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The sooner you know, the more you can do
Although early detection of HIV can help prolong and enhance life, more than 60% of all Americans at risk for contracting the HIV virus have never been tested for it. If you're not comfortable getting tested at a private clinic or even by your own doctor, consider using a home kit. Then you can ensure complete confidentiality and privacy. The tests are relatively easy to use. Some test saliva, while others test blood. Anyone engaging in unprotected sex or sex with multiple partners, or who may be exposed to contaminated needles or blood, should be tested.
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Why Use an At-Home HIV/AIDS Test?
At-home HIV/AIDS test kits are the center of a great deal of controversy. Some say that they are the only way to assure the privacy and complete confidentiality of your results. Others say the chance of inaccuracy (particularly with those tests not approved by the FDA) and the window period during which an infected person can test negative may lead to the spread of the disease by giving people a false sense of security.
Most importantly, the lack of proper counseling available when performing an HIV/AIDS test is a grave concern. You may consider getting counseling before and after your test results, no matter what your results are.
Important note: antibodies can take up to six months to show up in the blood. At-home tests cannot detect recent infections. There is a significant window of time during which you may not test positive even though you are infected. You can still transmit the disease during this time.
What Tests are Available?
Approved by the FDA
- At present, only the Home Access test system is approved by the FDA.
- The Home Access system requires that you send a blood sample to a lab, wait up to a week, and call a hotline for your results.
- FDA-approved tests provide pretest counseling via printed material included in the test. Read this literature carefully.
- With the Home Access test system, if you receive a positive result, telephone counseling is provided at the time of delivery of results.
- Although the Home Access test system requires that you send your sample to a lab, your identity is concealed. You are known only by a Personal Identification Number.
- In states that require reporting of new cases of HIV/AIDS infection, Home Access reports only the number of new cases they process -- not the identity of the person.
- FDA-approved tests are extremely sensitive and can detect even low levels of HIV-1 antibodies. There are no dietary restrictions prior to the test.
Not approved by the FDA
- These test systems have no guarantees regarding accuracy and no documented history of accurate results.
- The appeal of unapproved test systems is immediate results and no contact with an external lab. This also means no counseling is provided in the event of a positive result.
The choice of which type of test to use is entirely personal. However, the stakes in such a test are extremely high, and the consequences of false results, whether they be positive or negative, are extremely serious. In using an unapproved test, you trade accuracy and support counseling for speed. You need to decide whether or not this is a sacrifice you are willing to make.
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Why Use an At-Home HIV/AIDS Test?
- At-home HIV/AIDS tests provide completely confidential and private testing for the HIV/AIDS virus.
How Does the Test Work?
- The body creates HIV-1 antibodies when it is infected by the HIV virus.
- Home HIV tests detect the presence of HIV-1 antibodies in blood or saliva samples.
- These tests are very sensitive and can sometimes give a false positive result(i.e., the test shows that you have antibodies to HIV when in reality you do not). If the antibody test is positive, a second test for HIV -- known as the Western blot test -- is done as an added measure to protect against false positives.
Prepare Yourself for the Results
- Be prepared to experience anything from anxiety and nervousness to sleeplessness and depression during your wait.
- Think ahead. You may or may not want to be alone when receiving your results. If you think you may need a close friend near in the event of a positive result, make sure he or she is with you at the time of your phone call.
- It's prudent to have health insurance before testing yourself, as it can sometimes be difficult to obtain new health insurance coverage if you have a pre-existing condition.
- You might consider skipping a home test and going immediately to a doctor, clinic, or anonymous testing site.
Test Results Are Not Always Accurate
- Hemophiliacs report a 19% false positive rate.
- Alcoholic patients with hepatitis report a 13% false positive rate.
- Hemodialysis patients report a four percent false positive rate.
- A history of injection drug use may interfere with results.
- A woman may produce a false positive result if tested during a pregnancy which is not her first.
- The test may have a cross reactivity with other retroviruses present in the blood.
- Laboratory contamination is a possibility.
How to Perform the Test
- Check the expiration date on the box. Outdated tests may not work properly.
- Call the toll-free support number if you have any questions. Part of what you are paying for is the support.
- Each test will come with its own instructions. Read them carefully before performing the test.
- Always follow the timing instructions appropriate to each particular product. These may vary.
- Not waiting long enough or waiting too long can affect the accuracy of your results. Adhere strictly to the timing directions.
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Preparing Yourself for the Results
- During the week-long wait for test results, you may experience anything from anxiety and nervouseness to sleeplessness and depression.
- Think ahead. You may or may not want to be alone when receiving your results. If you think you may need a close friend or loved one near in the event of a positive result, make sure he or she is with you at the time of your phone call.
The Test May Not Be Accurate
- However accurate a test may be, no test can determine whether or not you are infected with HIV until your body has begun to produce significant amounts of antibodies. It can take up to six months until the body produces enough antibodies to be detected by a test. This is called the window period.
- Because of this, a negative result does not mean that you do not have HIV. It simply means that you currently have little to no antibodies for HIV in your blood.
- Proceed with caution and always practice safe sex, even if you have tested negative repeatedly, either through home tests or lab-run tests.
Receiving Your Results
- With the Home Access test, if you test negative, you will get a recording. If you test positive you will be transferred to a counselor.
- Please note that if you have supplied insufficient amounts of blood for your test or there has been some other problem regarding your test, you may be referred to a counselor.
What Do I Do Now?
- Your tests results are confidential.
- If you receive a positive result, inform your doctor immediately as well as anyone who may have been exposed to your blood, semen, or vaginal fluids. This includes past and present partners as well as people with whom you may have shared needles.
- It is highly advisable to seek counseling upon receipt of a positive result.
Beware of False Positives
- HIV tests need to be done in tandem for the most accuracy.
- The initial screening is done to find antibodies against the HIV virus. If it detects antibodies, the test will yield a positive result. This does not mean that you are HIV positive. The test is very sensitive, so false positives do occur.
- A second, more sensitive test is performed after the initial test. Called a Western blot test, it's used to check all positive results to ensure that they are not false positives. It does this by showing whether any HIV proteins are present.
- For accurate results, any positive antibody test MUST be followed by a Western blot test.
Beware of False Negatives
- If you have a negative HIV test that does not necessarily mean that you do not have the HIV virus. It simply means that your body is not producing enough antibodies against the HIV virus for the test to detect.
- After a possible exposure to the virus, it can take up to six months (the window period) for your body to produce enough antibodies for a HIV test to turn positive.
- That means that after a possible exposure to HIV you need to wait six months to be absolutely sure that you are not infected. If you are exposed again you need to wait another six months. This means if you were exposed to HIV in January, you would have to wait until July for the most accurate HIV test. If you were exposed again within that period, you would have to wait until six months later for the most accurate test.
Confidential vs. Anonymous
- If you go to a clinic to have an HIV test performed you need to be aware of the difference between anonymous and confidential testing.
- For anonymous testing, you are given a number. This number is the only link that you have to your test results, because they are given on a number basis. If you lose that number you cannot get your test results. Anonymous clinics do not keep records of the results or who is linked to which number.
- For confidential testing, your name is linked to your test result. These records are supposed to be kept confidential (i.e., no one has access to them).
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Websites, Organizations & Manufacturers
Sources & Further Reading
Books
- 1. American Medical Association.The American Medical Association: Family Medical Guide. 3rd Ed. New York: Random House 1994.
- 2. Fauci, Anthony S. et al. Eds. Harrison's Principles of Internal Medicine, 14th ed. New York: MacGraw Hill 1998.
- 3. Segen, Joseph, and Joseph Stauffer.The Patient's Guide to Medical Tests: Everything you need to know about the tests your doctor prescribes. New York: Facts on File 1998.
- 4. Zaret, Barry L. Et al. The Yale University School of Medicine Patient's Guide to Medical Tests. New York: Houghton Mifflin 1997.
Find more books on health and wellness at  barnesandnoble.com.
Articles
- 1. Tien, Linda."For many, home is where the test is, but not all tests are created equal". Star Tribune; 8/13/1995.
- 2. MacDonald, Sue."Testing your health at home". Gannett News Service; 8/8/1996.
- 3. Stevenson, Martin M. "A simple oral HIV test". Modern Medicine; Vol. 64 8/1/1996.
- 4. Business Wire."Urine HIV-1 screening and confirmatory test processing now available through major reference laboratory". Business Wire; 8/11/1998.
- 5. Bergeonneau, Marie."Home HIV tests readily available". University Wire; 9/24/1997.
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