HIV testing is a critically important part of the overall fight against the HIV/Aids epidemic in South Africa, says Dr Avron Urison of AllLife.
Given the nature of the HIV epidemic, it is recommended that all adult South Africans undergo an HIV screening test annually. In addition, if a person believes that they may have become infected, it is very important that they make contact with their healthcare provider immediately, in order to discuss risk and make plans to test as soon as possible.
People who consider themselves as engaging in risky behaviour are also advised to get tested at least once a year. In some cases a healthcare provider may advise patients to undergo an HIV test based on their own assessment of an individual's health.
It is very important to note that testing for HIV too soon after potential exposure to the virus may not give an accurate result, due to what is known as the window period. A window period refers to the period of time during which HIV is not detected by tests, even if the virus has entered the body. During this time, a test may give a ‘false negative’ result.
Different types of tests
Different types of tests have varying window periods. To be sure of how long a person needs to wait, they should also always discuss the nature of the HIV test with a healthcare worker before getting tested. If a person is not sure of the date or time of their potential exposure to HIV, a healthcare worker will be able to advise appropriately on their HIV testing.
The ‘window period’ for an antibody test is estimated to be three months after exposure to HIV infection. A negative test at three months will almost always mean a person is not infected with HIV. If an individual’s test is still negative at six months, and they have not been at risk of HIV infection in the meantime, it means they are not infected with HIV.
Prior to HIV screening, a person should undergo pre HIV test counselling. The main purpose of pre-test counselling is to establish informed consent for the HIV test. The benefits of testing and knowing your status will be discussed as well as a clear indication of how the results will be given. Additional issues which may be discussed are:
Benefits of knowing HIV status and treatment possibilities
Risk and lifestyle
What tests are available and which test is recommended
The window period for testing
The difference between HIV and Aids
Screening test only takes a few minutes
The screening test will take a few minutes using either a finger prick blood sample or a saliva mouth swab. The result is given immediately with the appropriate post test counselling. There is always a small chance of a false positive result with a screening test and therefore one should always go to a healthcare provider to perform a confirmatory HIV test for every positive result. A laboratory blood sample should be used for this confirmatory test.
Reasons for low testing rates include the following:
The stigma associated with being HIV positive
Concerns about confidentiality, legal and insurance issues
Self perceptions of low risk in those who would test positive
Dislike of counselling
Wishing to avoid anxiety when waiting for results
Fear and denial are the most common obstacles to HIV testing among those acknowledging that they have been at risk.
Let’s use World Aids Day 2012 to "know your status", perform the HIV screening test and take the appropriate steps to prevent and manage the spread of HIV. Remember that early diagnosis of HIV clearly improves prognosis and that there are benefits of early diagnosis, to both the individual and the community at large.
(Written by Dr Avron Urison, Medical Director at AllLife Pty Ltd - providers of life insurance for HIV positive individuals)
- (Health24, November 2012)
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