Take the HIV test, but…
TODAY, June 27 has been designated National HIV Testing Day in the United States, and the event is being rigorously supported by many governments within the international community, in addition to their own national testing days. Against the backdrop of 2010 being the year targeted for achieving Universal Access to Treatment for some 80 % of the persons in need of it, this day is expected to assume greater significance, with greater zeal and robustness being applied by nations in order to meet and surpass targets set for HIV testing at this time.

The importance of such efforts at encouraging HIV Counselling and Testing cannot be overemphasized, since half of the people living with HIV probably do not know their status, and it is only by taking the HIV test that one can know his or her serostatus, and so be able to plan their life ahead.

When an HIV test is taken, a person’s result will either be negative, meaning that he/she does not have HIV, or positive, meaning that they are infected with HIV, which, quite unlike the days when it was regarded as a death sentence, has now come to be seen as a manageable chronic disease.

Now available globally, and even in the poorest of countries, HIV testing is a critical entry point to life-sustaining treatment and care for people living with HIV, and literally unlocks the gateway to amazing scientific breakthroughs in the management of HIV.  A positive HIV test can be equated to an alarm which signals that something has gone wrong, and it’s time to take action. It is a timely reminder that with Highly Active Antiretroviral Therapy (HAART),  it is now possible for persons in need of treatment to access such therapy, thereby allowing for the reconstitution of a damaged immune system, and ultimately a longer and improved quality of life.

UNIVERSAL ACCESS BY 2010
And by extension, through UNAIDS’ call for Universal Access by 2010, with the support of the G8 Group, country leaders  and other interested parties, it has had been made possible for more than 4.3 million PLHIV (in need of treatment) to date  in middle and low-income countries to be placed on antiretroviral therapy (ART).

But while all this is possible, it must be remembered that being able to access treatment and care for PLHIV, being graciously rolled out by governments and donors, begins with a decision by the individual to take the HIV test.  It should be a voluntary decision and not foisted on the person.  

COUNSELLING AND TESTING
Once you’ve taken the decision to get tested for HIV, a trained counsellor will talk with you to help prepare you for your test, and help you think about how you will deal with the result.

Should you test positive, your counsellor will offer advice on what you can do — the steps required to cope; how to reduce exposure; and generally how to protect yourself in the future in order to stay healthy.

If you test negative, it means that no antibodies were detected in your blood. Antibodies are proteins produced by the body in response to the presence of HIV in body fluids or tissues.

WINDOW PERIOD
If the result is negative when you take that initial test, it does not necessarily mean that you do not have HIV.  It simply means that antibodies have not shown up in your sample, since it could take between six weeks to six months, from the time of exposure, for the antibodies to show up. In such a case, you will be advised to take another test within three months of exposure.   According to the Center for Disease Control (CDC) guidelines: “Antibodies generally appear within three months after infection with HIV, but may take up to six months in some persons.”

During the waiting period, you will be advised to avoid having unprotected sex, or you may choose to abstain from having sex altogether for the period. If the result of this second test proves negative, then you will be relieved to know that you do not have HIV. If, on the other hand, your second test proves positive, your counsellor will now talk with you on the way forward, and advise you on other measures to be taken soon after. 

While you have a responsibility to adhere to instructions given you by your doctor or clinician, your counsellor will also prepare or empower you for the journey ahead.  More importantly, testing positive does not mean that you will immediately be placed on treatment.  That decision depends upon the extent to which your immune system has been compromised or damaged.  If the number has reduced to 350, your doctor will begin preparing you psychologically and otherwise for embarking on a treatment regimen (beginning treatment).

If placed on therapy, in order to benefit from the drugs, you must employ a disciplined approach, and strictly follow your doctor’s instructions in relation to adhering to the drugs being taken and other advice given.  Take the HIV test; follow your doctors’ advice,  and as you look back later on, you’ll be happy you did.

If you have tested positive for HIV, regardless of who you are and your personal preferences, there is only one channel to be navigated in embarking on that journey to restoration. That channel is based on universal guidelines, meaning that there are no shortcuts, nor room for complacency. On such grounds, we strongly advise that persons “take the HIV test, but not take the results for granted.” 

IMPORTANT Dos and Don’ts
Apart from preparing you for partner notification, informing close family members or finding a support group, there are some other things your counsellor or clinician may alert you to in the ensuing days/weeks, namely:

The need for you to take a CD4 test to determine the extent to which your immune system (which provides a defence against infections) has been damaged.  A point to note is that a person may have HIV for years before realizing that they do. Unfortunately, one of the disadvantages of not knowing your status is that if you’re positive, your situation may have progressed to AIDS by the time the first HIV test is taken.  Once a CD4 cell count is taken, your clinician will be in a position to advise whether or not you are ready to go on ART.  Hence, the sooner you take the test, the better.

The need for being screened for TB, since if you are co-infected with latent TB, the HIV will activate the TB, worsening your health condition.

If you are co-infected, even though your CD4 cell count may fall to 350 or under, you should not be placed on ART until you would have been effectively treated for TB.  The only way this is allowed, according to WHO guidelines, is if your CD4 cell count has been dramatically reduced to 200, meaning that you now have AIDS, and not just HIV.