When To Test For Hiv

What Happens If The Result Is Positive

The process can vary across the country but, generally speaking, when a test reveals that the individual is HIV positive, the post-test counselling is extensive . Typically, a provider gives a person time to absorb the results, discusses the impact of the positive test result, and provides the opportunity for the person to ask questions. Post-test counselling following a positive diagnosis usually includes support and extensive discussion and comprehensive linkage to other services, including HIV care.

If a rapid point-of-care test indicates a reactive result, the person is informed of the result and, after obtaining informed consent, the counsellor draws a blood sample, which is sent to a laboratory for confirmatory testing. The person is given post-test counselling immediately after receiving a reactive result and again when returning to pick up the result of the confirmatory test one to two weeks later.

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.

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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What Role Can Service Providers Play In Encouraging The Uptake Of Self

Although self-tests are intended for use by someone on their own, service providers can do a number of things to encourage and support self-testing, including improving awareness of self-testing through educational efforts.

For some people, the cost of a self-test is a barrier to accessing it. If it is feasible, service providers can try to work with partners to provide access to free tests for their community members. Research from other jurisdictions shows that initiatives that allow people to order a free test online can help to reach people who do not test as often as guidelines recommend. Research also shows that efforts to provide clients with tests to distribute to their personal contacts can help to reach first-time testers.

Some organizations may choose to allow people to take a self-test within their facilities . This may be a good option for people who would benefit from support before and after they take the test. However, service providers should not do the test on a client or interpret the results for them. This is because self-tests are only licensed for a person to perform on themselves. Service providers can help the tester to understand the instructions, which include how to do the test and how to interpret the results.

Related resources

Free HIV self-testing: Best practices, positivity rates, and associated costs Ontario HIV Treatment Network

References

Harrigan M

Terms And Technologies Used In Hiv Testing

This section provides detailed definitions and descriptions of the terms and technologies used in HIV testing.

4.2.1 Algorithms

Algorithms for HIV testing have been developed to ensure optimal sensitivity while preserving specificity by confirming reactive results as antibody-positive. The test sequence starts with the most sensitive screening test to identify all those with antibodies. A confirmatory assay is then performed only on the samples that tested reactive/positive on the initial screening test. This ensures that the screen test reaction is due to detection of HIV antibodies rather than a non-specific reaction. In the case of indeterminate or inconclusive results, additional supplementary testing may be necessary to determine if someone is infected with HIV. Each laboratory develops and validates its own algorithm to ensure that it provides the most accurate results possible. The positive predictive value and negative predictive value of a validated algorithm are close to 100%.

A typical laboratory testing algorithm follows:

Figure 3: Laboratory Testing Algorithm

A typical laboratory testing algorithm starts by screening with an enzyme immune assay test. If the EIA is non-reactive, then no HIV infection is present and no further testing is done.

If the initial EIA is reactive, then the EIA test should be repeated two additional times. If neither of the additional EIA tests is reactive, then the test is considered non-reactive, with no evidence of HIV infection.

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When Should I Test For Hiv

According to the Centers for Disease Control and Prevention , everyone between the age of 13 and 64 years should get tested for human immunodeficiency virus at least once in their lifetime, and more often for those at higher risk. HIV testing is very important for individuals who are sexually active, particularly those who have multiple partners.

Regardless of your background, here are common reasons to consider for HIV screening:

• If you recently had unprotected sex with a new partner, its a good idea for both partners to get tested for sexually transmitted diseases, including HIV.

• The CDC recommends that every pregnant woman must be screened for HIV.

• You should get tested before starting post-exposure prophylaxis in cases of sexual assault and occupational needle prick injuries.

• You should get tested after completing PEP.

• You should get tested quarterly while taking pre-exposure prophylaxis .

Certain groups of people are considered at a higher risk of HIV exposure and, therefore, should be tested for HIV at least once a year. These include:

• People who have unprotected intercourse with multiple sexual partners, or who have unprotected intercourse with someone who has multiple sexual partners.

• Sexual partners of people who are HIV-positive.

• People who inject drugs intravenously or use shared needles, and their sexual partners.

• People who already have tuberculosis or hepatitis.

HIV tests are strongly recommended for:

Standard testing:

Hiv And Health Insurance Among Black People

Despite increased access to healthcare under the Affordable Care Act, 1 of every 9 Black people is without insurance. Black trans people, especially Black trans women, often experience hostility in health settings. Black transmasculine people are often excluded from HIV discourse despite testing positive at higher rates in comparison to the general population.

Poor community access to health insurance, provider hostility, and lack of provider knowledge about trans communities may increase a person’s likelihood of testing HIV-positive. Among Black MSM, the lack of insurance increases the risk of HIV by 2.5 times compared to those who have insurance.

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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.

How Long Does It Take To See The Signs Of Hiv

The signs and symptoms of HIV may first appear within two to four weeks of infection. The stage in which the symptoms appear is called the stage of acute HIV infection. The symptoms appear due to the resistance or fight of the immune system against HIV. In the initial stage, the virus multiplies rapidly and spreads throughout the body. It targets and destroys the CD4 cells . As a result, the level of HIV in the blood and the chances of transmission at this stage are very high. It is crucial to recognize the early signs and seek medical help, since early diagnosis and treatment of HIV gets the best results.

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What Types Of Tests Diagnose Hiv

To diagnose HIV, healthcare providers can order any of three tests:

• Nucleic acid test: The NAT test looks for the virus in your blood. It is a thorough laboratory test but can be costly. The results can take several days to receive.
• Antigen/antibody test: This test looks for antibodies and antigens to HIV in your blood. Your immune system forms antibodies when it comes in contact with viruses, such as HIV. Antigens, however, are foreign substances that activate your immune system. HIV has a particular antigen that this test can find. This rapid test uses a drop of blood from a finger prick and can give you results in roughly 30 minutes.
• HIV antibody test: This test is similar to the antigen/antibody test, but it only looks for the antibody. Just like the antigen/antibody test, this test produces results in around 30 minutes. It uses either a drop of blood from a finger prick or a swab of saliva.

Some states allow for home testing. There are two types of home tests:

• Rapid self-test: The only rapid self-test available in the United States uses a saliva sample to check for infection. After you receive your kit, you swab your gums and use the test kit to get results.
• Mail-in self-test: This test uses a blood sample from a simple finger prick. All of the supplies are in the kit to help you take the sample, package it and send it to the lab. A healthcare provider will tell you the results.

Side Effects Of Hiv Treatment

People on current HIV treatments may experience mild side effects including:

• tiredness and fatigue
• skin rashes.

If you are on treatment, see your doctor every 3 to 6 months.

Regular blood tests are necessary to make sure your treatment is working and not causing serious side effects. It is recommended that you also get tested for STIs and talk to your doctor about your sexual health and overall wellbeing. Ensure you are having routine screening for cancers and keeping your vaccinations up to date.

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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 .

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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Clinical Indications For Hiv Testing

Individuals requesting an HIV test.

Individuals with symptoms and signs of HIV infection.

Individuals with illnesses associated with a weakened immune system or a diagnosis of tuberculosis.

Unprotected anal or vaginal intercourse or use of shared drug equipment with a partner whose HIV status is known to be positive.

Pregnant or planning a pregnancy and their partners as appropriate.

Victims of sexual assault.

What Are The Types Of Hiv Tests

There are three types of tests used to diagnose HIV infection: antibody tests, antigen/antibody tests, and nucleic acid tests . Your health care provider can determine the appropriate HIV test for you. How soon each test can detect HIV infection differs, because each test has a different window period. The window period is the time between when a person may have been exposed to HIV and when a test can accurately detect HIV infection.

• Antibody tests check for HIV antibodies in blood or oral fluid. HIV antibodies are disease-fighting proteins that the body produces in response to HIV infection. Most rapid tests and home use tests are antibody tests.
• Antigen/antibody tests can detect both HIV antibodies and HIV antigens in the blood.
• NATs look for HIV in the blood.

A persons initial HIV test will usually be either an antibody test or an antigen/antibody test. NATs are very expensive and not routinely used for HIV screening unless the person had a high-risk exposure or a possible exposure with early symptoms of HIV infection.

When an HIV test is positive, a follow-up test will be conducted. Sometimes people will need to visit a health care provider to take a follow-up test. Other times, the follow-up test may be performed in a lab using the same blood sample that was provided for the first test. A positive follow-up test confirms that a person has HIV.

Talk to your health care provider about your HIV risk factors and the best type of HIV test for you.

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What Are The Signs And Symptoms Of Hiv

The most common symptoms of HIV in men & women include

• Headache
• Persistent headache
• Pneumonia

Though the symptoms of HIV do not show initially, the virus maintains a low profile and keeps manipulating and damaging the CD4 immune cells. Some people may experience the symptoms after 14 days or later and some may not notice the symptoms even for years. So, it is highly recommendable to get tested for HIV RNA if you experience the above symptoms and having multiple sex partners.

What Happens After A Positive Hiv Test

After a client receives a positive HIV test result, the result is reported to public health. A positive result initiates a series of processes to support the care of the client, to identify recent partners who may benefit from testing, and to prevent onward transmission.

Public Health notification

HIV is a reportable, or notifiable, illness in all Canadian provinces and territories except for Quebec1. This means that when an HIV infection is confirmed by a clinic, doctor or laboratory, it is reported to public health authorities . Each province and territory has public health laws that stipulate specific requirements for reporting HIV diagnoses. HIV is a reportable disease because it is considered to be of significant importance to public health.

The amount of information collected and shared with public health varies according to each province or territory. However, all provinces and territories provide non-nominal data on positive tests to the Public Health Agency of Canada, which facilitates the production of national-level reports on the state of the HIV epidemic in Canada.

Partner notification

HIV partner notification, or contact tracing, is the practice of identifying, locating and informing someone that a partner they have had sex or used drugs with has been diagnosed with HIV. Contact tracing is meant to encourage the partners to test for HIV to identify new HIV infections as early as possible.

Linkage to prevention and care

Acknowledgement

Resources

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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.

Is There Anything Else I Should Know About Being Tested For Hiv

The decision to take the test and then wait for the results can be very stressful. If your test result is HIV-positive, you will have many decisions to make.

Even though it is stressful, you need this information to decide what is best for you and your family. Be reassured that there is support available if you find out you are HIV-positive during your pregnancy.

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