HIV testing procedures have become more available and give patients more options than they did several years ago. Factors that impact the way that the testing is performed and reported include privacy issues, false negatives and false positive tests, the type of bodily fluid used, whether the test is done in the lab or at home and the reliability of these tests.
Privacy issues when doing HIV testing are often a concern of the person who believes they may have the disease. A diagnosis of HIV carries with it many social issues which patients must face as they go through treatment protocols, attempt dating, desire children and just live life.
States have two options for performing HIV testing. There are anonymous tests and confidential testing. All states have confidential HIV testing. This means that the test is done and kept confidential by the doctor, clinic and laboratory staff. The name of the patient is attached to the test results. The results only are shared with the patients private physician, and are thus made a part of the chart, if the patient signs a release to have the results sent.
And again, the results are made a part of the patient record if they attempt to receive insurance benefits to pay for medication. Otherwise the test results remain confidential and are reported to the public health authorities so they may work with the patient to determine the risk to any other sexual partners.
In anonymous HIV testing no names are provided to the testing center. This type of testing isnt available in all states. The person who is being tested is given a unique identifier code and only that person can share the results of the test. Although this type of test conforms most closely with privacy laws it also places others in danger when people who test HIV positive dont communicate with past, present and future sexual problems.
There are home test kits currently available that will keep the test results anonymous. One test kit, the Home Access Express HIV-1, is the only one that is approved by the FDA. There are others which use urine, blood or saliva but which dont pass the criteria for accurate testing by the FDA. The Home Access Express test relies on the patient to supply a blood sample that is mailed from the patients home to a lab and the results are mailed back.
Other home test kits are read at home between 5 and 15 minutes. These are often sold on the Internet as test kits that are approved by the FDA. To date all home test kits require evaluation at a laboratory and offer counseling to the person being tested. Dont be fooled by other test kits that cant be as accurate in the home environment as a tightly controlled lab environment.
The accuracy of HIV testing today is vastly improved from those done even 10 years ago. Antibodies to the HIV virus usually appear within the first several weeks after transmission of the virus. Current recommendations are for testing in the first month, at 3 months and then again at 6 months. Only if those three tests are negative is the person considered to be free of the virus.
HIV testing in those six months test for the antibodies the body produces to fight the virus. There are two tests the ELISA and the Western Blot. However, getting a positive test on either then puts into motion more testing for CD4 and viral load. If other testing is negative the original tests are repeated to ensure that a false positive result wasnt obtained.
When the HIV testing is performed tests are specific for the antibodies and sensitive to the amount of the antibodies present. The ELISA test is very sensitive to the amount of antibodies in the blood which is why it is often used first. But because the test is highly sensitive it could return a false positive. This is why every test that comes back positive also has a Western Blot test performed, which is more highly specific. False positive test are extremely rare after the Western Blot is done.
HIV testing is offered in the US on an optin basis. This means that people must ask to be tested; it isnt assumed that they will be tested and thus must opt-out of the testing procedures. In only one condition does the CDC (Center for Disease Control) recommend opt-out testing and that is in the case of pregnant women because new medications are able to significantly reduce the transmission of the disease from mother to baby if caught and treated early.
HIV testing in the general population is different than testing a person who is already tested positive. So why test when you are already positive? When a person who is HIV positive continues to engage in risk taking behaviors, such as unprotected sex with multiple partners and sharing drug needles, they can acquire another strain of HIV that is more virulent. When medications stop working and patients are engaged in risk taking behaviors HIV testing is performed to determine if there are two DNA HIV types in the person.
These types of test go beyond just determining if the body is positive or negative for the HIV antibodies. Instead these tests evaluate the DNA of the HIV virus.
With HIV testing patients are also offered HIV counseling to help support them through the process of coming to grips with the diagnosis. Most people are well aware of the changes that happen in peoples lives with the diagnosis of HIV and AIDS. Being socially ostracized, taking medications every couple of hours around the clock, financial concerns when medications are expensive and health that may not allow continued employment are only some of the challenges that people with HIV and AIDS face.
Although HIV is no longer an immediate death sentence and many people go on to live for years longer than they had with previous treatment protocols the challenges that they face continue to be stressful. HIV testing is only the beginning of the process of learning to live with a disease that takes over most every waking hour, affects relationships, health, work environment, precipitates depression, anxiety, sleep disorders and decreased appetite.
People with HIV continue to fight a battle that rages, not only in their bodies but also in their minds and in their families. With counseling and support many people are able to live functional and happy lives while maintaining and engaging in new relationships. It isnt the disease that defines the person but rather the person who defines the disease.