HIV Transmission and Testing

HIV Transmission and Testing

KNOW YOUR STATUS

HIV is a serious, long-term chronic illness; it affects your life greatly; medically, emotionally and, indeed socially, and may lead to AIDS. There is no cure for HIV or AIDS. Safer sex practices and not sharing drug-using equipment is the best way to prevent infection. But many of us have taken risks, made mistakes or assumed we or our sex partners didn’t have HIV. Having a blood test is the only sure way to know if you have HIV.

There can be many advantages in knowing your HIV status, but it’s not a decision to be made lightly. We now believe it is time for gay and bisexual men and other men who have sex with men to consider having an HIV test. To know your status, especially if you are HIV positive, will help you to avail of early medical and emotional interventions, assist you in making appropriate life changes, thus assuring you will have a long and good quality of life, including a healthier sex life. If you are HIV negative, it can be a way to confirm your safer sex practises, or help you to plan for a safer and healthier sex life.

Why should HIV still be an issue for me?

1 in 2 gay and bisexual men have not tested. Gay health research in Ireland (Vital Statistics and Real Live) shows that over 40% of men who have sex with men have not tested for HIV. This means, unless you or your sexual partner has tested recently, you really don’t know if either of you is HIV- or HIV+.

1 in 2 Gay and Bisexual Men Have Not Tested

According to Vital Statistics Ireland, over 40% of men who have sex with men have not tested for HIV. With the developments of medical treatments, the advantages of testing have increased. If you have never tested for HIV, or if it has been a long time since you last tested, maybe it is time to test or retest.

Don’t presume you or your sex partners are HIV negative

Take time to read this booklet. If you need more information or if you feel you would like to talk to someone about any concerns or worries you might have, contact one of the agencies listed.

Talk to someone before you decide to test and request pre-test counselling

All sexual health clinics (STI/GUM Clinics) have professionals who are available to discuss the test with you. Some clinics have counsellors who will talk with you about all the issues or concerns you might have. If you intend to have an HIV test somewhere that doesn’t offer pre-test counselling, we would suggest that you talk with one of The Project’s counsellors.

What is HIV?

HIV stands for Human Immunodeficiency Virus. When HIV enters the bloodstream it begins to attack the immune system. Your body then produces antibodies to fight off infection. Although these antibodies cannot destroy HIV, their presence is used to confirm HIV infection. HIV tests look for antibodies not for the virus itself.
Over time, if left untreated, HIV greatly affects your health. Your immune system becomes so damaged that it can no longer fight off infections and cancers that don’t usually cause problems. AIDS (Acquired Immunodeficiency Syndrome) is the term used to describe these unusual symptoms or cancers in HIV positive people. HIV is not AIDS

How does someone get infected with HIV?

HIV is transmitted in blood, semen, vaginal fluids or breast milk. In Ireland, having unprotected sex or sharing needles with an infected person are the two most common ways, in which people get HIV. If you have never shared needles, then this leaves sex as the main way of becoming infected. Having other sexually transmitted infections (STI’s) such as syphilis or gonorrhoea can greatly increase the chances of becoming infected with HIV.

3 things have to happen for HIV to be passed on

1) A person has to be HIV positive and
2) HIV has to get out of their body (in their blood, semen (sperm,
cum), vaginal fluids or breast milk) and
3) HIV has to be able to get into another person’s blood stream

What is an HIV test?

Usually this involves taking a small amount of blood from your arm. The test looks for antibodies to HIV in your blood. Antibodies are produced when your body detects an infection, like a virus. However, it can take up to three months for your body to produce enough HIV antibodies to give a positive test result. We recommend you attend an STI/GUM clinic for a HIV test.

You might want to test if:

• You had sex without a condom
• You took cum in your mouth
• You had difficulties with a condom during sex (it tore or slipped off)
• You engaged in any form of sexual activity that involved drawing blood
• You shared sex toys
• You received blood or blood products before 1986
• You have shared needles
• You tested a long time ago
• You are in a relationship and you and your partner want to stop using condoms
• You want to father a child or donate sperm
• You just want to be sure

What if I’m negative?

A negative result means that the antibody to HIV was not identified in your blood. This can mean two things:

• You have not been infected with HIV

• Or it is too soon after your last risk for the test to be conclusive. (This is known as the ‘window period’)

 To have a conclusive test, it’s advisable to test at least 3 months after your last risk.

A negative result does not mean that you’re immune to HIV. You could be infected in the future if you put yourself at risk. A negative result for you doesn’t mean your partner is negative.

Why might I have to wait three months?

After someone has been infected with HIV, it can take up to three months for antibodies to HIV to develop. The test involves looking for these antibodies to HIV in your blood. If you test within three months of your last risk, you might get an HIV negative result, which in fact, may be incorrect. This period between the last risk and the development of antibodies to HIV is known as the ‘window period’. With most people the HIV antibodies takes three months to show, in very rare cases it can take six months to show up.

During this window period, you should continue practicing safer sex.

What if I’m positive?

A positive HIV test means that you have been infected with HIV, the virus which can cause AIDS. You will be referred to a specialised HIV centre for ongoing monitoring, and, if necessary, treatment for HIV. While waiting to see your new HIV specialist we advise you consider psychological or peer support which will help you with whatever worries you may be having. It will also reassure you that you are not alone.

Currently, there is no cure for HIV. But don’t despair. Things have changed for the better. Now, by treating HIV with special drugs before any symptoms of AIDS appear, it will alter the course of the disease, to improve and extend your life expectancy. These anti-viral drugs have given HIV positive people new hope.
Basically this means, that in a person who takes their anti-viral drugs as prescribed, the level of HIV (viral load) in the blood can be kept very low. Allowing the immune system to be restored to almost normal levels.

Most newly diagnosed HIV positive gay and bisexual men don’t need to start taking medication straight away. With good advice and support you may not need medical interventions for some years. Some men found out they were HIV positive when they were so ill that their treatment options were limited, making it too late to treat them effectively.
In some treatment centres you can avail of specialised psychological supports. You will also be informed of the nearest support organisations if you wish to use them. People who are trained to provide you with support will be aware of all the issues which might be going through your head.

What if the result is unclear?

In a very rare number of tests, the initial assessment is unclear. It could mean that the antibodies to HIV are still developing, but equally, it can have nothing to do with HIV. Usually it has something to do with technical difficulties or some other problem with the blood. These uncertainties occur very rarely and are sorted out over a few weeks. You will be advised to have another test by the doctor some weeks later and you should be offered support by the counsellor.
If you are HIV positive, it’s better to find out sooner rather than later.

What are the issues involved in having an HIV test?

There are many possible issues involved having an HIV test. Some are easy to deal with, some are very difficult to deal with.

Some of these could be:

• For those who are HIV negative, knowing this can put your mind at rest
• If you are HIV negative you can continue planning a healthier sex life while protecting yourself and others
• Knowing that you are HIV positive while still healthy can greatly increase your life expectancy, also your options around treatment should you need medical interventions.
• If you know that you are HIV positive, you can plan for a healthier sex while protecting yourself and others.
• HIV is a virus, not a moral judgement. Sadly, there is still a stigma associated with being HIV positive which can lead to difficulties with your partner, family, friends or in the workplace . Accessing professional or peer support can help you greatly.
• If you test HIV positive, it doesn’t mean that your current sexual partners are positive too. But if you have had unprotected sex with them, it would be advisable that they are also given the opportunity to test
• You may wish to tell, any of your known previous sexual partners. Do seek support before you tell. HIV, by law, is not a notifiable disease
• Insurance companies should not discriminate against you for having an HIV test. Many companies require applicants to test. However, if you are HIV positive you will have difficulties getting certain types of insurance and assurance. You might want to look for further advice on this and have a test at a clinic before seeking insurance
• Some people would rather not know if they are HIV positive. They feel that they would not be able to cope if they knew that they were HIV positive. In reality, most men living with HIV with good support, advice and education cope well, and have found a good quality of life including a healthy sex life.

HIV and Worry

The thought of being HIV positive can cause a lot of worry for some gay and bisexual men. Sometimes you can become really worried, despite the fact that you did not put yourself at risk.

Do you:

• Go for HIV tests over and over again, even though you have been given negative results?.

• Worry about having put yourself at risk, when you might not have done so?

• Find that worry is affecting your health, your relationships or other areas of your life?.

Worry can be very distressing and can affect how you feel both in body and mind. Talking about your fears and worries with someone may be helpful. If you think you are worrying too much, it might be worth talking with a counsellor.

Where can I test?

Testing takes place at (STI/GUM) clinics throughout Ireland or at outreach clinics and saunas. We advise attending a STI/GUM clinic as you can avail of other sexual health screenings while there. At some clinics pre- and post-test counselling is available. Testing is free at all clinics, and it usually takes two weeks before you can collect your results.

Is the test confidential?

If you have an HIV test in a STI/GUM clinic, the test is confidential. The blood will be sent to the laboratory with some identifying information, such as a date of birth, initials and a medical chart number.

If you are HIV positive only the clinic or hospital will have your details and cannot give them to anyone else without your consent, although all positive cases are recorded for reports by use of special codes. You cannot be identified.

Is testing anonymous?

In Ireland it is not usually possible to have an anonymous HIV test. However, if you do use a false name and date of birth – it is really important that you remember the details you gave (write them down somewhere).

Are You New To Northern Ireland?

Regardless of your legal status or where you are from you can get a free HIV test from any STI/GUM clinic. You can also have a free sexual health screen and treatment. Testing at the STI/GUM clinic is confidential and information about your visit cannot be accessed by others.

Because of HIV we forget sometimes about the other Sexually Transmitted Infections (STI’s) most of which if detected in time are curable. Some like Hepatitis B can cause serious illness or death. Having an STI increase the risk of getting HIV as STI’s can affect our immune system. Gonorrhoea, Hepatitis B and C, Chlamydia, Genital Warts, Herpes, Non-Specific Genital Infections, (NSU) and Syphilis are quite common.

Condoms give protection to most STIs and there are cures for most of them. There is a vaccination for Hepatitis A and B. You can get and give STIs from the throat, as well as from the penis and vagina. If sexually active go to your local STI clinic for check-up at least every six months.