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HIV Test- An Overview

What is HIV?

HIV or human immunodeficiency virus is a type of virus that is spread through blood, sexual contact or from mother to child during pregnancy or childbirth. HIV can also be transmitted through the exchange of a variety of blood fluids from infected people such as blood, semen or even vaginal secretions. However, individuals cannot be infected through physical contact like kissing or shaking hands. HIV attacks the body’s immune system. If HIV is not treated on time, it can lead to AIDS which is Acquired Immuno Deficiency Syndrome and that can be fatal. Learning the basics about HIV and testing can keep one healthy and prevent transmission.

How to know if one is HIV positive?

HIV is a sexually transmitted infection. The most common way for someone to get infected is through sexual activity or the exchange of bodily fluids can also cause HIV. The only way an individual can find out is through a test. Some people might face flu-like symptoms after infection with HIV. This phase is called acute HIV infection. Other symptoms include fever sore throat and even rashes.

How HIV can be tested?

HIV can be diagnosed through rapid tests. Rapid tests provide same-day results. HIV tests are generally original and accurate. But the main issue is no test can detect the virus immediately after infection is caused in the body. No single test can provide a full HIV diagnosis. Confirmatory testing is required which is conducted by a qualified and trained health worker at a community centre or clinic. HIV infection can be also be detected with great accuracy using WHO prequalified tests within a nationally approved testing strategy. The accurate result of the test depends upon different factors and the type of test one opts for. HIV tests are ideally performed on drops of blood or oral fluids. They can also be performed on urine.

Most proven HIV diagnostic tests detect antibodies produced by the infected person as part of their immune system’s response to fight HIV. In those cases, infected people develop antibodies to HIV within 28 days of exposure. During this time, people experience the ‘window period’. The window period is when HIV antibodies haven’t been produced in high enough levels to be detected and when they may have had no signs of HIV infection but have the capacity to transmit HIV to others. After infection, an individual may transmit HIV to a sexual, drug-sharing partner or for pregnant women to their infant during pregnancy or the breastfeeding period.

While testing for adolescents has been made simple and efficient, this is not the case for babies born to HIV-positive mothers. The serological test is not sufficient to identify HIV infection for children less than 18 months of age. In that case, virological testing must be provided as early as birth or at 6 weeks of age. New technologies are now becoming available to perform this test at the point of care and enable same-day accurate results which accelerate appropriate treatment and care.

What are the types of HIV tests?

There are mainly three types of HIV diagnostic tests one can go for. They are :

· Nucleic Acid Tests (NAT)

· Antigen/antibody Tests, and

· Antibody Tests.

Nucleic Acid Tests (NAT)

The NAT test looks for the virus in the blood. It tests the actual virus that is present in the body through veins. Nucleic acid tests provide typically accurate results. HIV test accuracy depends on several factors, but however, this test can either determine if a person is HIV positive or perceive how much virus is present in the blood. This is called an HIV viral load test. NAT detects HIV infection approximately up to 10 to 33 days after exposure. Though NAT is safer and can detect HIV sooner than the other types of tests, NAT is very expensive and not regularly used for screening individuals. Until and unless the infected person recently had a high-risk exposure or have early symptoms of HIV infection, NAT tests can be set aside.

Antigen/antibody Tests

An antigen/antibody test detects the HIV antibodies and antigens of an infected person. When a healthy person is exposed to the HIV virus, the antibodies are produced by the immune system of the body. Antigens activate the immune system and if someone is HIV positive, an antigen named p24 gets activated before the antibodies. Antigen/antibody tests are recommended for testing done in labs and the test involves drawing blood from a vein. After exposure, the antigen/antibody test can detect infection 18 to 45 days if performed in a lab. If the sample is from a finger prick, the time frame is 18 to 90 days after the exposure.

Antibody Tests

HIV antibody tests are done to detect the antibodies of HIV in an infected person’s blood or oral fluid. The antibody tests using blood detects HIV sooner rather than oral fluid. Mostly rapid tests and the ones FDA has approved HIV self-test are the antibody tests. HIV antibody tests usually take 23 to 90 days to detect the infection after exposure. But antibody tests can be rapid too that produces results in around 30 minutes through saliva or a drop of blood, unlike antigen/antibody tests.

Although these three tests are prevalent all over the world, People can also use HIV self-tests to test themselves. Some states also allow for home testing of HIV.

There are two types of home tests:

Rapid self-test and

Mail-in self-test

Rapid self-test: Rapid self-test is only available in the US. This test is done using a saliva sample to check the infection. The kit is received in one’s home and once it is received, an individual can swab the gums and use the test kit to get rapid results.

Mail-in self-test: Mail-in self-test is done using a blood sample from a simple finger prick. All of the supplies are provided in the kit to help an individual take the sample, package it and send it to the lab. A healthcare provider notifies the results to the individuals.

Results of HIV test

The result can be both positive and negative. Doctors can go for a variety of tests in sequence until and unless they determine for certain that an individual is either HIV-negative or HIV-positive.

Positive HIV test results

If an individual tests positive for HIV for both the initial and follow-up testing, it confirms that the person is HIV-positive.

Researchers show that there is no such cure for HIV but treatment has come a long way in the past few decades, offering extended and improved quality of life for many. If a person is infected with HIV and properly receives treatment, the individual can have a near-normal life expectancy. Early treatment can help one stay well and prevent or delay the onset of AIDS. Partners should also be careful and test immediately to be sure and safe.

Negative HIV test results

A negative test result from HIV testing may be somewhat confusing. It is either the person doesn’t have HIV or the person needs to follow up the re-test for confirming. If a person is recently exposed to HIV, one might test negative for HIV antibodies because the body hasn't had time to create them yet. In that scenario, retesting is a must for HIV antibodies in three months, and practising safe intercourse.

Is HIV testing confidential?

If an individual tests positive for HIV, the person’s status becomes part of one’s private medical record and is protected by federal privacy laws. An individual’s state may require the person’s healthcare provider to report the infection to one’s state health department. State departments send results to the CDC without revealing personal details.

An individual can choose anonymous testing. Anonymous tests don’t link the results to one’s information. The state health department collects the statistics, but the results aren’t part of the medical record.

In some states, there are laws that require a person and their partner’s healthcare provider to notify them regarding the HIV-positive status. If an individual does not report the status of the partner, the individual can be charged with a crime.

Importance of HIV Testing

Human immunodeficiency virus or HIV is a virus that attacks the body’s natural defence system against disease. If HIV is left untreated, the virus can weaken the immune system so much that it can no longer fight infection. This late stage of the virus, known as AIDS, can be dangerous. HIV can affect people of all ages or genders. But detecting HIV and getting treatment is easier in today’s life. People with HIV positive can have long and healthy lives.

Taking an HIV test is the only way to know if the exposed person has the virus. HIV spreads from person to person through bodily fluids like blood or semen. So, HIV is contracted through unprotected sex or sharing needles.

HIV testing is essential to prevent HIV infection. People who are HIV positive should get HIV treatment. The sooner the people start treatment after diagnosis, the more they benefit and live a healthy life. HIV treatment can reduce the amount of virus in the blood and help prevent transmission to others. People with HIV positive who are into medications have effectively no risk of transmitting to HIV-negative sex partners. People who get tested and learn they are HIV negative should also make decisions about their intercourse, drug use, or health care that can protect them from HIV.

What Are the Benefits of HIV Testing?

Knowing one’s HIV status is a great way to protect one’s health and the health of one’s loved ones. There are quite a lot of benefits of getting tested for HIV. They are:

· The test is rapid: HIV test is done through blood sample or saliva to analyse. The results are rapid and the test is free in some parts of the world too.

· Living a healthy life: A positive person can get the treatment and stay healthy. In today’s world, antiretroviral drugs make it possible for people with HIV to live normal lives.

· Protect one’s partners: When an individual is aware of their HIV status, one can take steps to protect one’s current and future sexual partners and encourage previous partners to get tested, as well.

· Having peace of mind: one can be nervous about getting tested. But it's normal to feel worried about one’s status. So, awareness should be spread and it is always recommendable to take action than to ignore the concern. Getting an HIV test can provide peace of mind.

Are there any disadvantages to voluntary HIV testing?

Having an HIV test and finding out one's status can have been disadvantaged for the person concerned. These disadvantages include coping with the report, stigma, rejection and discrimination, and abuses in family or society. A positive test result can come as a great shock for an individual and be very difficult for a person to cope with. People diagnosed with HIV may also experience anxiety, depression, fear, stress and suicidal feelings. Proper counselling can help a person to accept their results and cope with the scenario.

HIV positive people have always been rejected by their families as they fear the infection. The infected people often have experienced discrimination or violence. Awareness should be spread for the same. Women with HIV are particularly vulnerable. Some of them have lost their homes and children, or have been beaten and abused when their HIV status is known in society. Partners and children of people with HIV, who may not be infected also face stigma and discrimination in society.

Conclusion

HIV testing is not mandatory. HIV testing should be given with full consent and proper support to oneself, unless in the case of blood donor screening and organ donation. Choosing to take an HIV test can be hugely beneficial for oneself and their loved ones. However, some countries require one to get an HIV test in order to enter the country. Again, some insurance companies and employers may require an individual to test for HIV.

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