AIDS and the HIV Antibody Test
Health Services > Sexually Transmitted Infections > AIDS and the HIV Antibody Test                                                  En Español

What is AIDS?

AIDS (acquired immune deficiency syndrome) is a disease that is caused by the human immunodeficiency virus (HIV). In the years following HIV infection, the body's immune system breaks down, and people with HIV get rare infections (called opportunistic infections) and/or some unusual cancers. The viruses, bacteria and fungi that causes the opportunistic infections of AIDS may also be in the bodies of healthy people but do not cause serious disease if the immune system is healthy.

The two fatal diseases most commonly found in AIDS patients are Pneumocystis carinii pneumonia (PCP), a lung infection caused by a parasite, and Kaposi's sarcoma, a rare form of cancer or tumor of the blood vessel walls. The nervous system, including the brain can also be involved. Other less serious conditions are often found in HIV-positive people long before any serious breakdown of the immune system has occurred.

HIV was officially declared to be the cause of AIDS in 1984. Shortly after the discovery of HIV, a test was developed to detect antibodies to the virus.

How does a person get HIV?

HIV is present in body fluids such as blood, semen, breast milk, and vaginal discharge of infected people. To get HIV, a person must get infected body fluids into her/his bloodstream.

HIV is spread through unprotected sexual contact and through exposure to blood or some blood products. It is spread through sharing needles or equipment used for injecting drugs, because some blood gets into these and remains there after injection.

Health workers may become infected if exposed to infected blood.

A woman infected with HIV can give it to the fetus while she is pregnant or to the child at the time of birth or through breastfeeding. HIV cannot be spread by casual means. HIV cannot be transmitted through touching, hugging, shaking hands, sneezing, coughing or kissing, or from mosquito or other insect bites.

What is the HIV antibody test?

When a person is infected by a germ of any kind, including a virus, the body's white blood cells begin to fight the infection by producing things called antibodies. A different antibody is produced for each different germ. A lab test can be done to look for the specific HIV antibody in a person's blood or other body fluids. A positive result means that the HIV antibodies have been found.

If you have this test done, a small amount of blood or other body fluid will be collected for testing. If a blood sample is taken, you may have some slight discomfort where the needle punctures the skin, and a small bruise may develop. Otherwise, there is little or no risk of physical injury. The sample will be sent to a state licensed laboratory for testing.

Sterile, disposable needles are used. A new, clean needle will be used to draw your blood. After your blood has been collected the needle will be disposed of in a special container. You are not at risk of getting HIV from this blood drawing procedure.

Who is at risk? Should you be tested?

The number of women with AIDS is actually increasing faster than the number of men with AIDS. Heterosexual contact is the most rapidly increasing transmission category for women. Many women don't think they are at risk because they mistakenly think only gay men or drug users get AIDS.

One act of unprotected (without a condom) intercourse can give you HIV and AIDS. If you recognize any of these behaviors that can increase your risk of infection, please consider being tested:

• more than one sex partner (casual or steady);
• sexual activities without protection (no condom, vaginal pouch, or dental dam) including vaginal, anal, and oral sex, both receptive and insertive activities;
• sex with a person known to be HIV-positive;
• sharing needles or having sex with persons who share needles;
• history of STIs and having sex with persons who have STIs, especially genital lesions;
• sex in exchange for drugs, money, or other inducements;
• use of substances such as alcohol, cocaine, etc., in connection with sexual activity;
• inconsistent condom use; · exposure to the following since 1978:
• artificial insemination with untested donor semen;
• blood or blood products transfusion (especially between 1978 and March of 1985);
• tissue or organ transplantation (especially between 1978 and March of 1985);
• unsterile tattoo, body piercing, scarification, or other body decorating that may draw blood.

Women considering becoming pregnant, or already pregnant and planning to continue the pregnancy, may also wish to have an antibody screening test. If positive, there are medications that pregnant women can take to reduce the chance of transmission of HIV to the fetus.

Some sexually transmitted infections (such as syphilis and herpes viruses), hepatitis, and other diseases have been shown to increase the risk of getting HIV. Reducing the risk of all sexually transmitted infections helps reduce the risk of infection with HIV and may slow down progression to AIDS.

Anyone may get an antibody screening test simply by requesting it. You should discuss your situation with the medical staff in deciding whether to be tested for antibodies to HIV. It is worth knowing whether your test result is positive or negative. If the result is positive, you get a chance to slow the disease down by obtaining specific medical care. You can also use behaviors that avoid infecting others. If your test is negative, but you have been involved in high risk behaviors, you can change your sexual or drug using practices. (You should also re-test in 3-6 months.) Low-risk-taking people with a negative test result can be reassured. You would have the opportunity to learn how to continue to lower your risk in the counseling sessions.

A positive HIV antibody test result can have a significant psychological impact on both the person tested and those who are close to him or her. At the present time, there is no cure for HIV. Antiviral therapy is available, however, and may slow the progress of the disease.

It is possible that some insurance companies or employers may seek information about positive test results as a condition of coverage or employment. Under the Americans with Disabilities Act (ADA) it is illegal for most employers to inquire about, or base a hiring decision on a person's HIV status. If an employer inquires, you can deny their request by discussing the fact that this is illegal under the ADA. As of now, insurance companies still have the opportunity to deny insurance to you based on an HIV-positive test result. They will consider that you have a pre-existing medical condition, and that means they don't have to insure you. In some states, reporting of positive results to the state may be required by law.

What about confidentiality or anonymity?

We understand a person's need for confidentiality or anonymity in connection with an HIV antibody test.

Anonymous testing means that you never give your name to anyone at the clinic and there is no record of your test results. Some states do not permit anonymous HIV antibody testing.

For anonymous testing, a unique patient number will be given to you when you call for an appointment. You use this number for identification when you come to the clinic to be tested. You will be able to give a false name (e.g., Jane Doe). The specimen is labeled with your unique patient number. You also use this number to collect your test results.

For confidential testing, your name will be known to clinic staff. The confidentiality of all charts is respected. All employees and volunteers have signed a pledge to respect the confidentiality of patients. (If you request that your chart be copied and sent to another health center, your HIV test result would not get copied.)

What does a positive test mean?

A positive test result nearly always means the person has been infected with HIV, the virus that causes AIDS. Among persons at high risk for having the infection, false positive HIV antibody test results (where the test is positive but the person really doesn't have HIV) are extremely rare. If you think a mistake has been made in your test results, you may get tested again.

Infection with HIV is for life. There is no cure--yet--for HIV or for any other virus. A positive test doesn't necessarily mean a person has AIDS, but it does mean she or he has the HIV virus in their body. Based upon other signs and symptoms, she or he may be diagnosed as having AIDS currently and, if not, will likely develop it in the future.

As many as 50% of people with HIV may develop AIDS within the first seven years of infection. Persons with HIV infection must take better care of their health, and regular medical evaluations are strongly recommended. Antiviral therapy is available, and usually slows the progress of the disease. More HIV-infected people develop AIDS as they age and have more years with HIV infection. However, some people have had HIV for over 10 years and have not developed AIDS.

An HIV-positive person can give the virus to someone else, even though he or she may look and feel healthy. A person can get infected with HIV, develop AIDS, and die, even if the person who gave HIV to her or him remains healthy.

What should I do if my antibody test is positive?

• Be honest with any sexual partners. The decision whether to have sex should be jointly made by you and your sexual partner. Your partner must decide how much risk he or she wants to take.
  
• Previous contacts (such as sex partners or people you've shared needles with) have a right to know they may have been exposed. You can ask your counselor for help in how to deliver this message yourself, or you can ask about programs that can notify your contacts of their risk while maintaining your confidentiality.
  
• Avoid sexual practices in which exchange of body fluids such as semen, blood, and vaginal secretions takes place. Don't have vaginal, oral, or anal sex without using a latex condom or latex vaginal barrier (like a dental dam). You will get a copy of the PPFA fact sheet, How to Avoid Getting or Transmitting HIV and you should follow the suggestions in that fact sheet.
  
• If you shoot drugs:
  
• Try to get off IV (intravenous) drugs if you can. Go for detox and treatment so you can stop using drugs.
  
• Always use works that are either new or sterilized with bleach and rinsed with running water. In the PPFA fact sheet, How to Avoid Getting or Transmitting HIV, you will find instructions on how to clean your works.
  
• Do not let others use needles and works you have used and do not use someone else's needles and works.
  
• Do not donate blood or plasma, sperm, body organs or other tissues.
  
• HIV-positive women have a higher risk than HIV-positive men of progressing to AIDS and should get regular medical checkups, especially pelvic (internal) exams.
  
• An HIV-positive woman has a 30% (one in three) chance of giving HIV to a fetus during the pregnancy, or to a baby while it is being born, or when it is breastfeeding. HIV-positive women should not breastfeed newborn infants. Pregnancy has not been shown to be good or bad for an HIV-positive woman's health.
  
• Don't share toothbrushes, razors or other implements that could have blood on them.
  
• After accidents resulting in bleeding, all surfaces with blood on them should be cleaned with household bleach and rinsed with water.
  
• Let any doctor and dentist that you see know that you a positive HIV antibody test so that they can do their best in caring for you and in preventing spread of the virus. Also tell the people you have asked to tattoo, body pierce, or scarify you. You can help prevent the spread of the virus by allowing the people who come in contact with your blood to be protected.
  
• You do not need to worry about casual social contacts or change the way you behave with friends, with people at work, or in the community.
  
• You should be very cautious about sharing the results of your test. While contact notification and social supports are helpful, you need to guard against discrimination at work, in seeking housing, or in obtaining insurance. These can occur if you are not cautious about who knows your HIV status.

What does a negative test mean? 

A negative antibody test does not guarantee that a person is HIV-negative. When a person is infected with HIV, antibodies begin to be made right away but it can take weeks to months from the time a person is infected until the time antibodies can be detected in the blood or other body fluids. During this time, the person may have a negative result on an HIV antibody test, even though she or he has been infected. For this reason, people who are no longer taking risks but who have had a recent history of any risky behavior should have two negative tests six months apart to be sure of the negative results.

Even with negative antibody test results, people who participate in risky behavior should continue to refrain from donating blood, plasma, or semen for artificial insemination. They need to know that a negative test result does not mean that their risky behavior is safe. They may be found to be HIV positive at the next HIV test. Regardless of the positive or negative result of the test, people must realize that eliminating their risky behavior is the only way to lower their risk of HIV infection. The most risky behaviors can be eliminated by either abstaining from sex, or having safe sex, and not sharing needles or works to inject drugs. See the PPFA fact sheet How to Avoid Getting or Transmitting HIV and follow those suggestions.