HIV Pre- and Post-Test Counseling Frequently Asked Questions
Q. What is the Clearview Complete HIV test and how does it work?
A. The Clearview Complete HIV antibody test is a fast and accurate test that provides and easy to read result in 15 minutes. Clearview Complete is used to detect antibodies to HIV 1 and 2 in a sample of your blood. It is performed with a fingerstick.
Q. What does my test result mean?
A. A preliminary positive result suggests that antibodies to HIV may be present in your blood. If you receive a preliminary positive result on the test, the result must be confirmed with a blood test with results confirmed in 1 to 2 weeks.
A negative test result means that HIV antibodies were not detected in your blood at the time of testing. This does not completely rule out infection. If, in the last 2 months, you have engaged in high risk behavior, there is a possibility that you may still be infected with HIV. A recent infection may not produce enough antibodies to be detected by this test. Ask your test counselor if you should consider getting tested again to be sure that you are not infected.
Q. If my result is a preliminary positive, what additional tests will be ordered?
A.The first is called the ELISA (enzyme-linked immunosorbant assay). The ELISA is a sensitive test that will be positive if it detects HIV antibodies. If the ELISA is positive, a second ELISA is performed. If the second ELISA is reactive, the Multispot will be performed automatically by the lab using the same sample. The Multispot is both sensitive and specific to HIV-1 and HIV-2. It will only be reactive if HIV antibodies are present.
Q. What does a positive result mean?
A. A positive result indicates that all three tests (two ELISAs and a Multispot) were reactive and that HIV antibodies were detected in the sample. This means that the diagnosis of HIV infection is confirmed.
Q. What is the window period?
A. The window period is the period between HIV infection and the time the body produces antibodies to HIV in sufficient quantities to be detected by an HIV antibody test.
Q. Do I need to test again?
A. It is possible that someone who tests negative less than four weeks after exposure may be infected but his/her body has not had sufficient time to develop antibodies. Therefore, to rule out HIV infection, it is important to re-test two months after exposure. It is extremely rare for an HIV-infected individual not to develop antibodies within two months. An individual who tests negative two months after an exposure does not require further testing unless he/she may have had repeated exposures or their antibody test results are incompatible with their clinical history.
Q. If I am exposed to HIV, does that automatically mean I am infected?
A. No. Contact with HIV-infected fluids or sexual contact with an HIV-positive individual does not equal infection. There are a number of variables that contribute to infection, including the amount of virus in the fluid and the access of the virus to the blood stream (mucous membrane; direct entry, as with needles; etc.).
Q. I am not in a high-risk group. Do I really need to worry?
A. It's more helpful to talk about "high-risk behaviors" than "high-risk groups". What behaviors have you engaged in that might put you at risk for HIV infection?
Q. Can the virus live outside the body?
A. HIV cannot remain active outside the body for very long. It does not survive when exposed directly to air. HIV is packaged in a delicate outer wrapping or envelope. In the natural world HIV is quickly destroyed, such as in tap or pool water. HIV's envelope is extremely sensitive to even mild chemicals, like detergents or small amounts of chlorine bleach.
Q. Can using a mouthwash or douching reduce the risk of HIV infection?
A. No. Although some people believe that oral, vaginal or anal cleansing after intercourse can reduce the risk of HIV infection and other sexually transmitted diseases. It is likely that cleansing may actually increase the risk og HIV infection by washing infected semen deeper into the vagina or anus.
Q. Is deep kissing a risky behavior?
A. No, there are no known cases of HIV transmission from kissing.
Q. Are lambskin condoms effective protection against HIV?
A. HIV and other viruses are many times smaller than sperm cells, so they can pass through the pores of lambskin and natural-skin condoms. Thus, natural-skin condoms offer no protection against HIV.
Q. What if I am allergic to latex? What if my partner is?
A. If you want to use condoms but have a reaction to latex a polyurethane (plastic) condom is now available. Lab studies show that these condoms have the same barrier qualities as latex. A disadvantage is that they are much more likely to slip or break than latex condoms.
Q. If I am not the receiving partner in anal sex, am I still at risk?
A. You are at much lower risk, because HIV cannot be transmitted through the skin of the penis. You could still be infected through the urethra, or through sores on the penis caused by herpes or other sexually transmitted infections. Men who are circumcised appear to be at lower risk of infection through insertive vaginal intercourse, and this may also apply to anal sex as well.
Q. How risky is oral-anal, mouth to anus sex?
A. Oral-anal sex, sometimes called rimming, is a low-risk activity for HIV transmission unless there is blood present. However, oral-anal sex is a high risk for a number of other infections, including hepatitis A virus, herpes simplex virus, and a number of parasites and bacteria that can cause diarrhea.
Q. If my partner has HIV with an undetectable viral load, do we still need to use condoms?
A. People with undetectable viral loads do not transmit HIV infection to others; we now view sex with an undetectable viral load as “safe” or “protected” sex from the standpoint of HIV transmission. However, condoms should still be considered for two reasons: (1) viral load is only tested every 3-6 months, and may not remain undetectable during that time period, (2) having an undetectable viral load will not prevent transmission of other sexually transmitted infections, such as syphilis, gonorrhea, chlamydia, and hepatitis C.
Q. Are the other ways I can protect myself against HIV infection besides condoms?
A. One way is to avoid the highest risk activities, especially receptive intercourse. HIV-negative people can also consider taking pre-exposure prophylaxis (PrEP), which involves taking one tablet of Truvada daily. PrEP is highly effective at preventing HIV transmission, and is available at Southwest CARE Center. Remember that PrEP will only prevent HIV infection; it does not prevent infection with other sexually transmitted diseases such as syphilis, gonorrhea, chlamydia, or hepatitis C.