It’s often been said that young people view HIV as a chronic disease rather than the “life sentence” it was before there were effective treatments. The fact that an HIV infection can be managed with antiretroviral drugs is a boon from modern medicine, and there are hopes for better treatments on the horizon.
But HIV is only a manageable infection if you, well, manage it, and most Americans with HIV aren’t being treated with the medications we have in our arsenal. Only 3 out of 10 Americans who are infected with HIV are controlling the virus with medication — but when you zoom in on that population and look specifically at young people, the numbers are even more dismal, with only 13 percent of youth, ages 18 to 24, receiving treatment.
Knowing your HIV status is easier than it’s ever been.
Much of this problem is due to a lack of access — without adequate health coverage, these medications can be out of reach for many. But that’s not the whole story — it’s estimated that nearly half of 18- to 24-year-olds with HIV don’t know it. If they haven’t been diagnosed, they can’t know to seek treatment; if they don’t seek treatment, they can’t manage their infection; if they can’t manage their infection, their risk of health problems and early death increases — as do the chances of transmitting the virus to someone else.
So, if a 20-year-old tests positive for HIV and begins antiretroviral treatment right away, he or she can expect to live another five decades — to age 71, not bad compared to the average life expectancy of 79. But if that 20-year-old does not take antiretorvirals, he or she can only expect to live another dozen years — to age 32.
That’s why it’s so important to get tested and know your status.
HIV testing is easier than it’s ever been. It’s covered by the Affordable Care Act, can be obtained free of charge at some places, and comes in many different “flavors.” Each type of test has its advantages, allowing you and a health care provider to pick the method that’s right for you.
Once the immune system recognizes a new invader, it gets to work on designing antibodies, which fit into pathogens like a key into a lock — but because they take a long time to manufacture, it could take around three months for an HIV infection to be detected by an antibody test. These three months are called the “window period,” and during this time it is possible to test negative for HIV despite being infected. (Note: Some sources describe the window period as being between three and six months while others say it’s between two weeks and six months.)
An antibody screening test can be performed by a health care provider on blood or oral fluid. A home test called Home Access HIV-1, which involves pricking your finger and mailing a blood sample to a laboratory, also tests for antibodies. In both cases, you’ll need to wait patiently — up to two weeks — for your lab results, which will determine whether or not your immune system has manufactured antibodies in response to an HIV infection. If you think that wait will be too agonizing, you might consider a rapid HIV test, which might cost more, but will reveal your HIV status in 10 to 40 minutes.
To get around the three-month window period, some health care providers can test directly for antigens, which are products of the virus itself. A “fourth-generation HIV test” can screen a blood sample for a viral component called p24. The window period for an antigen test is between 11 days and one month — though it is only accurate in an infection’s early days, because the antigens become undetectable once the body manufactures antibodies that attach to them.
A PCR test can detect the actual genetic material of the virus within two to four weeks of infection, depending on the type of test. They are used to test babies born to mothers with HIV, as well as to test donated blood and organs for the presence of HIV. Otherwise, its use is not common, but it can be used when an early diagnosis is needed.
A fear of having one’s blood taken, whether by a needle or a pin prick, might give many people an excuse not to get tested. Luckily, a sample of your oral fluid can be collected painlessly, and can be taken by a professional in a clinic, or by yourself in the comfort of your own home. While a blood test will detect an infection sooner, if the needles truly are a deal breaker, an oral test is the way to go.
In a clinic, a health care provider will take a sample of oral fluid from your gums. This sample is usually used to conduct an antibody screening test. You will have to wait days or even weeks for your results, unless you get an oral rapid HIV test.
What about home testing? The FDA approved OraQuick in 2012, which can be purchased at a drugstore or online. Once you’ve read the instructions, you can test yourself in the comfort of your own home by taking an oral sample from your gums. Your results will be visible in 20 to 40 minutes. One line means HIV was not detected; two lines mean HIV was detected — sort of like a pregnancy test. If you test positive, you need to have your results confirmed by a blood test. OraQuick has a 24-hour toll-free number to call for emotional support, or simply information about local resources for followup testing and care.
If you test negative for HIV, bear in mind that every test has a window period, meaning that false negatives are possible. This means that practicing safer sex is still important!
No matter what testing method you decide on, the important thing is to get tested! Visit your nearest Planned Parenthood to get tested, find other testing sites near you, or pick up a home-testing kit at a local drugstore.
Click here to check out other installments of our monthly STD Awareness series!