How Does Someone Know If They Have HIV? What Test To Go For?

Human Immunodeficiency Virus (HIV) can lead to Acquired Immune Deficiency Syndrome (AIDS), the late stage of HIV infection. How can people with HIV get to this stage? One of the reasons is the non-specific HIV signs in the early stages of infection. The symptoms of HIV in the early stages are usually similar to other infections. As a result, many people with HIV are unaware that they have been infected with the virus. However, the virus can be detected through some specific methods. Follow the further explanation through this article. 

How Do You Detect HIV?

First of all, all personal information related to the patient will be handled confidentially by their respective medical officers. So you should not be afraid or embarrassed to see a doctor if you suspect you have HIV. The patient will then be constantly monitored for treatment of the disease and will be provided with support such as counselling and so on. HIV can be identified or detected through a number of testing methods that are usually done by taking a patient’s blood sample. Tests to detect HIV are as follows:

• Antigen / Antibody Test
  

This test is to detect antigens from HIV or antibodies towards HIV in your body. Antibodies are produced by your immune system when you are exposed to an infection. Meanwhile, antigens are foreign substances that activate your immune system. If you have HIV, an antigen called p24 will be detected before antibodies in your body are formed. An antigen/antibody test is recommended to be done in the laboratory. This laboratory test involves taking blood from the vein.

There is also an antigen/antibody rapid test that is done using blood from a finger prick, which is also reliable to screen the infection.

The time period between exposure to HIV and when the tests can reliably detect that virus or immune response is referred to as the window period or incubation period. The window period varies depending on the type of test used to detect HIV. An antigen/antibody test that is done with blood from the vein can detect HIV infection within 18 to 45 days after exposure. Meanwhile, an antigen/antibody test performed with a finger prick can only detect HIV after 18 to 90 days after exposure.

• HIV Antibody Test 

This test detects antibodies to HIV in your blood or oral fluid. In general, antibody tests that use blood from the vein can detect HIV quicker after infection than the tests done with finger prick or oral fluid. Antibody tests are the most rapid tests and the only currently approved HIV self-tests. Besides, the HIV antibody test which uses the rapid test method is also used as the premarital HIV testing in Malaysia which need to be done by any couples before marriage. Test results are ready within 30 minutes or less.

HIV antibody test can detect the infection 23 to 90 days after being infected (window period). 

If the test result is POSITIVE, it means that there are HIV antibodies in your blood. This requires immediate advice and treatment from a doctor. However, HIV results can be NEGATIVE even if you have actually been infected. This is likely because you are still in the incubation period or window period, which is when HIV antibodies have not been developed yet. Therefore, repeat testing should be performed 3 months later or within 6 months. 

• NAT (Nucleic Acid Tests)

This test detects the actual virus in the blood and is done by taking a blood sample from the vein. Other than finding out whether a person has HIV or not, this method also allows medical practitioners to get to know the viral load (amount of virus) present in the blood. The amount of viral load is important to know the effect of antiviral medication, the patient’s adherence in taking the medication as well as a person’s potential in spreading the infection. NAT is also known as the HIV viral load test. The cost of NAT is higher, so these tests are not performed routinely. NAT usually takes 10 to 33 days after exposure, to detect if a person is infected. 

• Anonymous And Voluntary HIV Screening

This screening method is an anonymous or confidential HIV counseling and voluntary testing program. The program not only aims to detect HIV infection, but also to treat it.

Rapid test methods will be used for HIV testing. If the test result is "reactive", then your blood sample will be taken and sent to the HIV Screening Center (Hospital Laboratory) for confirmation testing.

This method will begin with a counseling session by a medical officer or counsellor. During counselling, you will be given information about HIV/AIDS. Then, the counsellor will ask for informed consent from you before performing an HIV screening test. On the scheduled consultation date, for example, 2 weeks after the blood sample is taken, you are required to see a medical officer to get the test results and for post-test counselling. 

If the HIV test result is NEGATIVE, you will be given the next consultation date for a repeat testing. If your result is POSITIVE,  you will also be given post-test counseling by a medical officer followed by a discussion of your treatment regime. To perform this test you can refer to any government clinic that provides HIV treatment and counseling services. 

Overall, various tests can be used to elicit diagnosis and treatment of HIV, these tests can provide information on:

• HIV negative or HIV positive

• The most effective medicine for you

• The body's response to therapy/treatment

• If there are side effects of the medication being taken

• If your body rejects the drugs

When Is The Right Time To Take An HIV Test?

The Centers for Disease Control and Prevention, CDC recommends that individuals between the age of 13 and 64 undergo HIV test at least once in a lifetime. However, if you are at high risk of getting HIV, you will need to get tested more often, at least once a year. Some of the things that indicate you are at high risk are: 

• Had multiple sexual partners

• Having unprotected sex with someone who is positive or may have HIV, including someone whose sexual history you do not know. 

• Taking drugs using a syringe, or other device shared with others

  

• Has or is being tested for tuberculosis, hepatitis, or a sexually transmitted disease, including syphilis, gonorrhoea, chlamydia, or herpes

• Having sex with someone who has a history of all the things above