to the Centers
for Disease Control and Prevention (CDC), approximately 1.2 million
Americans are living with HIV. However, more than 15 percent of them have no
idea that they are infected. Although the CDC recommends HIV testing as a
routine part of medical care, these guidelines are rarely implemented. Many
Americans have never been tested for HIV.
you haven’t been tested for HIV, consider asking your doctor for an HIV test. You
can also seek out free, anonymous HIV testing at a clinic near you. A list of
local testing sites can be found at hivtest.org.
This government service allows you to search for test sites by zip code.
Who Needs HIV/AIDS Testing?
to the CDC recommendations, everyone should be offered HIV testing at least
once in all healthcare settings. In addition, you should be tested:
- at least annually,
if you are at high risk of infection. High-risk groups include people who
have multiple sexual partners or who engage in unprotected sex, as well as
intravenous drug users.
- before entering a
new sexual relationship
- if you just found
out you are pregnant
- if you have symptoms
of another sexually transmitted infection (STI)
different types of tests are available to detect HIV infection. Not all tests
require a blood sample or a doctor’s visit. In 2012, the U.S.
Food and Drug Administration (FDA) approved the first rapid test for HIV
that can be performed at home.
to Diagnose HIV
A number of different tests can be used to diagnose HIV
infection. HIV tests can be performed on:
- blood samples
- saliva samples
- cheek swabs
It can take up to six months after infection for a
standard HIV antibody test to turn positive. This is because they look for
antibodies to the virus. Antibodies take several months to develop. If you know
you have recently been exposed to HIV, tell your doctor. Alternatives to the
antibody tests can be used to detect a very recent infection.
Early detection and treatment can greatly improve your
health. They can also reduce the risk you pose to any partners. If you know you
have been exposed to HIV, seek care as soon as possible. In certain cases, post-exposure prophylaxis may be able
to reduce your chances of infection.
Tests to Monitor HIV
In addition to detecting HIV, tests can also
be used to monitor the progression of HIV infection. The two most common ways
to assess HIV infection are CD4 count and viral load.
cells are a type of white blood cell. They are targeted and destroyed by the
HIV virus. A healthy person has a CD4 count well above 500 cells per cubic
millimiter (cells/mm3). This number tends to drop as HIV
progresses. When a person has a CD4 count under 200 cells/mm3, they
are considered to have AIDS.
count can be used to monitor the effectiveness of HIV treatment. CD4 count
should remain level or increase if a treatment is working. The CD4 count is
also a good indicator of the overall function of an HIV patient’s immune
function, and as it drops below particular levels, your risk for certain diseases
increases substantially. Therefore, based upon your CD4 count, your doctor may
recommend starting antibiotics to prevent some of these particular infections
test measures the amount of virus in your blood. Lower viral loads mean
that HIV is less likely to affect your health. In addition, people with lower
viral loads are less likely to transmit HIV.
load can also be used to monitor the effectiveness of HIV treatment. Effective
treatment should reduce the viral load to undetectable levels. HIV infection is
extremely unlikely to progress to AIDS in people who can maintain an
undetectable viral load.
determines if your strain of HIV is resistant to any anti-HIV medications. It’s
used in making decisions about what the best anti-HIV drug regimen will be for
Other Tests for HIV
Monitoring Treatment Effects
If you have HIV, tests may be used to monitor you for
side effects of infection and treatment. You may need regular tests for:
- liver function
- kidney function
- cardiovascular and metabolic changes
- sexually transmitted diseases (STDs)
- urinary tract infections
CD4 count is not the only way to determine if HIV has progressed
to AIDS. AIDS can be also be defined by the presence of certain opportunistic
illnesses or infections. Those illnesses said to be AIDS defining
(yeast infection) of the bronchi, trachea, or lungs
diseases, such as coccidioidomycosis, cryptococcosis, or cryptosporidiosis
herpes simplex ulcers (lasting longer than 1 month)
a type of lung infection
an intestinal disease
avium complex, a bacterial infection
carinii pneumonia (PCP)
multifocal leukoencephalopathy (PML), a brain disease
a parasitic infection of the brain
syndrome, or extreme weight loss