Category: HIV & AIDS

The human immunodeficiency virus (HIV), the virus that causes the acquired immunodeficiency syndrome (AIDS), cannot be detected except through a laboratory test. People can carry the virus without having symptoms. You should be tested for antibodies to HIV in the following circumstances: if you know or suspect that you’ve been with a sexual partner who has HIV; if you have unprotected vaginal, anal or oral sex with anonymous partners, multiple partners or men who have sex with other men; or if you are an intravenous drug user. To be tested for HIV you have two options. You can go to a clinic or medical facility. Or you can take an at-home test and send it anonymously to a laboratory for results.

Things You’ll Need

• HIV-1 Test System (optional)

• Decide which testing service you will use for your HIV test—an at-home test or a clinical testing center.

• Purchase the at-home test if you choose this option. The FDA has approved only one at-home test kit, the Home Access® HIV-1 Test System. Follow the instructions that come with the kit. You must make a pre-test phone call to a Home Access counselor in order to register the kit and receive your anonymous code number. A simple, quick finger-stick is required to draw blood for a testing sample. Mail the test as directed. You’re responsible for calling Home Access to get your results using the code number.

• Make an appointment at a local clinic if that’s your choice. Call CDC-INFO at (800) 232-4636 for the HIV test site nearest you. Most clinics conduct HIV tests anonymously.

• Arrive at the appointed time for your in-person appointment. Fill out all paperwork as requested and allow the technician to draw your sample. You may be tested using a sample of blood, oral fluid or urine.

• Wait for the results of your HIV test. Some clinics may use a quick-response test that provides a response while you wait. Results from other types of testing can take up to a week to be returned. If you’re concerned about the time frame, ask what testing methods are available when making your appointment at the clinic. Quick-response tests may use blood or oral fluid as test samples and may not be available at all clinics. At-home testing kits don’t provide quick-response tests.

• Get retested if you test positive for HIV antibodies. A clinic will always ask to conduct a second test to verify the results. Follow the instructions provided by the clinician handling your visit. At-home testing counselors will assist you with local referrals for a second test. Pre-test and post-test counseling are available with an at-home test kit.

• Continue the fight against HIV, even if your test results are negative. Practice safe sex. This includes using a latex or vinyl condom or dental barrier when having anal, vaginal or oral sex. If you use intravenous drugs, don’t share or reuse needles. If you have multiple sex partners or other risk factors, you should be tested for HIV yearly.

Tips & Warnings

• Testing positive is not a death sentence. See a health-care provider who has experience treating people with HIV. Anti-viral treatments now available allow for a long and healthy life. If you feel well now, maintaining your health can help you to fight this virus.
  If you test negative for HIV that does not mean your partner or partners are negative.
  Whether or not you test positive for HIV, practicing safe sex, including using latex condoms, helps to protect you and others from further STDs.
  End substance abuse of any kind as it can weaken your immune response.

• Stop having unprotected sex if you test positive for HIV.
  Stop sharing or reusing needles if you’re an IV drug user.

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The human immunodeficiency virus (HIV) is the virus that causes AIDS (acquired immunodeficiency syndrome). HIV is transmitted in blood, semen, vaginal fluids and breast milk. HIV attacks the body’s immune system and makes it harder for someone to fight off infections. AIDS is the most advanced stage of HIV infection, where the body has been the most affected by the virus and is less able to battle infections.

Development of AIDS

• It takes the body up to 10 years or more to develop AIDS; with current treatments, this time frame is believed to be increasing. The onset of AIDS is the first time many people notice symptoms of the HIV infection. During this incubation period, HIV is destroying the body’s T-cells (cells that fight off infection in the body). A person is still able to transmit HIV to others before an AIDS diagnosis.

AIDS Diagnosis

• Patients can be diagnosed with AIDS if they develop one or more of several infections, cancers, or if they have less than 200 T-cells. It is possible with treatment to recover from these infections and diseases and raise T-cell counts. However, once an AIDS diagnosis has been made, it is not reversed.

Testing

• Since many people can go years without experiencing symptoms from HIV, it is important to get tested regularly if you could be at risk for infection. Testing can be done on blood, urine or by an oral swab. It is possible to be infected with HIV and have a test come back negative, depending on the test and how soon after infection you are tested. If you receive a negative test, you should be sure to get re-tested at least six months after exposure to ensure seroconversion (change in the body to having a response to the infection) has completed.

Treatment

• There are many treatments available for people with HIV/AIDS that can keep people healthier longer. It is important to be on treatment when you are diagnosed with HIV, even before being diagnosed with AIDS. Getting into treatment right away and taking care of your health are the best ways to fight the disease, stay healthy for as long as possible and delay the onset of AIDS.

Prevention

• Since HIV is transmitted in blood, breast milk, semen and vaginal fluids, the best way to prevent infection is to avoid coming into contact with these fluids. If you are an injection drug user, you should not share needles or works with anyone else, and you should disinfect your needles and works before and after each use. You should not engage in oral, anal or vaginal sex. If you are sexually active, you can reduce your risk by reducing your number of partners and using a latex or polyurethane condom or barrier with each sex act. Pregnant women should speak with their doctors about the best way to reduce the risk of transmission to their baby and should not breast-feed.

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According to avert.org, more than one million Americans are living with HIV today, and more than half of these are not aware that they are infected. The special nature of HIV, wherein a long phase of the infection is asymptomatic, makes this possible, and it is therefore important to take active steps to know your HIV status.

Things You’ll Need

• HIV testing appointment

Knowing your status

• Be regularly screened for HIV. After infection, some people will experience brief flu-like symptoms, but many people do not develop symptoms until their HIV has advanced to AIDS, the point at which the immune system can no longer effectively combat infection.

• Visit a local testing center to be tested if you think you may have been exposed to HIV. Most people develop a detectable level of antibodies to HIV within a month after infection, but it can sometimes take up to six months, so it is important to be re-screened within three to six months after possible exposure.

• Follow through on further recommended testing. A test performed before antibodies to HIV develop will return a false negative. There is also a possibility of a false-positive result, which is why all initial positives are re-screened with a more sensitive test.

Tips & Warnings

• Visit hivtest.org to find a testing site near you. This website includes which sites offer free and anonymous services.
  Use the information provided by HIV counselors to help reduce your risk of infection in the future.

• Do not assume you can tell whether you or someone else is HIV-positive. The asymptomatic latent period of HIV infection leaves no physical indications, so neither you nor anyone else can tell whether infection is present just by looking. The only definite way to know is to be tested.

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Understanding the process of HIV seroconversion and the symptoms are key factors in early detection and treatment of HIV infection. This article will first explain what seroconversion is, and then outline the symptoms of seroconversion. If you are exposed to HIV and exhibit any of these symptoms within the first 2-6 weeks of exposure, visit your doctor immediately.

Understanding Seroconversion

• Seroconversion describes the process of the body’s immune response to either infection or immunization. When the immune system detects an antigen (virus, bacteria, toxins, etc.), antibodies are made and can be detected in blood tests. This process of creating detectable antibodies to a specific antigen is called seroconversion. In HIV specifically, individuals are considered seropositive when HIV antibodies are detectable in blood tests.

HIV Seroconversion: Acute Infection Phase

• For two weeks to three months after exposure to HIV, individuals may experience what is considered the acute infection phase. This is the time during which seroconversion occurs. The body is recognizing the HIV virus and producing antibodies to try to fight the infection. The immune system becomes overwhelmed, and physical symptoms develop. Often, the symptoms are manageable, although some individuals may required medical treatment and even hospitalization. By the end of the acute infection phase, the body has generally produced enough antibodies to be detected in a routine HIV test. At this point, a positive HIV antibody test results in the diagnosis of HIV infection.

Symptoms of HIV Seroconversion

• The symptoms of acute HIV infection (seroconversion) are similar to the flu or mononucleosis. Individuals may experience headache, aching muscles, fatigue and fever. Symptoms may also include nausea, vomiting and diarrhea. In some cases, a sore throat, mouth ulcers and a rash may also be present. In almost all acute infection phases, the lymph nodes will be swollen as a result of the body’s immune response to the introduction of HIV.

Confirming Seroconversion

• The only reliable and definitive way to confirm HIV seroconversion is through a blood test. An HIV test may not give reliable results after exposure for up to six months, so it’s important to retest within six months of exposure. Additionally, the Centers for Disease Control recommends annual testing for individuals at high risk of HIV infection.

Treatment During Seroconversion

• If HIV infection can be detected during the seroconversion phase, immediate and aggressive anti-retroviral therapy (ART) has been shown to be effective in significantly reducing viral loads, sometimes to undetectable levels. While ART therapy may be effective at all stages of HIV/AIDS disease progression, it is particularly effective during the seroconversion period, so an understanding and recognizing of symptoms of HIV seroconversion becomes even more critical.

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Serostatus is a word used to describe whether particular antibodies are present in the body. Seropositive means someone does have the antibodies being tested for, seronegative means they do not. If someone is seropositive for HIV (the Human Immunodeficiency Virus), it means their body has been producing antibodies for HIV, which can be detected with an HIV antibody test, the most common type of HIV test used.

Seroconversion

• Seroconversion is the point at which the body changes from being seronegative to seropositive. Once the virus is in the body, the immune system will begin producing antibodies. It takes most people two to eight weeks to seroconvert; though, for a few people, it can take up to six months—this is called “the window period.” If an HIV antibody test is done before seroconversion, it can come back negative. It is possible to transmit HIV to another person even before seroconversion takes place. During the seroconversion process, a person may experience flu-like symptoms.

Serodiscordance

• If two people in a relationship, sexual or romantic, have different HIV statuses, they are referred to as serodiscordant. If two partners have the same status, they are referred to as seroconcordant. Serodiscordant couples can take steps to reduce, but not eliminate the risk of transmitted HIV to the uninfected partner. If both partners are infected, they should also take steps to reduce the risk of re-infecting each other and passing new strains to each other.

Risk of Transmission in Pregnancy

• The CDC currently recommends that all pregnant women be tested for HIV. If a woman has HIV, she can still become pregnant and give birth. It is possible for a woman to transmit HIV to her baby during pregnancy or delivery, or by breast feeding, but current HIV treatments have greatly reduced the risk of transmission in pregnancy and delivery to approximately two percent. If you are pregnant, it is important to see your doctor regularly.

Transmission Prior to Pregnancy

• For serodiscordant couples, where the male partner is HIV positive and the female partner is not, it is possible to reduce the risk of transmission while still conceiving a child. The Bedford Research Foundation Clinical Laboratory offers the Special Program of Assisted Reproduction. This process takes semen samples with undetectable amounts of the HIV virus, “washes” them, and then uses the semen for in-vitro fertilization (IVF).

Prevention

• The best way to reduce your risk of getting HIV is by abstaining from all oral, anal or vaginal sex or any sexual activity where blood, semen or vaginal fluids could be exchanged. If you do engage in sexual activity, you can reduce your risk by using latex or polyurethane condoms or barriers each time you have sex. If you use injection drugs of any kind, you should not share needles or “works” and should always disinfect your needles. Remember that HIV is transmitted through blood, semen, vaginal fluids and breast milk. To reduce your risk of HIV infection, you should avoid contact with these fluids.

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HIV is the virus that causes AIDS. AIDS is a series of opportunistic infections that occur when the immune system is weakened by the HIV virus. HIV is a blood-borne pathogen and is transmitted through the exchange of bodily fluids, specifically, blood and semen. The most common routes of transmission are unprotected sex with an infected person and exposure to infected blood and blood products, where the blood comes in contact with broken skin. There is no cure for HIV or AIDS, so prevention is the best course of action.

• Use barrier protection consistently and every time. Barrier methods, like condoms and dental dams, provide a large measure of protection from transmission by preventing direct contact with semen and blood. Condoms and dental dams should be made of latex. Natural materials, like lambskin, are porous and will not prevent the virus from passing through.

• Reduce the number of sexual partners. The higher the number of partners, the greater the risk of transmission.

• Get tested. With HIV, ignorance is not bliss. Sex is the most common method of HIV/AIDS transmission and it’s not possible to tell, at a glance, if someone is HIV positive. Testing confirms HIV status and reduces the risk of transmission. Testing, however, does not replace safe-sex practices, especially with new partners.

• Use clean and sterile needles. Whether for medical or recreational purposes, intravenous drug users need to be certain that they do not share needles with anyone and that they use sterile needles each time.

• Clearly label and properly dispose of sharps. Health care professionals are at great risk because they come into contact with bodily fluids and needles and other sharp objects. Sharps need to be handled carefully and immediately placed in specially marked, puncture-proof containers after use.

• Use personal protective gear. Health care practitioners (and those who live with people with AIDS or are HIV positive) should use gloves, face masks and shields; and cover any areas of broken skin when handling blood or items that come in contact with an infected person’s blood or fluids.

Tips & Warnings

• While HIV is present in small amounts, such as in saliva and sweat, danger of infection from these fluids is low.

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HIV disease continues to spread worldwide. It is important that we are aware of its characteristics, including the markers of infection. Before entering an intimate relationship, HIV knowledge and understanding is essential to remain disease-free. One of the primary terms to describe an established HIV infection is “HIV positive,” but “HIV negative” does not necessarily mean no infection is present. The following will explore just what these two terms really mean.

Facts

• First, it is necessary to define the difference between HIV exposure and HIV infection. Exposure simply means that an individual has been exposed to the HIV virus. It does not necessarily mean that the individual will become infected with the virus, although continued exposures increase the chances of infection.

  When infection occurs, the body will recognize the invader and fight back. The body’s infection response mechanism produces antibodies to fight the virus, and it is the presence of these antibodies that confirms that an individual has been infected. The presence of HIV-specific antibodies in an individual’s blood then defines that person as “HIV positive,” meaning he also carries the HIV virus, and he can spread it to other people. “HIV negative” means the body has not produced antibodies to the virus.

Considerations

• When an individual is HIV negative, it usually means the person is disease-free. However, there is one exception. Once an HIV infection is established, it takes the body up to six weeks to produce antibodies to the virus. It is possible for an individual to be HIV negative with an active infection if that infection occurred within a few weeks, and the body has not yet produced antibodies.

How Do I Know My Status?

• An HIV status–positive or negative–is easy to determine, and it involves a simple blood test. Results are usually available in a few days. There is also an oral test, which involves no needles. The technician simply swabs the cheek tissue, which is painless. Results are available in as little as 20 minutes.

Benefits

• Knowing your status–and the status of your sexual partner–is important to avoid infection. Safer sex with the use of a condom becomes essential with an individual who is HIV positive or with someone where the status is not known.

Misconceptions

• Being HIV positive does not mean an individual is outwardly sick; he may appear to be perfectly healthy. Without an HIV antibody test, he may not even know he carries the virus and can spread it to others. Only a test will verify a status. HIV transmits via semen, vaginal fluids and blood. It is not spread through saliva and sweat. Besides sex, the most common transmission vehicle is shared needles.

Prevention

• HIV status knowledge is the key to preventing the spread of HIV disease and to preventing illness with those that already have been infected. Although there is no cure yet, promising therapies have delayed the onset of serious disease.

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Many people undergo HIV testing to see if they have this disease. When the test comes back positive, another test is performed immediately to assure that a false positive did not occur. If the second more specific test comes back positive then the person is most likely infected. If it comes back negative, then, most likely, the first test was a false positive.

Facts

• Many factors may cause false positive HIV tests (see References). The general screening test for HIV uses a protein-based solution that seeks out the target. However, many times other processes going on in the body may release antibodies that fool the protein into thinking it found its target. For example, if one has certain conditions such as tuberculosis, malaria or rheumatoid arthritis or if one is taking certain antibodies such as a flu vaccination, then any of these factors may cause a false positive. The test solution changes to the color for positive because of the antibody present in the blood from the condition of the person.

Interpretation

• Another cause of a false positive is the guidelines of the test itself. Since there is no standardization in the testing procedure, different drug companies may interpret the results differently. In addition, different parts of the world interpret the tests differently (see References). These different interpretations can yield a positive result from one source and a negative from another–even if they were both looking at the same sample.

Time Frame

• If a person has the HIV virus, then it is imperative to seek treatment as soon as one knows of this condition. However, do not seek treatment for HIV if you have only had the general screening test, because this could have a false positive. Take the second specific test immediately after the first positive to confirm presence of the HIV or to determine if the first test is a false positive.

Types

• There are two common types of testing for HIV. The general first-screening test, called Enzyme-Linked Immunosorbent Assay test, or ELISA, targets a specific subject and yields a positive if it finds the target. Western Blot tests are specific tests geared to confirming the ELISA positive test. This test detects viral components specific to HIV and sends back a positive if this detected. It is possible to get false positives with both of these tests.

Warning

• When a person receives a positive result for HIV, he should immediately seek a second test called the Western Blot test. This is a specific test for the HIV virus, and if it is also positive then the person is most likely infected. The tests may be wrong even if you have two positives, so report to a health care provider for proper treatment and further testing if you do receive a positive HIV test.

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Occasionally, an HIV test will come back “inconclusive.” While this is not necessarily cause for alarm, it is always advisable that an individual with an indeterminate test result follow the appropriate protocol to achieve a conclusive HIV status.

Causes of Inconclusive HIV Tests

• An inconclusive result might mean that there was a problem with a blood sample that prevented it from being tested. Alternately, it could also mean that even though the test was completed using the sample, it yielded neither a positive or negative result. If this is the case, an infected individual who is tested could be in the process of what is known as “seroconverting,” the time in which one is actively becoming HIV positive. Therefore, achieving an accurate response is not possible. Alternately, an individual might have an underlying viral infection or certain antibodies that cause an inconclusive result.

What to Do When Tests are Inconclusive

• Dr. Oliver Bacon of the University of California-San Francisco’s Positive Health Program poses that the best thing to do would be to repeat the test (if the individual used a home HIV testing kit). However, if the new test yielded a negative result, there may be confusion as to which test was accurate. Bacon poses that another solution would be to go to a free testing clinic and inform counselors of the indeterminate result. More thorough testing might be required, such as the RNA test or a p24 antigen test.

RNA Testing

• RNA testing is done through polymerase chain reaction (PCR) tests and involves assessing a blood sample to determine if genetic material has been produced by the HIV virus. However, these tests may come back false-negative or false-positive if the individual has been infected within five days. RNA testing is typically used to assess the condition of those already infected with HIV.

P24 Antigen Tests

• The p24 antigen test is also a more thorough HIV screening and can identify HIV proteins in the blood from one week to four weeks after an individual is infected.

Why Traditional HIV Testing is Thorough

• The enzyme-linked immunosorbent assay (ELISA) test is done by drawing a blood sample from a vein. If an initial test comes back with HIV antibodies, the test is repeated. If the second test is positive, the Western blot test is used to confirm findings of HIV protein in the blood. This last measure is extremely necessary as sometimes non-HIV antibodies may yield a false-positive result. Traditional HIV testing takes around two weeks.

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Blood antibody detection is the most common HIV test. A blood sample is collected in a doctor’s office, lab or hospital, or by using a home collection kit. The sample is tested in a lab for the presence of HIV antibodies.

Early Testing

• The length of time it takes for the immune system to develop HIV antibodies varies from person to person. Early testing is advised in order to begin treatment as soon as possible if testing yields a positive result.

Window Period

• The “window period,” or the time it takes for antibodies to develop, usually ranges from 2 to 8 weeks following exposure. The average is 25 days, though some individuals will take longer to produce detectable antibodies.

Repeat Testing

• Following exposure, 97 percent of people will develop HIV antibodies during the first 3 months. As there have been cases of development taking up to 6 months, persons testing negative in the first 3 months are urged to repeat the test.

False Positives

• Repeat testing after 6 months can also eliminate the possibility of a rare false-positive result.

RNA Testing

• A ribonucleic acid (RNA) blood test can detect the HIV virus directly within 9 to 11 days of infection. As of May 2009, RNA tests are more costly than the antibody-detection method and not in widespread use.

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