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 www.PrevAIDS.org - About the HIV test.
What you MUST know:
A contagious HIV infected person can have a negative test during 3 months!!!
Usually, the available tests are searching in your blood the presence of a molecule called “antibody" that your body will produce by itself within a few months after it got infected by the virus of AIDS.
The tests which are able to detect the virus itself in the blood are expensive and are used only in very particular cases that doctors only can evaluate.
TIP:
Any new couple should only have "safe sex" practices or be abstinent during the first 3 months of their relationship. Only after this 3 months period, both partners should go for a HIV blood test together. Only if confidence is totally established, unprotected sexual practices are allowed (but not necessarily advisable... see the article about confidence). A man who deserves confidence should even not ask himself to stop the use of condoms. It should be the receptive partner who should suggest it if she/he prefers. That should be the normal behavior of educated and trustable persons in era of HIV.
How to test?
The best way is to go to any public hospitals because the test will be made free (or very cheap) in nearly all countries. The test is trustable since nobody has financial profit in this procedure. In Thailand, the national protocol includes a good logistical environment (even counseling and psychological resources are available).
You should go together with your partner since the best protocol includes few useful questions that may surprise you but will never make you feeling uncomfortable! It has been proved that the positive partner does not always dare to tell the truth to his/her partner and may lie sometimes under the pressure of psychological stress. If you go together and if there is a bad news to hear, you will be surprised by the smart way the care taker will introduce the “best way for future” for both of you.
There are a few particular figures
- For personal reasons, you prefer total anonymous procedure:
- You can go to a private clinic (No guaranty for reliability of the test and quality of counseling) and not free.
- You can obtain an anonymous test in official hospitals if you ask for it.
- In the big towns like Bangkokor Chiang Mai, there are some dedicated places for total anonymous HIV blood test.
- You want to have the result in 5 minutes without speaking with specialized nurses or doctors... Go to a private clinic and ask for a “HIV rapid test”. It is around 5 US$ for one test (No guaranty for reliability of the test and the quality of counseling)
- You want a free test. It depends where you are. A public hospital or some NGOs can offer a free test for you... If you want to know more about the possibilities of free HIV blood test in your city, the best source of information is probably to ask questions in public hospitals or in meeting points of HIV high risk groups (gay bars, brothels, etc.) where NGOs are usually having some AIDS prevention activities. You can also read such information on posters, tracts available on such places or in regional newspapers. Look on posters, leaflets, booklets and tracts in health centers, city hall, sport center…
Which kind of test?
Don't worry too much about that. The problem is not the test but the professionalism and tact of the health care taker who does it for you.
In official hospitals, the protocol uses usually 2 different tests for the same blood specimen. It doesn't matter the kinds of test they use (often one of the 2 test is the "Elisa" test). The protocol is established to obtain finally a result totally sure and reliable.
In other institutions, results are sometimes totally sure (combination of 2 tests) and sometimes not. It depends of the many factors like economical profits, standard of deontology, skill of health workers, turn over of patients, etc. If only one test is done, you must know that false positive results are more common than false negative (if using reliable technology). The HIV rapid test should be preferred because it needs less skill for similar reliability.
The most available technologies
(These topics are typically dedicated for health professionals and not for patients)
- Elisa: "...Since ELISA tests require skilled technical staff, equipment maintenance and a steady power supply, these test are less suitable for smaller or more isolated hospitals, clinics or laboratories. Regular maintenance of the ELISA equipment is crucial for obtaining reliable results..." UNAIDS library (May 2004)
- Rapid test: Several tests for antibodies do not need special equipment or highly trained staff and can be as reliable as the ELISA tests. These tests are called rapid as it takes less than 10 minutes to obtain the result. There are four types: agglutination assays, comb/dipstick assays, flow-through membrane assays and lateral flow membrane assays. In most formats, a positive result is indicated by the appearance of a clearly visible dot or line. Many of these tests have an internal sample addition control that validates each test run. These tests are appropriate for use in small laboratories and for emergency testing in both developing and industrialized countries. Currently, however, the test kits are relatively expensive and most require refrigeration. " (UNAIDS library (May 2004)
- Test to detect the virus itself: "...the tests are very expensive (US$ 60 to 100), need complex equipment, rigorous laboratory conditions and highly trained staff, and are still largely a research tool...." (UNAIDS library (May 2004)
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Annex 1
"...Tests are available that can use whole blood, dried bloodspots, saliva or urine. The collection of these specimens is more client- friendly than traditional blood sampling by vein puncture, and can be done in informal situations such as in a bar or on the street. In particular, saliva and urine tests have proven useful for anonymous testing of hard-to-reach population groups such as sex workers and injecting drug users, and for people who are opposed for religious reasons to giving blood.
The level of antibodies in these alternative specimens is much lower than in serum or plasma, and therefore specific testing procedures must be followed rigorously. While these tests are sufficiently sensitive for surveillance, confirmation of a positive result for diagnosis still requires a serum or plasma sample..." - UNAIDS library (May 2004)
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