December 1st is observed as World AIDS Day. The theme for this year is “Know Your Status” which aims at raising awareness about the importance of knowing a person’s status and calling for the removal of all barriers to access HIV testing.
According to a 2017 study published in the Indian Journal of Medical Research, in the year 2016, there were around 37 million people living with HIV all over the world. Additionally, there were about one million AIDS-related deaths and 1.8 million new HIV infections. India is home to about six percent of the global people living with HIV making it the third highest burden country in the world.
The National AIDS Control Organization reports that the prevalence of Human Immunodeficiency (HIV) infection in Indian adults is 0.26%. Moreover, India has an estimated 2.1 million people living with HIV infection. Although the number of HIV cases in India has decreased by 50% in 2011, only 40% of HIV-infected people are formally diagnosed and have access to care. This can be attributed to poor awareness about the testing and diagnosis of HIV infection. Hence, this World’s AIDS Day let’s spread some awareness about HIV testing and diagnosis.
Why is HIV testing Important?
HIV testing is the only way to know the HIV status of a person meaning whether a person is HIV positive or negative. It is important to get tested and know your HIV status so as to keep you and your partner healthy.
If you test HIV negative, you can still take steps to prevent HIV by following simple tips such as using condoms during sex. If you belong to the high-risk category, then you can even consider pre-exposure prophylaxis (PrEP) which involves taking medicines to prevent HIV infection as per the clinician’s advice.
If you test HIV positive, you need to consult a doctor for starting the treatment. People who are diagnosed with HIV are recommended antiretroviral therapy (ART), which is to take a combination of medicines on a daily basis to treat HIV infection. The sooner you start the treatment, the lower is the severity of the infection and its complications. Moreover, ART helps you live a healthy and better quality of life and also lowers your risk of transmission of the HIV virus.
Who Should Get Tested For HIV?
The Centers for Disease Control and Prevention (CDC) recommends that everyone above 13 years to 64 years should get tested for HIV at least once as a part of a routine health care check-up. However, as a general rule, people who are at high risk for HIV infection should get tested every year. You are at an increased risk of getting an HIV infection if you have had:
– Vaginal or anal sex with an HIV positive person or whose HIV status is not known.
– Sex with another man or are a sexually active bisexual man.
– More than one sexual partner since your last HIV testing
– Injected drugs or shared needles with others
– Exchanged sex for drugs or money
– Diagnosed with or treated for another sexually transmitted diseases such as syphilis.
– Diagnosed with or treated for hepatitis or tuberculosis
– Sex with anyone who has any one of the above-listed factors
If you have any of these risk factors, it is wise to consult a doctor and get tested for HIV infection. Moreover, pregnant women should also get tested for HIV so that they can undergo treatment for HIV infection if tested positive. This can help lower the risk of mother-to-child transmission of HIV.
What are the types of HIV tests?
There are three common types of HIV test available, which are usually performed on blood or oral fluids. In some cases, the tests can be performed on urine. The common tests recommended to detect an HIV infection are:
An antigen/antibody test: This is a lab test that detects both antibodies and antigens in the blood sample. Antibodies are immune cells which are produced by the immune system on exposure to virus, bacteria or any antigens. Antigens are foreign particles which activate the immune system. For example, if you are infected with the HIV virus, an antigen p24 is produced even before the antibodies are developed by the immune system.
Antibody tests: There are numerous antibody tests which detect antibodies to the HIV virus in the blood or oral fluids. Generally, antibody tests that use blood from a vein can detect HIV infection sooner than those which use blood from a finger prick or use oral fluids. Some of the common types of antibody tests are:
–Lab-based screening tests use blood drawn from veins to test the virus. The results of this lab test require several days to be available.
–The rapid antibody screening test, which is also known as self-testing kit or home test, involves the use of blood from a finger prick or use oral fluids to detect antibodies. You can get the results within 30 minutes or less.
–Oral fluid antibody self-test uses a swab of your mouth to collect oral fluid sample and provides results in less than 30 minutes. You can get the tests in stores or online.
–The home collection kit involves pricking your finger to collect a blood sample and sending it to a lab for HIV testing.
Nucleic Acid Test (NAT): It is a blood test which detects the actual virus in the blood. It not only helps to detect the HIV status of a person but also gives you the amount of virus present in the blood, which is known as the HIV viral load. The test is not routinely used for HIV screening as it is very expensive. However, the test is used for people who have had a recent high-risk exposure to the virus or show symptoms of HIV infection. It is usually considered accurate during the initial stages of the infection.
When should I get tested for HIV infection?
Every person should know that no HIV test can detect HIV immediately after an exposure to the virus. The best time to get tested for HIV is probably 90 days after a possible exposure to the virus. This is because, the window period, which is the time after exposure to the virus that the body doesn’t show any antibodies against the virus, is approximately 90 days. Getting tested during the window period might provide false positive results, which means that the test might show positive results even if you are HIV negative. The window period might vary from person to person and also depends on the type of test used for HIV testing. Ask your doctor about the window period of the test you are taking.
Where can I get tested for HIV?
There are many Government run testing centers in all cities and towns. You can even visit your doctor or go to any Government-run hospital to get tested for HIV. In some areas, there are community-level testing centers such as Integrated Counselling and Testing Centres (ICTC) for HIV testing. You can even buy a home testing kit online or book a lab test online to get tested for HIV infection.
HIV Testing: Points to Keep in the mind
– If you test HIV negative but have a doubt about your HIV status or are not satisfied with the test result, you can get tested again after six months.
– You do not have to fast or take any precautions when getting tested for HIV. All you need to do is visit a hospital or community center and give some sample (blood or saliva) for testing.
– Most people are scared to get tested for HIV as they think their details will be leaked and everyone will know about their HIV status. However, it is not true. The World Health Organization (WHO) has recommended that all HIV testing services must follow the 5Cs – Consent, Confidentiality, Counselling, Correct test results and Connection (to care, treatment and, other allied services).
(The article is reviewed by Dr. Lalit Kanodia, General Physician)
1. Karim QA. Current status of the HIV epidemic & challenges in prevention. Indian J Med Res. 2017 Dec;146(6):673-676.
2. National Strategic Plan for HIV/AIDS and STI 2017 – 2024. National AIDS Control Organization. Ministry of Health and Family Welfare. Government Of India.
3. Testing. HIV basics. HIV/AIDS. Centres for Disease Prevention and Control (CDC).