Do you know your HIV status? Getting tested can help save lives. Learn the background and importance of HIV testing from our disease area partner, Tamar Tchelidze, M.D., MPH. She’ll explain how HIV/AIDS began, how the disease works, the advances made in testing and therapy and the challenges people living with HIV still face.
In the late 1800s, scientists believe the disease was passed to humans when they came into contact with an affected chimpanzee’s blood. Human Immunodeficiency Virus (HIV) is a virus that attacks the body’s immune system.
Over decades, the virus spread throughout Africa and then to the rest of the world. In the 1980s, HIV became a public health concern because cases were on the rise. While the numbers of infections and deaths are much lower today, many people living with HIV or at risk for HIV infection do not have access to prevention and treatment, and there is still no cure for the disease. Members of Black and Hispanic-Latino communities face higher HIV infection due to a low percentage of prescriptions for pre-exposure prophylaxis (PrEP), used as an HIV preventative, even though they make up two-thirds of people who could potentially benefit from the preventive medications.
HIV attacks a specific immune cell, known as the CD4 helper cell, or T cell. When HIV destroys this cell, it becomes harder for the body to fight off other infections. When HIV is not treated, even a minor infection, such as a cold, can be much more severe. HIV can also lead to severe or serious conditions, such as kaposi sarcoma, which causes lesions in soft tissues.
HIV is preventable. It’s important to know one’s HIV status so that therapy may begin as soon as possible. However, detection of an HIV infection doesn’t show up immediately in tests, as it takes days and often weeks for the infection to grow to the point of detection. Some PCR HIV tests can detect disease within five to 10 days of infection. This is a huge leap over antigen tests, which may take 30 to 60 days to detect the disease.
People may think they are being careful by testing immediately after a sexual experience or needle exchange with someone who has discovered they have HIV. However, to truly be conscientious, they should consider taking immediate PrEP and baseline and follow-up HIV testing should take place, ideally with a PCR test.
PrEP reduces the risk of getting HIV from sex by about 99% when taken as prescribed after first testing negative for HIV. Only 25% of the estimated 1.2 million people for whom PrEP is recommended were prescribed it in 2020. Testing before PrEP helps a doctor determine whether PrEP is right for you. Testing during PrEP helps them monitor your progress.
Early testing and detection can lead to earlier treatment, which is more likely to lead to a functional cure. Acutely infected patients play a major role in HIV transmission because these patients typically have very high viral loads and are unaware of their infection status. Identifying and treating these patients may play a critical role in stopping the spread of the HIV epidemic.
Words matter. We should all learn how to talk about HIV in a way that doesn’t put people down or make them think less of themselves. HIV is like any other chronic disease. It’s important to see the human first, before the disease.
Stigma can result in depression and even suicide, and is a factor in discouraging people to get diagnosed and treated. It’s important for people with HIV to have a strong support network that may include their friends, family and doctors.
One way to reduce stigma is to learn the facts about HIV and to make sure others are aware as well. Familiarize yourself with various HIV-related terms here.
It’s important to know your status. Everyone 13 to 64 should be tested at least once in their lifetime.
If you have had more than one sexual partner or if your sex partner has had more than one partner since your last HIV test, you should get tested again.
If you inject drugs or share needles and drug injection equipment, you should get tested at least once a year.
Knowing when to get tested is also important. Timing matters, and affects what test is best for you. A PCR test should be able to detect HIV infection 10 days after exposure. An antigen/antibody test performed by a laboratory on blood from a vein can usually detect HIV infection 18 to 45 days after an exposure. Antigen/antibody tests done with blood from a finger prick can take longer to detect HIV, from 18 to 90 days after exposure.
Like COVID-19 testing, PCR tests are the most accurate and commonly referred to as nucleic acid tests, and are more likely to be available at hospitals and laboratories. While antigen and antibody tests are more likely to be available at pharmacies or through mail order. Talk to your doctor about which test is right for you and where to get it, or look for testing sites here.
If you test positive, the disease can be controlled with effective treatment that allows people with HIV to live long, healthy lives and protect their partners. With early intervention and treatment, it’s possible to live a normal lifespan. If you have an undetectable viral load, you have effectively no risk of transmitting HIV to an HIV-negative partner through sex.
After a positive test, here are some things you should do first:
See a health care provider even if you don’t feel sick. This is important, as many people newly infected do not feel sick.
If you test positive with an antigen test, you’ll need to get the result confirmed with a PCR test.
If your diagnosis is confirmed, your doctor will want to start treatment right away.
Consider seeing a mental health provider if you feel depressed or stressed. Treating the infection and the feelings that come with it are important in treating the whole person.
Biomedical and scientific research have led to the development of HIV tests that reduce the window period for detection, HIV treatments that allow for customization, and prevention strategies and improved care for people with HIV.
While different innovative approaches have been investigated for many years, finding a cure for HIV has been elusive. Much hope has been directed recently at the first human trials for a series of mRNA-based vaccines against HIV that began in early 2022. Researchers have been working diligently toward a cure for many, many years and we’re confident we’ll get there.
Disclaimer: This content is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with a licensed physician. Always seek the advice of your doctor or another qualified health provider regarding a medical condition.
Tamar Tchelidze, M.D., MPH, is a disease area partner at Roche Diagnostics. She has over 20 years of experience in global health, managing change and transformation with demonstrated agility in academic, private and government environments. Before joining Roche, Tchelidze was the lead liaison for a PrEP Project, designed to review, discuss and recommend strategies that would allow less resource-intensive clinical trial options to approve new PrEP interventions while maintaining scientific rigor.