HIV Testing

Question 1

Why might someone request a HIV test?

Answer 1

Sexual contact with someone who has tested positive for HIV
Sexual contact with someone who may have HIV- e.g. from an at risk area
IVDU
Exposure to body fluids of someone else- may be HIV positive
Sharps injury
Worried well
Paid for sex abroad or in the UK
Following sexual assault
Concerning physical sx
Routine in antenatal screening, screening before blood donation and before surgical procedures

Question 2

For what respiratory condition should you always request a HIV test?

Answer 2

Anyone presenting with TB

PJP too

Question 3

Who should be routinely screened for HIV?

Answer 3

Men who have sex with men
Women who have sex with men who have sex with men
IVDU
Partners of men known to be HIV positive
Anyone who HIV could be a reason for Sx
Men and women from a country of high HIV prevalence
Men and women who have had sexual contact abroad from countries where HIV is more prevalent

Question 4

Why is it beneficial to know HIV status?

Answer 4

• HAART means that with early and effective treatment life expectancy is normal and viral load can be reduced to a level that means the disease has a very low risk of transmission to others
• Precautions can be taken to prevent HIV spread to others
• If female, precautions can be taken to reduce the risk of transmitting HIV to an unborn child- c-section.
• Steps can be taken to prevent and treat early any opportunistic infections that occur due to immunosuppression

Question 5

Why might older HIV tests be unhelpful in the period immediately following HIV exposure?

Answer 5

Older HIV tests only tested for Anti-bodies developed against HIV

Anti-bodies against HIV can take up to three months to develop and so these tests could produce an incorrect negative result during seroconversion

Question 6

If suspecting seroconversion illness after possible exposure to HIV which generation of HIV test needs to be requested and why?

Answer 6

Fourth Generation- These test for both HIV antibodies and HIV antigens

There is a delay to anti-body production and so in the earlier stages a HIV infection would not be detected by just checking for anti-bodies.

Fourth generation tests therefore allow for an earlier diagnosis and then PEPSE can be given

Question 7

What should be done if a patient signs of seroconversion illness but the initial HIV test is negative?

Answer 7

Repeat the test in two weeks time

Question 8

What should be done if an initial HIV test comes back negative?

Answer 8

Consider a repeat test after three months for absolute certainty that HIV has not been acquired. This is recommended.