Know your status - get tested!

The only way to know your HIV status is to get tested. It is impossible to tell from a person’s appearance whether he or she has HIV infection. A person who is HIV positive may look and feel perfectly well, and be unaware that they are infected.

The Benefits of Being Tested

The sooner you get tested, the sooner you can access treatments and information to help you manage the condition and delay the onset of AIDS, should you test positive for HIV. The earlier on in the progress of the infection you get tested and get effective treatment, the easier it is to keep your immune system healthy. Your doctor can monitor your immune system and help you avoid opportunistic diseases, or manage these when they occur.

You may not need antiretrovirals or opportunistic infection prevention yet; however, there are additional ways of ensuring that you stay as healthy as possible, such as learning about how to follow a lifestyle with good nutrition and suitable exercise, and avoiding damaging substances such as cigarettes, drugs and alcohol.

• If you find out you are infected, you can make sure you protect your sex partner from becoming infected. If more people know their HIV status and use the knowledge to protect others, the pandemic can be better controlled.
• If you are pregnant and test HIV positive, appropriate treatment can reduce the risk of your baby becoming infected. Without treatment, HIV-positive women have about a one-in-four chance of infecting their baby during pregnancy or birth. Treatment can reduce this figure to about 1%
• Finding out your HIV status as early as possible, gives you time, if you are infected, to make plans for yourself and your dependents to be looked after when you do get sick.
• You can help educate others about HIV/AIDS, and improve their attitudes and behaviour related to the disease, by talking about your HIV status and your decision to get tested. Remember that giving out this information is entirely your decision. The health professionals and counsellors who conduct and discuss the test with you must, by law, keep the results strictly confidential.

Different Types of HIV Tests

HIV antibody test:

This test shows whether a person has been infected with HIV, the virus that causes AIDS. Information on this page concentrates mainly on HIV antibody testing. Antibody tests are also known as ELISA (Enzyme-Linked Immunosorbent Assay) tests.

Antigen test:

Antigens are the substances found on a foreign body or germ that trigger the production of antibodies in the body. The antigen on HIV that most commonly provokes an antibody response is the protein P24. Early in the infection, P24 is produced in excess and can be detected in the blood serum by a commercial test (although as HIV becomes fully established in the body it will fade to undetectable levels). P24 antigen tests are sometimes used to screen donated blood, but they can also be used for testing for HIV in individuals, as they can detect HIV earlier than standard antibody tests. Some of the most modern HIV tests combine P24 and other antigen tests with standard antibody identification methods to enable earlier and more accurate HIV detection.

DNA or RNA test:

These types of tests detect the genetic material of HIV itself, and can identify HIV in the blood within a week of infection. DNA/RNA tests come in a number of forms. Babies born to HIV positive mothers may be tested using a type of DNA test called a PCR (Polymerase Chain Reaction). Blood supplies in developed countries are screened for HIV using an RNA test known as NAT (Nucleic Acid-amplification Testing). When a person already knows that she or he is infected with HIV, they may also have a viral load test to detect HIV genetic material and estimate the level of virus in the blood. DNA/RNA tests are rarely used to test for HIV in adults, as they are very expensive and more complicated to administer than a standard antibody or P24 test, and can yield false positive results in some instances.

HIV Rapid Test:

The disadvantage of sending a blood sample to a laboratory for HIV testing is that you will usually have to wait for a few days and must return to the clinic or testing centre to get the results. For this reason, rapid tests to detect HIV antibodies have been developed.

These tests are simple to perform and do not require any laboratory equipment so that they can be done by a health care professional at the clinic or testing centre or at the bedside of a patient.

A rapid HIV antibody test is a blood test, which can be done by pricking the finger with a lancet, and applying the test tube. The result is ready within 15 minutes.

Rapid tests are very useful for the diagnosis of HIV infection in rural or isolated areas that are far removed from diagnostic laboratories and where clients often cannot afford to come back for test results. These tests are relatively cheap and they demonstrate a high rate of reliability if they are correctly used. The accuracy of rapid tests is variable but some tests are just as good as an ELISA test.

As with ELISA testing, the accuracy of a diagnosis of HIV infection using rapid tests is higher if two rapid tests both give a positive result. All positive rapid HIV results should, however, always be confirmed with a second rapid test (from another batch) or with a laboratory-based ELISA antibody test. A second confirmatory test will, however, not be necessary if a person presents with clear symptoms of immune depression.

Rapid HIV diagnostic home-kit tests are also available, but these tests should be used with extreme care. It is not advisable to do the home test without proper pre-test and post-test counselling. The results can also be incorrect if the testing instructions are not followed exactly, if the test has not been stored at the required temperature, if the expiry date of the test has been exceeded, or if tests of a low quality are used. A positive result obtained from a home test should always be confirmed by a subsequent laboratory test.

Saliva and urine tests for HIV:

There are ELISA tests and rapid tests that can test for HIV antibodies in saliva or urine instead of in blood.

The advantage of these tests is that a blood sample is not needed, so it is not essential for a qualified health professional to collect the sample, and there is no pain involved. Testing for HIV antibodies in saliva or urine is slightly less accurate than testing a blood sample.