June 27th is National HIV Testing Day
The CDC estimates that only 1 in 7 people who are infected with HIV are aware that they have HIV and have sought treatment. This is a clear indication that there is a lack of education, resources, and services within high-risk populations as well as the general public.
STOP THE STIGMA! Getting tested for HIV and other STDs shows that you respect yourself and your sexual partner.
Routine HIV and STD screening should be a part of an, overall, healthy lifestyle.
There are many social projects, both privately and government funded, that are working to increase awareness and make HIV testing part of standardized health care protocol. Momentous strides have been made in the availability of testing and treatment. Yet, even with so many medical and service-based advances, the identification and treatment (pre and post exposure) of HIV is still lacking at a level that is dangerous and poses a real health risk to all sexually active individuals.
This year marks the 23rd Annual NHTD and is promoting itself with the theme of “Doing It My Way.”
“Doing It My Way,” signifies the fact that there are more resources, opportunities, and services, than ever, to be screened and pre-screened for HIV and other STDs. This 2018 theme is consistent and aligned with the CDC’s (Center for Disease Control’s) year-round “Doing It,” Campaign which is part of their overall Act Against AIDS, initiative.
The overall goal of both the NHTD “Doing It My Way,” and the CDC’s Act Against Aids initiative is to instill and de-stigmatize the routine testing for HIV as part of any sexually active persons regular healthcare/well check routine. In the words of the “Doing It” campaign:
“He’s doing it. She’s doing it. YOU should be doing it, too.
Within the “Doing It” campaign is the call to, not only be tested, but to become educated, aware, and involved.
STDAware is committed to supporting the efforts of the CDC and the Secretary’s Minority AIDS Initiative Fund (SMAIF) to educated as many people as possible and to provide accessible testing solutions along-side no-cost resources to assist in the reduction of the spread of HIV.
STDAware offers both RNA and Antibody HIV testing.
- To learn more about the RNA Early Detection testing offered by STDAware, click here
- To learn more about the Antibody HIV testing offered by STDAware, click here
In honor of the 2018 National HIV Testing Day, STDAware has compiled the following overview of HIV facts and resources.
What IS HIV?
Human Immunodeficiency Virus (HIV) is a retrovirus. A retrovirus is an RNA virus that inserts a copy of itself (DNA genome copy) into a human cell and “tells” it to replicate and multiply. HIV specifically attacks and inserts itself into the CD4 white blood cells (T Cells), which are responsible for the body’s immune response to other virus and bacteria. HIV, in essence, destroys the human body’s ability to fight infections and illness by mutating the cells responsible for those essential immune system functions.
If left untreated HIV will, over time, turn into AIDS (Acquired Immune Deficiency Syndrome) at which time an opportunistic infection, cancer, or even a basic cold, can take hold in the body and become fatal.
There are 3 stages of HIV:
Stage 1: Clinically referred to as an “acute HIV infection,” this stage will present itself as a flu or cold within 2-4 weeks after infection. During this stage, the “viral load” (amount of HIV in the blood) is very high and therefore increasingly contagious. However, it is all too common for someone infected with HIV not to experience any symptoms and to subsequently continue to spread HIV to others without knowing it. This fact, coupled with the viral load of someone in the acute stage of an HIV infection, makes getting tested before entering into any new sexual relationship a critical factor in reducing the spread of HIV. It is also important to know that a standard HIV antibody test will often miss an acute infection because it seeks to identify antibodies for HIV. During the acute stage of HIV, the body has not had enough time to produce enough antibodies to be recognized by a standard or rapid antibody test. An early detection or RNA HIV test will yield more accurate results and checks for an actual HIV infection rather than the antibodies.
Stage 2: This is the “latent” stage of HIV, which means that, while HIV persists within the body, the rate of replication has slowed down and the viral load is reduced (compared with the acute phase). During this phase, an infected individual will experience no symptoms or illness but they will remain contagious and can continue to spread HIV to others. The latent stage of HIV can last for approximately ten years, although, based on an individual’s internal and external factors, some people may move through the latent phase faster or slower than others. However, if someone who is infected with HIV is treated and properly “adheres” to their treatment protocol (takes medication every day, at the same time, on schedule), the latent stage of HIV can last several decades. Many people who are HIV positive live long, happy, and fulfilled lives when treated.
Stage 3: At this point of infection, the viral load increases to a point where there are not enough T cells (below 200 T cells per mm) to fight off any form of infection and a person is considered to have AIDS. During this time many opportunistic infections can invade the body and become lethal. People with AIDS are highly contagious, and the average life expectancy is three years (CDC, 2018).
There are two types of HIV
- HIV-1 is the most common form of HIV in the world and has a quicker progression to AIDS than HIV-2, when not treated.
- HIV-2 is mostly found in the western parts of Africa and has a lower mortality rate than HIV-1 as it takes longer for it to progress to AIDS.
Both HIV-1 and HIV-2 are transmitted in the same way but the DNA differences in each virus are large enough (55% different) that some antigen HIV tests will not recognize and HIV-2 infection (AIDS Map, 2012).
STDAware provides an HIV antibody blood test that is sensitive to both HIV-1 and HIV-2 markers. To learn more about the HIV Antigen blood test, offered by STDAware, click here.
How Is HIV Transmitted?
HIV is transmitted when the blood, semen, pre-seminal fluid, rectal fluid, vaginal fluid, or breast milk of an infected individual comes into contact with the mucous membrane of an uninfected person. Mucous membranes are found in the vagina, penis, rectum, mouth, and eyes. Sharing of needles and needle equipment can also transmit the virus because infected blood can remain on the needle or equipment when used by another person.
HIV can be passed from mother to infant during pregnancy and breast feedings. While HIV positive pregnant women can reduce the risk of passing HIV to their babies during pregnancy, with proper HIV treatment, mothers with HIV should opt to formula feed their babies or apply for breast milk from a milk bank.
HIV is not transmitted through saliva, sweat, or tears unless there is blood mixed with it. HIV cannot be transmitted by mosquito, tick, or other bug bites. And HIV cannot be spread through any physical contact that does not involve the exchange of bodily fluids (such as mutual masturbation or social touching, closed-lipped kissing, shaking hands, etc.) HIV cannot be transmitted by food handled by an HIV positive person.
To read the CDC’s resource about HIV transmission and risks, click here.
Who Is At Risk For HIV?
The CDC estimates that at the current rate, 1 in 50 men will be diagnosed with HIV at some point in their life. And only 1 in 8 women living with HIV has been tested and diagnosed.
High-risk individuals are people who have unprotected oral, anal, or vaginal sex. Men, who have sex with other men and anyone who has multiple sex partners within a short timeframe, have an elevated risk of HIV. Intravenous drug users who share needles are at high risk of HIV infection due to blood that can remain on the needles and needle equipment. In addition to the risk of HIV infection from shared needle use are the risks of Hepatitis and other blood-borne pathogens. Other individuals at risk are those who work in a healthcare environment that could expose them to the virus through needle stick injuries or handling of biohazardous products, and anyone who shares needles with a potentially infected person(s).
In 2015, men who had had sex with other men accounted for 67% of all new HIV infections among males in the United States (CDC, 2018). Therefore, men who have sex with other men or individuals who have multiple sex partners in a short time span should consider being tested two to three times a year.
Specific groups are at higher risk of HIV infection due to geographic community, socioeconomic, and resource accessibility factors. To see the CDC’s compilation of data about the different population risks, click here.
STDAware makes getting tested for HIV quick, simple, and stress free. To find out more about how to get tested at STDAware, click here.
Other STDs Can Increase The Risk of HIV
The relationship between other types of STDs and HIV infection is one to take under serious advisement. Many people with certain types of STDs are often co-diagnosed with multiple STDs at one time. The reason for this is the fact that having one infection creates an “opportunity” for another virus to invade the body easily.
Having herpes, gonorrhea, chlamydia, or syphilis, as well as any form of hepatitis, can increase your risk for HIV infection by the nature of how HIV attacks the body. In the case of herpes, where there is an open sore on the skin of an affected individual, HIV then has an additional open pathway into the bloodstream. Coupled with the fact that HIV is attracted to and attacks the T cells that will be abundantly present on a herpes sore as the body attempts to fight off the herpes infection, it is wise to consider being tested for HIV if you are diagnosed with herpes. Likewise, any other STD (gonorrhea, chlamydia, syphilis, hepatitis, A, B, C) will increase the presence of T cells in the body making a more abundant source of target cells for HIV to attack.
STDAware offers full panel and individual STD & HIV testing options. To learn more about the testing services provided by STDAware, click here.
How Do You Know If You Have HIV?
The only way to know, for certain, if you have HIV is to get tested. While many people with HIV will experience flu-like symptoms among other associated symptoms, many people will exhibit no symptoms at all or mistakenly contribute their feelings of malaise to other, unrelated, illness.
With over 4,000 testing laboratories, nationwide, getting tested for HIV with STDAware is convenient and simple. To find an STDAware testing location near you, click here.
When Should You Get Tested For HIV?
If you are experiencing symptoms such as chills, fever, rash, ulcers in the mouth, body aches, or swollen glands and believe that you may have been exposed to HIV, getting tested is vital to proper treatment and management of an HIV infection.
Individuals interested in the preventative HIV treatment called PrEP (pre-exposure prophylaxis), which can be taken before exposure to HIV, such as would occur due to occupational hazards or when planning on entering into a sexual relationship with an HIV positive person (medically referred to as serodiscordant coupling), are required to have a negative RNA test result.
Individuals who have reason to believe that they have been exposed to HIV due to a need stick injury, sexual intercourse with someone whose sexual health is unknown, or sexual assault are required to have a negative RNA test result to qualify for starting post-exposure treatment or PEP (post-exposure prophylaxis). PEP must be initiated within 72 hours of suspected exposure in order to be effective. While an RNA test result may not detect an acute HIV infection before three days, a negative test result will confirm that the individual is not already infected with HIV from any previous encounter before starting treatment.
Individuals who undergo PrEP or PEP will be required to have follow-up HIV testing performed throughout the course of their treatment. To learn more about PrEP and PEP in the STDAware blog, click here.
How Do I Get Tested for HIV, And How Does It Work?
Getting tested for HIV involves a simple blood test. A small sample of blood will be taken to check for either the virus itself (RNA test) or antibodies for the HIV (Antibody test).
STDAware makes getting tested for HIV simple, fast, and convenient. We know how nerve-wracking it can be waiting to get test results. That’s why STDAware provides the fastest turn around time for test results in the industry. Once testing is completed, patients will receive their results within 1-2 days.
My HIV Test Result Was Negative. Should I Get Tested Again?
A negative test result does not always mean that you do not have HIV. This could be due to two main factors.
- The type of testing being performed
- The time period in which the test was conducted
Depending on the time frame and the type of HIV testing conducted, a negative HIV result may miss an acute infection.
There are two main types of HIV blood tests:
An RNA HIV blood test will be accurate within three days to 4 weeks after suspected exposure. An RNA HIV test will detect actual HIV in the bloodstream and will, generally, yield the most accurate results for an acute HIV infection. To find out about the HIV RNA blood tested offered at STDAware, click here.
In comparison, an Antibody HIV blood test will only look for antibodies against HIV in the bloodstream rather than the actual virus. And because it takes the human body some time to create enough antibodies to be detectable in a blood test, the antibody test is not accurate until between 2-9 weeks after exposure. To learn more about the HIV antibody blood test offered by STDAware, click here.
A follow-up test at least 90 days after your most recent, suspected, exposure is advisable, to confirm a negative test result. It is also prudent to be retested before and after entering into any new sexual relationships, needle sharing partnerships, or new sexual behaviors.
If your last HIV test was negative, but you have had unprotected sex with a new partner since your most recent test, the only way to confirm your HIV negative status is to get tested.
My HIV Test Result Was Positive. What Next?
If your test results come back positive for having an HIV infection, a doctor will reach out to you to arrange for a confirmation test to ensure that the test results were accurate. If the second test comes back positive, treatment for HIV should begin immediately.
STDAware cares about you and your health and wants to ensure that you have the resources and care you need to move on with your life. That’s why STDAware offers a free post-test consultation to any STDAware patient who tests positive for having HIV. The post-test consultation call will consist of the doctor reviewing the test results (current viral load) and what they mean (what stage of HIV infection you are in). You will also be provided information about and resources for obtaining treatment. To find out more about the no-cost consultation and services offered by STDAware, click here.
Receiving a positive HIV test result can be life-altering. It is normal to experience a range of emotions from depression, sadness, and anger. It is important to remember that many people live long, successful, and happy lives while managing an HIV infection. Medical technology, advances, and breakthroughs are continually being made, making HIV a very livable condition. Finding support is a vital key to maintaining a balanced life. Finding other people who are living with HIV and learning from their stories can be highly beneficial. You can find support groups and hear other people’s stories at several websites such as Positive Spin, HIV Treatment Works, and Let’s Stop HIV Together, among others.
Can HIV Be Cured?
There is no known cure for HIV or AIDS at this time. However, there are several successful and effective treatments available to manage HIV and its symptoms. The type of treatment used for HIV is called ART (Anti Retroviral Therapy) and consists of taking a combination of antiretroviral medications that are tailored to the individual’s unique factors and medical history (WebMD, 2018).
There are more than 24 specific antiretroviral drugs, currently available, which each act in a particular way to slow the replication of HIV in the body. Each drug falls into one of seven categories according to the specific manner in which they control HIV and reduce the viral load that any one person carries at a time. The seven groups of Anti Viral Medication are:
- Non-nucleoside reverse transcriptase inhibitors (NNRTIs) which work by turning off the protein needed by HIV in order to replicate. The drugs most commonly prescribed as NNRTIs are efavirenz (Sustiva®), etravirine (Intelence®) and nevirapine (Viramune).
- Nucleoside reverse transcriptase inhibitors (NRTIs) which work by providing an unstable “target” for HIV so that when HIV attempts to use the NRTI to replicate itself, it will degenerate instead of multiplying. The drugs most commonly prescribed as NRTIs are Abacavir (Ziagen) and the combination drugs emtricitabine/tenofovir (Truvada ®), Descovy ® (tenofovir alafenamide/emtricitabine), and lamivudine-zidovudine (Combivir).
- Protease inhibitors (PIs) work by inactivating the HIV protease (another protein needed by HIV in order to multiply). The drugs most commonly prescribed at PIs are atazanavir (Reyataz®), darunavir (Prezista ®), fosamprenavir (Lexiva) and indinavir (Crixivan).
- Fusion inhibitors work by creating a protective barrier around the body’s T cells blocking HIV from being able to attach to the target cell.
- Chemokine Coreceptor CCR5 antagonists work to block the receptor on the T cells so that HIV cannot enter the cell and create copies of itself. There is currently only one CCR5 medication, Selzentry® (maraviroc).
- Integrase strand transfer inhibitors (INSTIs) and work by turning off another protein needed by HIV to multiply (integrase). The drugs most commonly prescribed as INSTIs are raltegravir (Isentress ®) and dolutegravir (Tivicay ®).
- Post-attachment inhibitors (PIs) work by inhibiting an infected cell to complete the replication process. The post –attachment inhibitor drugs Trogarzo™ Ibalizumab is administered by injection. PIs are usually “boosted” with another medication such as cobicistat (brand name: Tybost) or ritonavir (brand name: Norvir ®) to increase the effectiveness of the PI.
HIV treatment is typically a “cocktail” prescription of at least three different medications from two to three of the seven categories. First-time treatment generally involves two medicines that are NRTI medications plus an INSTI and an NNRTI or PI with a boosting medication. Treatment will change and evolve throughout the management and treatment of an individual HIV infection. To learn more about different treatments and drug facts, provided by the DHHS (US Department of Health and Human Services) click here.
Successful HIV treatment means taking ART every day, at the same time of day. Adherence to the prescribed protocol and schedule means a commitment to finding ways to keep to a medication schedule and creating a lifestyle that supports your healthcare routine.
Typical side effects of HIV treatment can include upset stomach, nausea, vomiting, kidney and liver dysfunction, weakened muscles, and bone density loss.
Close contact with your doctor, regular check-ups, and additional testing are vital to ensuring any HIV treatment protocol is working, as it should. Your doctor will be able to make adjustments based on your reaction to the medication and personal health history.
The goal of HIV treatment is to reduce the viral load that a person has (amount of active HIV in the blood) to an undetectable amount (<50 copies/mL). Once ART is started, the average time it takes for treatment to become effective is 3-6 months. It is critical to note, and it cannot be overstated that even though ART may succeed in making the HIV viral load undetectable, it does not mean that HIV is cured. And, while it does reduce the risk, HIV can still be transmitted and infect other people while being treated at undetectable amounts.
Most insurance plans will cover or partially cover HIV treatment and prescription services. However, if you are unemployed, underemployed, do not have insurance, or otherwise cannot afford HIV treatment there are many government services to assist in HIV treatment services and medication. Some services that aid in providing HIV medication include Medicaid, The Ryan White HIV/AIDS Program, as well as many Healthcare centers and other government-funded programs for women and children, veterans, and Native American groups https://www.hiv.gov/hiv-basics/staying-in-hiv-care/hiv-treatment/paying-for-hiv-care-and-treatment. To find out more, click here.
Can I Get Infected With HIV More Than Once?
Yes. It is possible to become infected with multiple strains of HIV resulting in what is referred to as an HIV superinfection (HIV SI). The first finding of an HIV SI occurred when an individual was found to have both HIV-1 and HIV-2 at the same time. In this clinical case, the HIV-1 strain was distinctly different than the HIV-2 infection. Medical authorities also believe that some cases of HIV SI could occur when the same strain of HIV mutates to create two similar but separate HIV strains in a single host (NCBI, 2013).
To detect an HIV SI, blood tests are done to look for both HIV-1 and HIV-2. Unfortunately, testing cannot identify two types of HIV-1 and therefore increases the need to need for regular STD testing throughout treatment. Having an HIV SI can make successful treatment difficult, if not impossible.
HIV positive individuals should take every precaution to avoid behavior that puts them at risk for additional infection (AIDSMAP, 2009) from both other forms of HIV and other STDs as the immune system is already compromised and therefore vulnerable. Routine testing and follow up appointments during HIV treatment is a critical element for successful treatment and management of any HIV infection.
HIV & Pregnancy
In general, pregnant women can safely take HIV throughout pregnancy and should continue to do so for the rest of their lives. HIV medication protects both the infant’s health as well as the mother’s (DHHS, 2018).
HIV can be passed from mother to child during pregnancy. However, if HIV is caught and treated before the mother’s viral load is at a critical level, transmission to the baby can be reduced to less than 2% (March Of Dimes, 2018). Risk of transmission to a baby in utero is increased if HIV is acquired during pregnancy. Mother’s who test negative for HIV before or at the beginning of pregnancy should exercise measures to ensure they remain negative.
HIV positive women who are pregnant, or are planning to become pregnant should take every precaution to ensure their viral load stays at undetectable levels by strictly adhering to their treatment protocols and avoiding high-risk behaviors such as having unprotected sex with new partners who have not been tested for HIV or other STDs or sharing needles and equipment.
HIV positive mothers should be tested early during their pregnancy and at several points throughout the pregnancy to ensure the HIV viral load is at appropriate levels. The prenatal medical staff will monitor HIV viral load levels during the days leading up to delivery. Depending on the level of viral load a C-section may be performed to avoid the risks associated with a vaginal birth.
Babies born to HIV positive mothers will receive treatment shortly after birth and continue to receive treatment up to six weeks after birth. They will also be required to submit to HIV blood testing every 3 to 6 weeks until they are six months old.
HIV mothers should avoid breastfeeding, even if they are taking ART. Breastmilk is a high-risk mode of HIV transmission, and some of the medication prescribed for HIV could contribute some level of toxins in the breastmilk as well. Many hospitals will provide resources to subsidized formula payment and HIV negative breastmilk banks.
Outside of abstinence or being in a long-term, mutually monogamous, STD-free relationship, there is no 100% prevention against HIV or other STDs.
Routine and pro-active STD screening as part of an overall healthy lifestyle provides a significant reduction in the spread of HIV. Medical experts agree that when both parties of a new relationship are tested for HIV and STDs before having sex, the reduction of the spread of disease is remarkable.
Aside from a mature approach to sexual health and STD screening, other health measures to prevent HIV include:
- Consistent and correct condom use. To read the STDAware blog on proper condom use, click here.
- Reducing the number of lifetime sexual partners
- Do not share needles or needle equipment
- Have mature and open conversations with your sexual partner(s) about STDs
If you are unsure of your level of risk, the CDC provides an HIV Risk Reduction Tool that can help you to determine your personal level of risk based on the individual health and lifestyle factors you enter into the risk calculator. Click here to find out more.
Responsibility to Report an HIV Infection
Having an HIV or certain other STD infections require a certain level of disclosure to state and government authorities. HIV and STD infections are often reported to the CDC, World Health Organization (WHO), and other public health entities for census purposes only. Personal details will not be shared when disclosing the instance of disease.
However, depending on the state you live in, some liability is involved when it comes to “informed consent” (the requirement to inform any sexual partner of an HIV or STD infection before sexual contact). Failure to meet legal demands surrounding HIV or STD status could result in criminal or civil charges. To learn more about individual and government privacy rights as well as the current state laws surrounding HIV/STD status, click here.
HIV Awareness & Education
HIV testing services are abundant and accessible. The main reason for lack of proper HIV testing and HIV identification is due to lack of awareness and stigmatization of individuals living with HIV or other STDs.
The onerous of education, awareness, and testing and treatment availability falls to the current generation and community. Removing the stigma of getting tested for HIV is just one goal in the fight against the spread of HIV and AIDS.
If you are interested and would like to organize your own HIV Testing Day Event, the Secretary’s Minority AIDS Initiative Fund shares some great tips on how to prepare at https://www.hiv.gov/events/awareness-days/event-planning-guide. The DHHS (U.S. Department of Human and Health Services) also provides some tips on how to get involved and help promote NHTD and overall HIV awareness at https://healthfinder.gov/NHO/JuneToolkit.aspx
Communication surrounding what HIV testing is and how it supports the health and well-being of the US population is one step in ensuring that routine HIV testing is a standard part of overall healthcare and healthy lifestyle management.
- To visit the no-cost resource center provided by STDAware, click here
- To learn more about how simple, easy, and convenient getting tested at STDAware can be, click here.
- To contact one of our counselors click here or call toll free: 1-855-588-6958 or email: firstname.lastname@example.org
STDAware supports and wants everyone to join the CDC’s campaign mission:
“Doing It. Testing for HIV.”
STOP WORRYING. GET TESTED.