIV transmission by helping to prevent anal or vaginal tears. The right lubricants also help prevent condoms from breaking. Only water-based lubricants should be used with condoms, because oil-based lube can weaken latex and sometimes cause condoms to break.
The use of a dental dam, a small plastic or latex sheet that prevents direct contact between the mouth and the vagina or anus during oral sex, is also effective at reducing the risk of HIV transmission.
For people who may have a higher risk for contracting HIV, preventive medication is an option. Pre-exposure prophylaxis medication is a daily antiretroviral treatment.
Everyone at increased risk of HIV should begin a PrEP regimen, according to a recent recommendation from the US Preventive Services Task Force. This includes anyone who is sexually active with more than one partner, or is in an ongoing relationship with someone whose HIV status is either positive or unknown.
Although PrEP does provide a high level of protection against HIV, its still best to use condoms as well. PrEP provides no protection against STIs other than HIV.
Whats Happening In My Body At The Beginning Of A Viral Infection
If SARS-CoV-2 does succeed in hijacking a cell’s machinery, then its well on its way to infection. This first period, where a virus is gathering materials for replication, then creating initial copies of itself and releasing those copies to infect cells on either side, is known in some virology circles as a latent period. Its a given amount of time where a virus is busy finding accessible, permissive cells and setting up infrastructure to replicate itself and is therefore undetectable.
In a lab, when you infect a cell line and look at what comes out, youll not see anything for a fixed amount of time, Lee says. Eight hours, 16 hours, then it crosses a critical threshold and starts going up. Once SARS-CoV-2 has established its first few cellular factories, things begin to move quickly. Viruses replicate exponentially, Lee says. Infecting two cells doesnt mean twice the amount of virus. It can mean 100 or 1,000 times the amount.
When it comes to most of the viruses in our body, this is usually the end of the story. Most of the time, we dont even know were infected with something, Messaoudi says. We do battle, we win, and the immune system cleans up the area. We go on as if nothing happened.
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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.
When Is It Ordered
Several organizations recommend routine screening for HIV:
- The Centers for Disease Control and the American College of Physicians recommend that anyone between the ages of 13 and 64 be screened for HIV at least once.
- The U.S. Preventive Services Task Force recommends anyone age 15 to 65 get at least a one-time test.
- The CDC, USPSTF and American College of Obstetricians and Gynecologists recommend that all pregnant women be screened. Repeat testing in the third trimester may be done for women at high risk. Some women may opt to get tested when planning a pregnancy .
- The American Academy of Pediatrics advises that all sexually active youth be screened, and that youths between 15 and 18 years old be offered HIV testing at least once, regardless of sexual history.
For additional details on screening recommendations, see the articles for Teens, Young Adults, Adults, and Adults 50 and Up.
Annual screening is advised for those who are at high risk for HIV and is recommended when you:
- Have unprotected sex with more than one partner since your last HIV test
- Are a man who has sex with another man
- The CDC says that your healthcare practitioners may consider more frequent screening for you, such as every 3 to 6 months.
You should get at least a one-time test, regardless of age, if you:
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Is Hiv Testing Confidential
If you test positive for HIV, your status becomes part of your private medical record and is protected by federal privacy laws. Your state may require your healthcare provider to report the infection to your state health department. State departments send results to the CDC without your personal identifiable information.
Some states have laws that require you or your healthcare provider to notify your partner of your HIV-positive status. In some states, if you dont report your status to your partner, you can be charged with a crime.
You can choose anonymous testing. Anonymous tests dont link the results to your information. The state health department still collects the statistics, but the results arent part of your medical record.
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.
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Where Can I Get Tested For Hiv
There are many places to get HIV testing, including local health departments, private doctors, hospitals and sites set up specifically to test for HIV. It is important find a testing site that offers HIV counseling as well as the test. HIV counselors can provide you with important information about the test, discuss your risks for HIV, answer your questions about your risk for HIV and how to protect yourself and others in the future. They also can provide information about other resources available in the area.
Some locations may have rapid tests that can tell if you are infected within 30 minutes, while in other locations it may take up to 2 weeks to get results. Check with the test site to find out what type of HIV tests they have.
Making Hiv Testing Routine
Its recommended that you test for HIV and other sexually transmitted infections at least once a year if youre having sex, even if you always use protection.
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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What Is The Window Period And How Does It Differ Between Tests
No test can detect HIV immediately after infection. The time between when a person is exposed to HIV and when an HIV test can tell they have HIV is called the window period. The window period can vary between two weeks and three months. The length of the window period varies from person to person and also depends on the type of test used. Some people develop markers of HIV infection that are detected by HIV tests slowly and some people develop them more rapidly. Once these markers of HIV infection are present in amounts that the test can detect, the window period is over.
If someone has had a recent exposure to HIV and gets tested for HIV during the window period, the test result may come back as negative even though the person actually has HIV. This would happen if their body has not started producing the markers of HIV infection at levels that are detectable by the test. When a test result is negative after a recent exposure to HIV, the person should be retested at the end of the window period to confirm they are HIV negative.
The most commonly used HIV tests in Canada detect different markers of HIV infection. Some look for HIV antibodies only, while another looks for both antibodies and the p24 antigen . All antibody tests in Canada can detect both HIV-1 and HIV-2.
The Geenius confirmatory assay can detect HIV infection in 50% of people by 33 days after exposure to HIV and in 99% of people by 58 days after exposure.
What About False Results
Some HIV tests have a very slight chance of giving you false results. A âfalse-positiveâ result means your test shows you have HIV when you donât. Tests may also give you a âfalse-negativeâ result. That means the test says you donât have HIV, but you do.
The rapid oral fluid test is more likely to give you a false-positive result than other tests. If you take a rapid oral test and get a positive result, the doctor will give you a blood test to confirm your diagnosis.
The HIV RNA or viral load test is not generally used to diagnose HIV. If you have this test done and get a positive result, the doctor may start you on HIV treatment, but you should always take an antibody test a few months later to confirm your diagnosis.
If you test positive: These tests are all screening tests for HIV. That means that if you take an HIV test and get a positive or even an unclear result, youâll need another blood test to confirm that you do or donât have the virus. The results of both tests together are more than 99% accurate. The tests used to confirm HIV infection are either the Western blot or indirect fluorescent antibody test. If your screening test went to a laboratory, they can do this additional testing on the same blood sample. But if you were tested in a community clinic or at home, youâll need to give an additional blood sample for follow-up.
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How Healthcare Providers Can Facilitate Hiv Screening
Healthcare providers should take an active approach to HIV screening, as earlier diagnosis and treatment leads to better health outcomes. Individuals with positive results should be linked to treatment and care. Those with negative results may benefit from counselling on risk reduction and prevention measures.
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 youre sexually active or use needles to inject drugs, continue to take actions to prevent HIV, like taking medicines to prevent HIV if youre at high risk.
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.
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