Well, my building neighbors know, most of them, that I am HIV positive. All of this, this revelation, started the day I accepted a wonderful invitation from Astrid Fontenelle for one of the many programs she did in her life and, if you want to know, I loved, loved and loved Astrid. An odd figure.
How do I know if I have HIV? What to do to know if I have HIV?
I found this question in one of the first reports of access to my blog, when it was still a website, September 2000, on the servers of Braslink Network. As a person who already knew he was HIV positive, I saw the question as, in a way, silly. But this impression did not last a minute.
I realized the anguish of those words, even though it was the year 2000 and, yes, there was already a reasonable treatment, which brought millions of us here, in the 20s of the XNUMXst century, that question showed the wide darkness, an almost “middle age ”Of the public health in which we lived in relation to HIV and, let's face it, this little thing, I would say very little, has changed!
Everything about sexual and reproductive health was and still is taboo and it is so complicated that, we have to write, it will still be taboo for a long time. And, I believe, the risk is that it will be so forever and ever! Illustrating. If my memory serves me correctly (...) I think it was around 1991. I was visiting my late father's house and we were watching a very heavy film, involving crack, other drugs and human degradation.My sister by association was watching the movie with us when, in a Dantesque scene, an addict came out with this line to the dealer:- "I suck your dick for a stone"! - Continued the drug dealer shot the addict in the head and, see what my poor heart looks like now, for reminding me that I have a daughter who is just that: a knot.Well, my father's reaction to the scene, with the presence of my sister, was so frightening that I thought:- "Okay, fu ***, he'll shoot me"!
The Blue Chenille Quilt
It didn't work. In a later conversation I said to him:- “And you think she, at sixteen, doesn't know what that is? And do you think there is a very remote possibility that she never did? And if she did it, it’s not something she does, a gesture of affection, passion or love, hers, to whomever she did it or, on the other line, an act of her personal lust, common and inherent to all any human person who expresses himself sexually?
And for three seconds and forty-nine hundredths, I thought, as a joke, to ask him if he, bam, bam, bam, had never sucked a penis. I imagined the left hook that I would wear on my chin and, of course, I abstained! 😉
The site that I maintained differed from the one I have now, much more difficult to update that one page took a whole week to create and today it is more or less the same thing, however, the result of the creation is much better and , that is why, somehow the answer that I had posted the question was lost on my website and I republish it here. The answer to this harrowing question:
How do I know if I have HIV?
What to expect when doing an HIV test
The test is used to determine whether you have been infected with the human immunodeficiency virus (HIV). Although the test is commonly performed with a blood or saliva sample, a more recent urine-based test was approved for use in the United States in 2015.
Although testing options at the service location and at home are extremely accurate if used correctly, they can return a false-negative result if you test right after exposure. Yes, yes and yes, you need to wait the immune window is 30 days and period, ok Pandinha (forgive me please, I'm embarrassed)
Purpose of HIV testing
It is estimated that more than thirty million people live with HIV in the world and cynical excuses do not interest me. Go find out if you have no memory of personal suffering and respect these thirty million families. I won't give you a break from this. In 2018, 38.686 adults were infected with the virus. In Africa, there are countless families whose “boss” is a seven-year-old boy, also infected, preparing to pass the scepter to his sister of five. APOLOGIES. Fuck!
Nobody, nobody, can be forced to get tested for HIV but it is absolutely necessary that you make this decision and get tested. In Brazil, for pregnant women, it is mandatory and if the doctor who takes care of your prenatal care does not request it, it requires it, this can prevent your baby from being born seropositive.
Who to test and the euphemisms
Testing every three to six months can be recommended for people at high risk of infection, including:
- Sexually active gay or bisexual men
- Injecting drug users
- People who exchange sex for money
- Anyone who engages in high-risk sex, including sex without condoms or sex with multiple partners
- An HIV test can also be done after a person becomes aware of a partner's HIV status and during a medical evaluation after sexual assault.
Types and what they evaluate
There are indirect and direct methods of detecting HIV. Indirect methods do not detect the virus, but proteins, called antibodies, which are produced by the immune system in response to the virus. Direct test methods detect antigens (proteins on the surface of the virus) or RNA (the genetic material of the retrovirus).
There are a few test options, which vary in speed, accuracy and ease of use:
Rapid on-site testing can provide preliminary results in about 20 minutes. This may require a drop of blood from your finger, an oral swab from your gums, or a urine sample. Of these, the preferred method is the HIV antigen / antibody combination test (Ag / Ab) based on blood.
Tests Can Search for Antibodies (antigens)
Standard point-of-care tests are laboratory-based tests that detect only anti-HIV antibodies. Also known as HIV ELISA, the test requires a blood sample. Results are usually returned within five to 10 business days. The test is less commonly used today and has been largely replaced by the HIV Ag / Ab test combination.
The rapid home tests are for saliva-based antibodies that can be purchased online or at many retail pharmacies. Although less accurate than a point of care test, the test offers privacy and can provide results in about 20 minutes.4
Home collection kits can also be purchased online. This antibody test requires a drop of blood placed on a test card, which you send to a laboratory by express mail. You can then receive the results over the phone or online within one business day after the sample is delivered.
Nucleic acid (NAT) tests are blood-based tests that detect HIV RNA.
Although expensive, NAT can detect HIV earlier than other forms of testing and may be appropriate if you have recently had high-risk exposure or are experiencing acute symptoms of early infection. NAT is also used to screen donated blood or test newborns with suspected HIV. Results are usually returned within a few days.5
Any positive results called the preliminary positive-up require a second confirmatory test to ensure the diagnosis is correct. The only exception is NAT, which requires confirmation.
HIV tests are highly accurate if used correctly. However, some test methods are more reliable than others. Inappropriate collection or storage of samples can also impair the accuracy of a test.
In general, point of care tests are more accurate than home tests (due in part to home user error), while blood tests tend to be more accurate than saliva or urine tests (due to concentrations highest levels of HIV in blood).
Clinics in the United States report a 98,5% accuracy rate when using an antibody test and a 99,9% accuracy rate when combined with a confirmatory test. This translates into a false-positive result for each 250.000 tests. The latest generation tests promise even better results.
Try to get tested at a time when you are healthy. Even the flu can cause problems
Certain diseases can also trigger a false positive test result, which means that the test is positive for HIV while the person is not really infected. Diseases that can trigger a false positive include syphilis, lupus and Lyme disease. Confirmatory tests will almost always eliminate these incorrect findings.
Risks and contraindications
There are no contraindications for HIV testing and there are few risks. If blood collection is necessary, you may experience pain, swelling and bruising at the injection site. Dizziness and infection are also possible.
If you are afraid of needles or are afraid of blood, notify the nurse or phlebotomist in advance. Other test options may be available. In addition, if you have hemophilia or are taking anticoagulants, a butterfly needle can be used to reduce the risk of bleeding.
Before the test
HIV testing does not require preparation beyond your readiness to be tested. Fasting is not necessary, no preparation is necessary, except emotional preparation.
Here I will score something. Beto volpe has been doing the job of talking to people who seek support through Whats App, and I thank God that he likes doing this so much that he does it voluntarily. The other day a person approached him, from Minas Gerais, who took the test in a private laboratory, that some “professionals and health professionals strongly recommend” and the young man simply “saved” the result over the Internet and, without the presence of just one alive soul read by your side, in your results?
This, for me, is something of crazy or irresponsible people. They are not crazy, because they charge the test and charge it well. Therefore, it is irresponsible, as it is impossible to predict how a person will react to this result. A former boss of mine, a crook and a sacripanta, received the result and, with nothing better to do, beat the unfortunate man that I the result. BOYS, I SAW!
In the case of this young man, thanks to God, he had the presence of mind to seek help on the Internet and found this blog and, in this blog, Beto Volpe, very versed in the art of balancing the seven dishes on the seven wands!
With that said, HIV remains a highly stigmatized disease, and people often avoid HIV testing for fear of disclosure.
If you are concerned about your privacy, find a clinic that offers confidential tests (where your name is shared only with your health care provider, your insurance company and a government agency) or anonymous tests (where your name is shared without 1).
Time before testing the immune window.
Time is an important part of HIV testing. If you have been infected with HIV, there will be a period of time, called window period, immune window, the terror and endless drama of many! Panda, pandinha, please forgive me. During this period until sufficient antibodies are formed for detection, the test will not provide a correct result and, if you are contaminated, you will end up receiving a false negative, an inaccurate result, you will return to the normality of your life and, perhaps, transform yourself in a vector. And this is yet another reason why you should always use a condom. Always, always and always!
Always use a condom
Because HIV tests usually detect antibodies and / or antigens, you need to wait until your body produces enough to get a positive result. If you test too early, you will get a false negative reading. Even with NAT, you need to wait until the virus replicates to detectable levels.
Since detectable levels may vary depending on the individual, most clinics will advise you to wait to be tested for HIV after possible exposure:
One to three weeks before doing a NAT
One month before taking an Ag / Ab HIV test combination
Three months before taking any of the other HIV tests
The procedure involves three steps: pre-test counseling, HIV testing and post-test counseling. Depending on the test being performed, the process can take 30 to 45 minutes. Call centers can take much longer.
Local HIV tests are available at many medical and public health facilities. This includes hospitals, clinics, retail pharmacies, community-based HIV organizations, antenatal and family planning clinics, youth reception centers, mobile testing sites and drug and alcohol treatment centers.
To find a test site near you, use the online locator offered by the U.S. Department of Health and Human Services. Many of the sites offer walk-in tests. Others require a consultation.
Food and drink
There are no food or drink restrictions for an HIV test. However, if you are using an oral test at home, avoid brushing your teeth or mouthwashing 30 minutes beforehand, as this can affect the results.
What to take
Even if you are undergoing an anonymous test, the institution may require government-issued identification to confirm your residency. Call ahead for details. You should also check if they accept your insurance, if you have a plan. If so, bring your insurance card.
You can also take someone with you if you are not sure how you would react to a positive HIV diagnosis. Having support can be very important.
HIV disclosure laws
Regardless of whether your HIV test is anonymous or confidential, any positive test results will be reported to the local health department, which, as far as it is concerned, will disclose this information - without your name - to the Ministry of Health. Information is not shared. with any other government agency.
A positive result can also be shared with the doctor who referred you for the test. It cannot be shared with any other doctor or agency without your express written consent. Naturally, SUS will also receive this diagnosis and the doctors in charge of the care that will be necessary to care for your health.
If people try to blackmail you in order not to reveal your results, this is a crime and you must stand up in court against these people. These are legal matters and, at the moment, this blog has no way to guide you.
Seek the social worker from your health center and, above all, consult a lawyer you trust if you consider it necessary
It is a mistake to think that there is nothing you can do after being exposed to HIV recently. If you have had sex without a condom, shared needles, or had some other form of high-risk exposure, you can prevent infection by starting post-exposure to HIV prophylaxis (PEP) within 72 hours. This is a topic that I endorse.
PEP involves a 28-day course of two or three antiretroviral drugs. In general, it is used by health professionals and in cases of rape, the strategy can reduce the risk of infection by up to 79% .6
Find out more here: HIV post-exposure prophylaxis - [in translation]
What to expect when testing for HIV
On the day of the test, after registering, you will be asked to sign a consent form acknowledging that your test results can be shared with the relevant agencies and individuals.
Talk to the office administration if you don't understand any part of the consent form.
Many websites also ask you to complete a questionnaire to get some basic information about you, including your ethnicity, sexual orientation, sexual activity and substance use, and whether you have had an HIV test before. Some of the information will be used for confidential reporting purposes; some to assist in counseling.
Pre-test counseling is carried out in a private room with a qualified health professional. During counseling, you may be asked about recent exposure, if any, as well as your sexual or recreational drug practices. The questions are not meant to judge or embarrass you; instead, they help the counselor to better understand his personal risk of infection.
When I went to do my confirmatory test, right there, at CRT-A, I already had a “preliminary result” in my hands and knew that I would have to attend a lecture. I remember thinking- With six hundred thousand devils! Why, after all, do I need a **** from a lecture, if the worst of all I already know. Answering the questions of the speaker, my reader, I saw how ignorant I was about everything here and, please, the lecture does not last an hour! Hold your wave, keep the shuttlecock in the air and pay a lot, a lot of attention to the lecture. I learned the analogy of the train without brakes down the mountain there, trying to better understand the disease.
The speaker will then explain what HIV and AIDS is, how the test is performed, what an immunological window period is and what reactive (positive) and non-reactive (negative) results mean.
I take the hook to clear some things and put my experience. People were created by God simple and ignorant, there is no harm in that! But many are the ones who ask me what this reagent is with a confused voice!
It seems like a silly question and, I would say yes, it is silly for me, for Mara, for you who have been here the longest, for the health professional who honors me with your attention. But not for the person who, out of nowhere, receives a reactive result.
On this November 13, 2020, I completed another year of conformation, serological awareness and remembered all the pain, fear and chaos installed inside me. I had no doubts about the result.
The test reacted to the presence of anti-HIV antibodies. But for some people, when they receive the non-reactive result, the impression they have is that they have an organism so weak that it has become unable to react to any and all illnesses.
Immune Window: If it is determined that you are taking the test too early, the counselor may ask you to come back when the test is most likely to be accurate. The ideal is to wait at least thirty days. After this period, the result will be definitive in 99.9 of the cases and it is not possible, from the statistical point of view, that a sequence of non-reactive tests is wrong. Not all symptoms in the world, perfectly summed up, can generate this sequence of errors. I quote this excerpt from an article in El Pais:
If the worry starts to consume you, remember that there is an effective treatment and ways to pay it regardless of your income.
If you are unable to handle the situation and do not have someone to talk to, call the 24-hour toll-free HIV hotline in your state to get a referral to a qualified counselor in your area.
Interpreting the results
The time it takes to get results can vary. Many states require that test results be delivered in person only. Although some states allow doctors to provide negative results over the phone, the practice is frowned upon by most health professionals, as it does not allow for adequate post-test counseling and has the potential to break confidentiality that you have been testing (something that you don't want to share). HIV test results are not sent by post.
The test results are interpreted as follows:
If the preliminary test is not reactive, you are HIV negative, which means that you have not been infected or tested ahead of time. Although you do not need further testing (unless the timing of your test is not optimal), you will be informed about ways to reduce your future risk and whether routine testing is necessary if you are at high risk of infection.
If the preliminary test is reactive, the result is considered preliminary positive. To confirm the result, the laboratory will use a more sophisticated test called an HIV differentiation test and possibly NAT. If confirmatory tests are non-reactive, you can be sure with a high level of confidence that you are HIV negative.
If your preliminary and confirmatory tests are reactive, you are HIV positive, which means you have been infected with HIV. Post-test counseling will focus on your emotional and medical needs.
Post-test counseling is always carried out, regardless of the test results. The aim of counseling is twofold: to help you understand what the results mean and to provide you with information about “what's next” to stay safe and healthy.
A positive HIV test result can be shared with CDC, your insurance company, or your doctor, or certain individuals according to the rules you agreed to before the test. If your confidentiality is breached, you can file a complaint with the Department of Health and Human Services and seek legal damages under your state's laws.
When you are diagnosed with HIV positive, you will be informed that there are treatment options and support systems to connect you to medical care. You can also be referred to a care browser that can help you with referrals and any financial, emotional, family, legal or drug treatment services you need.
If you feel confused, you can ask to discuss these things another day or use the time to ask as many questions as you need. Coming to terms with an HIV diagnosis is a process. Don't feel rushed.
However, if you are ready to proceed and the test was performed at a clinic or hospital, you may be asked to do additional tests called CD4 count and HIV viral load. The CD4 count measures the number of immune cells (called CD4 T cells) in the blood and helps establish the strength of the immune system. The viral load uses technology similar to NAT and counts how many viruses are in a microliter (µL) of blood.
Both tests help to establish your initial state before treatment and will be repeated routinely to assess your response to therapy.
HIV treatment should ideally be started at the time of diagnosis. Genetic tests can be used to identify which drugs work best for you. Drug therapy itself usually involves a daily dose and, if taken as prescribed, can guarantee a normal quality of life and an almost normal life expectancy.
You will have ongoing medical assessments to monitor your condition for the rest of your life, the schedule of which will be determined by your doctor.
A positive HIV diagnosis does not mean the same thing as before. Advances in HIV therapy now allow you to live a long, healthy life and never face the prospect of a serious illness related to HIV or AIDS.
A word from Verywell
Getting an HIV diagnosis can be a life-changing event, and there is usually no way of knowing how you will react to the news. Whatever your answer, accept that it is normal. Some people may even feel a sense of relief that they no longer have to ask themselves about their status. By knowing your HIV status, you can make an informed choice about how to protect others from infection and yourself against reinfection.
This does not mean that living with HIV does not have its challenges. If you are having trouble handling the situation, consider joining a support group or seeking individual advice from a qualified therapist.
On the other hand, if you are experiencing extreme depression or anxiety, ask for a referral to a psychiatrist, who can offer you medication and therapy to help you deal with the situation better.