Charles Farthing (Chief of Medicine, AIDS Healthcare Foundation) gives expert video advice on: What are the symptoms of HIV?; Where can I be tested for HIV?; Is there a home test kit for HIV? and more...
Can I have HIV without symptoms?
The majority of people who have HIV don't have symptoms for the first years of infection. So it's very easy to have HIV and feel and look completely well.
What are the symptoms of HIV?
The symptoms of HIV are incredibly numerous and varied. When someone first contracts HIV, in the first few weeks, you might fall ill with a fever and a rash and recover spontaneously and just think you had the flu. And then for many years, for most HIV patients there are no symptoms of HIV whatsoever. Then various things may start going wrong. An HIV sufferer may lose weight. You may become weak and tired. You may develop oral thrush. You may develop various skin rashes. Then an HIV sufferer may start falling ill with pneumonia or from unusual organisms, fungal organisms, TB, protozoa organisms, viral illnesses. So it is rather hard to say exactly what HIV disease looks like because it can have so many varied presentations.
What is 'seroconversion'?
Seroconversion is just a fancy word that means going from HIV antibody negative in the blood, to HIV antibody positive in the blood.
How is HIV diagnosed?
HIV is diagnosed usually with the HIV antibody test which can be a blood test but can also be done on saliva and urine to look for the presence of human antibody proteins that the body makes in response to the HIV infection. And so you detect the HIV antibody in the test and then you diagnose HIV infection from that.
Where can I be tested for HIV?
HIV antibody testing is available in many different places. In Los Angeles, for example, it's even available in certain thrift stores the gay health care foundation runs, the Out of the Closet Thrift Stores. But there are many sexually transmitted disease clinics, in fact all sexually transmitted disease clinics, would offer HIV antibody testing. And at any doctor's office it can be done. We believe, at the moment, and the CDC believes, that HIV antibody testing should be done much more frequently and routinely than it currently is because a third of the people who are HIV infected in the United States don't know they're infected. And they are the people at most risk of transmitting the disease. Because when someone knows they're infected, they're likely to take precaution not to infect other people. The majority will. But if they don't know they're infected, they can't do that. So we would recommend that everybody who comes through an emergency room should routinely have an HIV antibody test. People who go to their family practitioner should have an antibody test every year. So that we can find people and help them in the early stages of the disease. And I think that change is going to happen. But the test is not done nearly as often as it should be, at least in the minds of HIV practitioners.
What is the difference between an 'anonymous' and 'confidential' HIV test?
An anonymous HIV test is where a number is taken rather than the name, and the laboratory and clinic do not even know the name of the person who is having the HIV test. A confidential HIV test is where the name is known, but the laboratory and the clinic promise not to tell anybody the name. Anonymous testing is probably not necessary in this day and age; it came about because of all the fear and scare and stigma of an HIV diagnosis, and the fear that clinics would leak names. However, I've been looking after HIV for twenty years and I don't think I've ever known a confidential HIV test to leak the name of a patient and someone's confidentiality be blown as a result. So, I would not think that anonymous HIV testing is any longer necessary. People who let their diagnosis become known usually do it themselves by telling people they shouldn't tell that they're HIV positive; it doesn't come from the hospital or from the laboratory, but rather from the person themselves disclosing this information. So, we always advise HIV positive people: be careful who you disclose this diagnosis to, don't just tell everybody. Don't tell your boss, for example, if you're boss is going to be discriminatory and sack you.
Is there a home test kit for HIV?
There is a home test kit for HIV, Anybody testing, and people can buy that and take it and do the test at home. They do have to send the blood in, and then they will get the result later. They can't get the HIV result at home by themselves. The reason for that is that people generally need some counselling around a positive HIV test because some people erroneously assume that HIV means AIDS and they erroneously assume that AIDS means death. AIDS certainly doesn't mean death now. It's a controllable disease; we have such good treatment. Nobody should die of AIDS, but people still have these beliefs, so we don't want people finding out they've got HIV all by themselves at home, thinking that it's the end of the world and perhaps committing suicide.
Are there any HIV tests that do not collect blood?
Yes, HIV antibody tests can be done on urine, although it's not very often used, and on saliva, which is quite often used. So you don't have to have a blood test to have an HIV antibody test.
Do I need to take more than one HIV test for an accurate result?
It's usual with HIV and antibody testing to do an initial screen with an ELISA antibody test, but that can have some false positives. So, that test is usually confirmed by a separate test which in the United States is usually a Western Blot antibody test. This test look more specifically not just at antibodies to the virus but looks at several different proteins in the virus to see if you have antibodies to several different proteins and if that test is positive, then you're pretty sure it's not crossed reactivity to something else with would could leave to false positive test.
When will I receive my HIV test results?
An HIV antibody test result can be available in 15 minutes with a rapid HIV test. And that's the HIV test that we recommend being used, because if you do the routine test and send it to the laboratory, when the result comes back in two or three days' time, often the HIV patient doesn't return for the result; and if the result is HIV positive, that's a bit of a tragedy. So we like to know right away what the result is so that we can do the confirmatory HIV test, test the patient's immune system to see if they need treatment for HIV, and get them into HIV treatment immediately and not lose them.