Get tested for HIV
by Kelly A. McCann
As you probably know, June is Gay Pride Month. Those of us in the LGBT community hear about, and participate in, all kinds of parties and special events that celebrate our gayness and our pride. June is all about the gay. What you may not know is that June is also an important month with regard to HIV.
This June 27 is the 15th annual National HIV Testing Day. Established by the National Association of People with AIDS (NAPWA) in 1995, National HIV Testing Day is intended to encourage citizens to get tested for HIV because knowing one’s status is the first step toward good health.
If someone is infected with HIV, early diagnosis is essential to successful management of the disease. The earlier one knows he is infected, the earlier he can seek treatment. And thanks to the variety of new and effective anti-retroviral treatments, people with HIV/AIDS can live longer and healthier lives.
Further endorsement of the importance of early detection comes from updated HIV treatment guidelines issued by the CDC in December 2009. The panel members who created the updated guidelines recommend earlier initiation of treatment. According to the new recommendations, all persons with HIV who have a CD4 (T-cell) count of less than 350 should begin medication, as should all pregnant HIV-positive women.
For those HIV-infected persons with a CD4 count between 350 and 500, the panel now recommends they start treatment. And 50 percent of the panel even voted to recommend treatment initiation for patients with a CD4 count of greater than 500!
Several studies provide data that supports the new treatment guidelines. Research has shown persons with HIV who start treatment earlier have fewer health problems and live longer than those who enter treatment later in their disease progression. But one can’t start treatment until he knows he’s infected, which takes us back to testing.
There are a number of tests used to diagnose HIV infection. One test looks for HIV antigens in the blood, but this test is generally not used for diagnostic purposes since it only works in the period immediately following HIV infection. The Polymerase Chain Reaction test (PCR) is a test that detects HIV genetic material. PCR tests are quite expensive and complicated to run, so they are only used to diagnose HIV in newborns. The most common, most cost-effective, and most appropriate test for routine diagnosis of HIV infection in adults is the HIV antibody test.
The HIV antibody test detects antibodies, which are proteins created by the immune system in response to infection. The immune system makes specific antibodies to fight specific infections. For example, if you contract chicken pox, your body will make chicken pox antibodies. Likewise, if you are infected with HIV, your body’s immune system will produce specific HIV-fighting antibodies, and those are the proteins detected by the HIV antibody test.
If you test positive for HIV antibodies, it means you are infected with HIV. But there are three exceptions to this rule:
- Infants’ immune systems do not make their own antibodies until they are about 18 months of age. Prior to that, infants retain their mother’s antibodies. So, if tested before the age of 18 months, it would be possible for an HIV-negative baby born to an HIV-positive mother to test positive for HIV antibodies.
- A very few people have participated in HIV vaccine trials, and though they are not infected, those individuals may test positive for HIV antibodies.
- Although antibody tests are extremely accurate, there exists an incredibly small chance that one might obtain a false positive on the initial screening test, the ELISA. However, follow-up confirmatory tests are always conducted on positive samples. When the ELISA and the confirmatory tests are combined, the chance of getting a false positive is less than 0.1 percent.
Another important fact about HIV antibodies is that an infected person doesn’t create them overnight. In fact, most people infected with HIV do not develop antibodies until six to twelve weeks following infection. The resulting “window period” between infection and the production of antibodies presents a serious issue for HIV testing.
During the window period, an HIV-positive person would actually test negative on an HIV antibody test. For that reason, it is recommended that people test for HIV about three months after engaging in the risky behavior. That way, antibodies will have time to develop and an accurate test result can be obtained.
Since HIV antibodies are present in the blood and saliva of an infected person, tests have been developed which can use either a blood sample or oral fluids. In addition, newer rapid tests can deliver results in 20 minutes.
Finally, there are numerous locations in Houston where one can get tested for HIV. Planned Parenthood, Legacy Community Health Services, St. Hope Foundation, AIDS Foundation Houston, and other community-based organizations offer testing on a regular basis. And in many cases, there is no charge for the service.
Let’s summarize: HIV testing is free or cheap, it’s widely available in our city, and it often doesn’t require a blood draw or more than 30 minutes of your time. And early diagnosis can add many healthy years to your life.
Now that you are armed with information, you can add HIV testing to your list of Pride-related events this month.
Kelly McCann is chief executive officer of AIDS Foundation Houston. For more info on HIV testing locations, call AFH at 713/623-6796.