The Human Immunodeficiency Virus (HIV) is the virus that causes Acquired Immune Deficiency Syndrome (AIDS). An HIV test will tell you whether you have been infected with the HIV virus.
How is HIV Spread?
Different types of viruses spread in different ways, and some are transmitted more readily than others. The HIV virus specifically is transmitted through contact with the blood, semen and pre-seminal fluid, vaginal and cervical secretions, and breast milk of an infected person. Most commonly this occurs when such bodily fluids are exchanged through sexual contact (vaginal, anal, or oral sex), or through the sharing of used needles by intravenous drug users. An infected mother may also infect her baby during pregnancy, at time of birth, or while breast feeding.
Once such bodily fluids are outside the body and exposed to the air, the virus soon becomes inactive. Contact with the still active virus outside the body in sufficient volume to result in transmission is very rare, though not impossible.
You cannot get infected with the HIV virus by donating blood.
How Can You Lessen Your Chances of Being Infected By HIV?
Since the HIV virus is spread through the exchange of certain bodily fluids, the best way to avoid being infected with the virus is by avoiding exchanging these bodily fluids.
You can reduce the risk of the sexual spread of HIV by abstaining from sex, refraining from sex acts that result in exchange of the bodily fluids that can transmit HIV, or making sure you and your partners always wear condoms when having sex. (Note that not all condoms are equal. The most effective in preventing the transmission of the HIV virus are latex condoms used with water-soluble lubricants.)
Partner selection is also a factor in your likelihood of being infected. You are at greater risk, all else being equal, if you engage in sex with someone you know is HIV-positive, or someone who is at high risk of being HIV-positive, such as a prostitute (male or female), someone who has had sex with many partners, or someone who engages in sex without using condoms or otherwise doesn’t practice wise precautions. The presence of a non-HIV sexually-transmitted infection (STI) can also be a factor to consider, in that the same behavior that can result in someone being infected with a non-HIV STI also increases their risk of being infected with HIV.
As far as the transmission of HIV through intravenous drug use, certainly the best thing you can do is to not inject illegal drugs. Next best is not to share your needles or “works” with other users. At the very least, you should learn to clean any needles or “works” that are shared.
Putting yourself in a condition, or in a situation, that you know tends to lead to your making riskier, less responsible decisions can also affect your likelihood of being infected by HIV. This may mean the abuse of alcohol, the abuse of drugs, failing to treat depression or other mental or emotional illnesses, socializing in certain environments, associating with certain people, etc. — anything that makes you more prone to engage in risky behavior.
PrEP to Reduce the Chances of HIV Infection
To reduce your chances of being infected with HIV, you also have the option of taking what is known as pre-exposure prophylaxis (PrEP). This basically means taking HIV medications as a preventative rather than as a treatment. Studies have shown that taking PrEP medications on a daily basis as directed reduces the chances of sexual infection by more than 90%, and reduces the chances of needle use infection by more than 70%.
There are multiple important precautions to keep in mind, though, if you are considering PrEP.
One, 90% and 70% aren’t 100%. PrEP can reduce the risk of infection, but it doesn’t eliminate the risk.
Two, PrEP involves taking medication daily. If you don’t stick strictly to the required drug regimen, you will not reduce the risk by nearly this much.
Three, you don’t want to fall into the psychological trap of thinking that PrEP has made you safe and that you can therefore engage in risky behaviors you might otherwise not have engaged in. PrEP isn’t benefiting you — in fact it’s harming you — if it encourages you to stop using condoms, choose riskier partners, share needles, etc. In order to be effective, PrEP should augment rather than replace other responsible precautions.
We’ll be happy to explain PrEP and its pros and cons more fully to you if it’s an option you’re considering.
Can You Be Tested to See if You Have Been Infected with HIV?
However wise or unwise you have been in avoiding HIV, you may be uncertain if you have been infected and wish to know. There are tests available that will tell you with a very high degree of confidence if you are HIV-positive or HIV-negative.
The Be Well Medical Clinic offers HIV testing that is performed on a specimen of blood. This is the same kind of blood draw that you have likely experienced many times at routine check-ups and carries virtually no medical risks.
Testing is available at numerous other medical practices, as well as at local health departments or clinics that may provide the testing free.
If you choose Be Well for your test, there are two options. One is to have the blood sample sent to an external lab, and the other is for the sample to be tested here in our office.
If you choose to have the sample tested in our office, the results will be available within an hour, usually within a few minutes, whereas if the sample is sent out to a lab, the results will be available in one to two days. On the other hand, insurance typically covers having the sample tested externally but does not cover it being tested in our office.
So you can have the results nearly immediately and pay out of pocket (about $30), or you can wait a day or two but have your insurance pay.
Should You Be Tested for HIV?
Whether to be tested for HIV is a very personal decision.
Some people definitely want to know if they are positive or negative, and get tested regularly.
Some people only get tested once or occasionally, in response to some specific experience that they are concerned could have resulted in their being infected.
Some people choose never to be tested. Their philosophy is that they’re going to live their life taking all the same responsible precautions against transmission of the virus that they would if they knew that they (or their partners) were HIV-positive, so in that sense they don’t need to know.
It’s worth noting, though, that there are important reasons in favor of being tested.
One is that HIV is now very much a treatable condition, and treatment can commence and be more effective if you learn of HIV infection sooner rather than later.
Another is that testing positive can lead to partners being tested and benefiting from finding out their status, which can also then lead to their altering their behavior to avoid putting others at risk.
HIV counseling and testing
At Be Well, we recommend at least considering HIV counseling and testing if you meet any of the following criteria:
You currently have a sexually transmitted disease.
You currently use intravenous drugs or have in the past.
You are a man who has engaged in sexual activities with other men.
You have had more than one sex partner.
You have had sex with a prostitute (male or female).
You received blood products or blood transfusions between 1978 and 1985.
You are a woman who is pregnant or is considering becoming pregnant.
You have had significant exposure to the blood or bodily secretions of someone who may be infected.
You have had sex with someone who fits in any of the above categories, especially an intravenous drug user.
But ultimately it remains your decision whether to be tested.
Also note that you are not required to receive your test results. Should you choose to be tested but then change your mind after having the test done, you can simply refrain from requesting your test results. Be Well does not attempt to contact those who have the test done at our office; you’ll only receive your results if you request them.
How Should You Prepare for Your HIV Test?
If you do decide to be tested for HIV, there’s really nothing you need to do physically (e.g., not eat for a certain number of hours) in preparation. However, it’s important to prepare yourself psychologically.
As with any health problem, some people who have been tested for HIV and have discovered that they have been infected with the virus have experienced significant stress or other emotional consequences.
You should think about this in advance. What will you do if you test positive? Whom will you tell, and how? What emotional and other support systems are available to you?
Is the HIV Test Confidential?
At Be Well, we do your HIV test anonymously and confidentially unless you tell us otherwise. Note though that if you don’t pay out of pocket for your test but instead have us bill your insurance company, then the test will no longer be fully confidential and anonymous.
What are the Implications of a Negative HIV Test?
False negatives (a test result of negative for a person who in fact is positive) are very rare with the HIV testing currently available. If you test negative, you can be confident that the result is accurate. For peace of mind, you may choose to be tested again to reduce the extremely low likelihood of error even further, but in general a result of negative means you’re negative.
The important exception, though, is if the infection has occurred so recently that it does not yet show up on the test. The test should detect the presence of infection about 95% of the time if exposure occurred at least 25 days earlier, and over 99.99% of the time if the exposure occurred at least three months earlier.
So if something occurred last night that concerns you, a negative test result tells you almost nothing. If it occurred a month ago, then a negative test result is highly significant. If it occurred over three months ago, then a negative test result basically settles it.
So keep in mind that time delay. A negative test result is very accurate in telling you that as of three months ago you had not been infected; it’s not nearly as accurate in telling you that as of the moment the test was taken you had not been infected.
If you do test negative, you may still want to consider counseling to learn how best to protect yourself from infection in the future. If you’re currently HIV-negative that’s great, but let’s keep it that way.
What are the Implications of a Positive HIV Test?
Just as false negatives are very rare with the sophisticated HIV tests now used, false positives (a test result of positive for a person who in fact is negative) are very rare as well. But we recommend that you be retested with a new blood specimen just to be absolutely sure.
A positive HIV test means that there are antibodies present in your blood that your body has generated as a natural consequence of the HIV virus entering your system. The HIV test alone does not tell you how long ago you were exposed to the virus. Nor does it tell you the strength or weakness of your immune system, whether the infection has developed into AIDS or any specific AIDS-related conditions, or how advanced any such conditions are. There are other tests and diagnostic tools for these things. The HIV test is just a way of ascertaining if the HIV virus has been introduced into your system and generated antibodies.
A positive HIV test of course is unwelcome, even devastating, news. But let’s be absolutely clear about a very important point: It is not a death sentence. Whatever the reputation is of HIV and AIDS, however things have been in the past, whatever you’ve heard or feared, to be told you’re HIV-positive is not to be told you’re about to get sick and die. With the extraordinary advances that have been made, an HIV-positive person who follows their treatment regimen strictly can expect to live almost the identical life span as an HIV-negative person, with little if any diminution of quality of life.
If you test positive, this is a time to call upon your emotional support system. This is when you need the help of the people closest to you, the people you can communicate freely and honestly with, the people you can rely on.
Please consider the team at Be Well to always be available to be a part of that support system. We have providers who have spent years — or in the case of Dr. Benson decades — of their careers dealing with all aspects of HIV care, from the physical to the emotional to the social. We have on-staff case care managers who specialize in HIV patients. We have a full time social worker with a Master’s degree in Social Work. We’re here for you.
Beyond that, we can connect you with support programs for people who test positive for HIV, and with mental health care providers who are experienced working with HIV-positive people. You can also call Michigan’s statewide AIDS information hot line at 800-872-AIDS (800-872-2437) to speak with a knowledgeable person who can answer your questions and provide you with more information.
We suggest you be thoughtful about whom you tell about your test result. There can be an impulse to talk about a positive result, as a form of emotional release and to seek consolation and support, and this can indeed be emotionally beneficial. But keep in mind that some people may not understand the nature of the infection or how HIV is actually spread, or they may not keep what you tell them as confidential as you might wish, potentially leading to misunderstandings or conflicts with friends, co-workers, or others. If you’re undecided whether to tell a given party, keep in mind that if you don’t tell them now, you can always change your mind and tell them in the future, whereas if you do tell them, you can never untell them.
If you test positive, you will not have your name released to anyone. For statistical purposes, we are required to report your age, county of residence and probable route of infection to the Michigan Department of Health and Human Services, but not your name or any other identifying information. If you wish us to release your HIV test results to anyone beyond what is required by law, you will be asked to sign a release form stating this.
If you test positive, you have both a legal and a moral obligation to inform current, past, and future sexual or needle-sharing partners of your test result, so that they will have the opportunity to get tested and to take whatever precautions they choose to take. We understand that this can be a painful or embarrassing obligation. One way we can assist you is for us to inform your partners that they have had contact with a person who has tested positive for HIV, without specifying that it was you. Of course this does not guarantee that they will not be able to infer who the HIV-positive person is (for instance, if you are the only partner they have had), but we are willing to do the notification for you if you are more comfortable with that.
Similarly, you are obligated to inform all health care providers, both medical and dental, who provide you treatment. This will help them care for you, and will reduce the possibility of their being infected or infecting others.
If you test positive, make a commitment to yourself to do all you can to live a happy and healthy life with HIV. Through maintaining your mental and physical health, you can reduce the risk of HIV infection progressing to AIDS. That means taking your medications as directed without any interruption, maintaining good nutrition, exercising, getting adequate rest, managing stress, maintaining positive emotionally supportive relationships with the important people in your life, and reducing or better yet eliminating your consumption of alcohol, tobacco, or recreational drugs.
Also make a commitment to be responsible about not putting others at risk. As noted, that includes informing any partner or potential partner of your positive status. It also includes either avoiding any sex act that can result in the exchange of bodily fluids or always using latex condoms with water-soluble lubricants, and never sharing needles. In addition, you can no longer be a blood donor or organ donor.
HIV is a chronic but manageable condition. Proper treatment is crucial. An important decision you have to make if you test positive is where to obtain your HIV treatment. You are not obligated to obtain treatment the same place you took your HIV test. You can be tested at Be Well and go elsewhere for your treatment; you can be tested elsewhere and come to Be Well for your treatment.
But wherever you were tested, we ask that you consider Be Well for your HIV treatment. Dr. Benson is board-certified in Family Medicine and is accredited as an HIV Specialist by the American Academy of HIV Medicine. He has been treating HIV patients since virtually the moment he entered the medical profession, which means he was treating them before the terms “HIV” or “AIDS” had even been coined.
As a primary care, family practice, Be Well is able to handle many common HIV-related problems without having to send you to other providers. For example, we are able to perform a routine skin biopsy rather than send you to a dermatologist or elsewhere. But when necessary, we do have a network of sympathetic and caring health care specialists to assist in your care.
Dr. Benson has a special interest in providing complete primary health care for HIV-positive patients, as for all patients. His medical philosophy is to get to know you and treat you in the best way possible for you, as an individual.
We would be happy to discuss further with you our philosophy, and all we have to offer HIV-positive patients.
Ryan White HIV/AIDS Care & Support Program
Ryan White HIV/AIDS program is the largest federal program designed specifically for people living with HIV/AIDS in the United States. This program provides care and support services to individuals living with this disease. Ryan White is a "payor of last resort" meaning Ryan White will pay for medical costs for individuals with limited income or no source of health insurance.
The Ryan White grant also provides coverage for prescription costs as well. If an individual has no health insurance or needs additional help with high copays, then MI Drug Assistance Program (MIDAP) will benefit you. Check out the link below for more about the Ryan White grant. Click here