HIV / AIDS who is at risk? What tests are available?
If you are searching for HIV AIDS, most like you are aware that this is a dreaded disease much like cancer. But, unlike cancer, it has a huge social stigma attached! Hence people are hesitant to even seek information and protect themselves. Read this post to get answers ..
HIV/AIDS is not curable, so what is the benefit of getting tested?
HIV (Human Immunodeficiency Virus) infection leads to destruction of the body’s immune system and the advanced stage is called AIDS (Acquired Immune Deficiency Syndrome). The immune deficiency lead leads to many opportunistic infections such TB, skin lesions, pneumonia, diarrhoea, neural/mental etc.. If left untreated most people succumb. With no treatment an HIV infected person will progress to AIDS within a decade in most cases
BUT, now drug treatment is available which can add decades to the HIV patients life and prevent progression to AIDS. These drugs also make the chances of transmission of disease from well treated HIV + patient to others very low
Therefore, on one hand, it is important to understand what are the risk factors for HIV infection and try to minimize them. On the other hand, it is also important that you get tested for HIV and other associated infections, if you have had some of the risk factors for HIV in your lifestyle so far!
What are the risk factors for HIV?
HIV infection spreads through sexual intercourse, exposure to infected blood, or perinatal transmission.
Sexual transmission of HIV
All sexual acts do not carry equal risk for HIV. The act associated with highest transmission is anal receptive intercourse without condom, therefore Men who have Sex with Men (MSM) are a high risk group. Vaginal intercourse and insertive anal intercourse are all associated with risk of HIV, even penile -oral intercourse carries risks of HIV. But acts of kissing, touching, biting or sharing sex toys has been classified as ‘negligible risk’ in medical literature
HIV transmission through blood
Getting a blood transfusion with HIV infected blood is one of the highest risk factors for HIV. All the good blood banks screen donors for HIV by antibody based screen, which detects most but not all people with HIV infection. These tests do not detect acute HIV infection in the window period of up to 6-8 weeks. The most advanced guidelines demand that donor blood be tested for HIV by a NAAT test (Nucleic Acid Amplification Test), so that people who may have acquired infection as near as seven days in the past are detected and forbidden from donating blood. Read more here. Therefore, if you have had to undergo blood transfusion in the past, you should consider getting tested for HIV nearly 2-3 months after that or anytime thereafter.
If you must have an injection, make sure the needle and syringe come straight from a sterile package
Tattooing, ear piercing, acupuncture and some kind of dental work all involve instruments that must be sterile to avoid infection.
IV drug abusers who share a needle are at risk of HIV. Also, exposure of blood to mucous membrane of eye or a skin wound is a risk factor.
Occupational exposure to HIV happens to healthcare professionals, most commonly in the form of needle stick injury and is a common risk factor
Mother to child transmission
This is why all pregnant women are screened for HIV before delivery so that the chances of baby getting infected can be minimized
What is not a risk factor for HIV transmission ?
Working with people infected with HIV: sharing office space, touch, even sharing cups etc. do not cause any risk HIV does not spread through body fluids like saliva, stool, urine and tears.
Who should get tested for HIV and how often?
Given the risk factors above, you would have an idea about whether you should get tested or not. But, to crystalise the points
Get tested for HIV if
- You have had multiple sexual partners whose HIV status you do not know
- Get tested even if you are in a monogamous relationship now, to protect your partner and vice-versa
- If you have had a blood transfusion or injections which could be unsafe/unsterile
- If inject any kind of drugs and share syringe
- If you have had unprotected sex in the recent past with someone with high HIV risk: paid sex worker, MSM etc.
- If your partner is HIV +ve
- If you are pregnant or planning to have a baby
- If you have signs/symptoms of other STDs (Sexually Transmitted Diseases): sore or ulcer on genital parts, swelling in groin area, genital warts etc.
Who need to get repeatedly tested for HIV
- People who continue to have unprotected sex – with out condom, especially with high risk groups or multiple partners
- People who inject drugs
How is HIV testing usually done?
Most common way of testing is a when your doctor orders a laboratory based test for you. It may take up to a day to get the result back for the test. The best test for first time HIV testing is a fourth generation antigen-antibody test.
Rapid tests are also available, which can be done in doctor’s office and are nearly as good as lab based tests
Recently home test kits for HIV testing have become available world over. The best ones are the ones which use blood by finger prick rather than saliva for the testing. In India, these are mostly imported and hence cost nearly 10000 INR. We would recommend going for a lab test instead
If the first test is positive, another confirmatory test is a must. Therefore, it is best to contact your doctor at this point, if not done already
Which other tests should you get done along with HIV?
If you are getting tested due to a blood related risk , you should get your Hepatitis B and hepatitis C status done as well. For hepatitis B a set of three tests (HBsAg, anti HBs antibody and anti HBc antibody) should be done. For hepatitis C anti HCV antibody is done
If you are getting tested due to a sex related risk, in addition to hepatitis B and C get tested for syphilis by VDRL as well. You may need tests for additional STDs if you have burning while passing urine, sore, ulcer or swelling in genitals etc. It is best to consult a doctor before ordering tests in this case
How can you protect yourself from HIV and other STDs
If you have had a one time exposure and want to be protected from HIV: seek your doctor’s help as soon as possible. They may give you a 28 day course of protective drugs, but this has to be started within 24 hours ideally and no more than 72 hours later
Vaccines: There are vaccines available for hepatitis B (HBV) and HUman Papilloma Virus (HPV), which can protect from dreaded diseases such as liver failure, liver cancer and cancer of uterine cervix. Read more on vaccines for adults
Condoms: One of the most important forms of protection against STDs and unwanted pregnancy. Read more about how to use a condom safely
Giving up on risky behaviour: Demand the HIV and STD safety status from your partner. Encourage them to get tested. Get help and quit IV drug abuse. Remain vigilant when undergoing treatment involving injections, blood products etc. and ask for information