Testing Guideline hIV

Question 1

Testing for those commencing chemo or immunosuppressive therapy

Answer 1

Yes at time of commencing

Question 2

Hiv prevalence of 2-5/1000 when to test?

Answer 2

High prevalence so test when having bloods

Question 3

Hiv prevalence >5/1000 and test?

Answer 3

Extremely high

Test all accessing healthcare regardless of whether bloods or not

Question 4

When is hiv test atypical?

Answer 4

On pep, prep, art
Can give slow development of actually positive hiv and blunt hiv antibody response
Atypical results on prep- stop prep then test at 4 and 8 weeks

Question 5

Contraception and HIV discuss

Answer 5

N-9 spermicide - Inxreased risk of transmission
Diaphragms and cap - Mec 3
All others ok
Efavirenz, nevirapine, nelfinavir decreased hormone concs so use other methods
Ritonavir - don’t use CHC but rest ok

Question 6

Ec and hiv pos on haart

Answer 6

Double lng

Ideally iud

Question 7

Haart and contraception

Answer 7

Coc pop and implant - may be reduced efficacy so use with Condoms due to induction of liver enzymes and metabolism of hormones