Testing, Testing, One, Two, Three: How HIV Tests Work

Brad Spellberg, MD

Should I Get Tested?
In a lecture on AIDS, an infectious disease specialist was asked how he determined whether to test a patient for HIV. The specialist replied, "My policy is, if they have a sexual organ, I test "em." In other words, everyone who has sex is at risk of getting HIV.

You should consider getting tested if you:

  • Are sexually active, regardless of your sexual orientation or number of partners
  • Have ever used intravenous drugs or shared needles
  • Have ever had a blood transfusion, particularly if it was before 1985
  • Are pregnant

If you are in a "monogamous" relationship, how certain are you that your partner is truly monogamous? How certain are you that your partner had not already contracted HIV by the time you met each other? A popular myth is that you can tell which people have HIV by how they look. If they had it, they would look ill, right? Wrong. People can be completely healthy for years before developing any symptoms of HIV-related illness.

Because HIV is most easily contracted by direct blood-to-blood contact, you can get HIV by having had a blood transfusion or using intravenous (IV) drugs. Due to strict screening, the risk of contracting HIV from a unit of donated blood is currently estimated to be in the neighborhood of 1 in 500,000. Transfusions performed in the 1970s and 1980s, however, carried a much higher risk. Sharing needles during IV drug use is a very significant risk factor. If you've had a transfusion in the past, or if you use IV drugs, you are a candidate for testing.

In the words of a medical school professor, "pregnancy is a sexually transmitted disease." This tongue-in-cheek statement is nevertheless accurate, since pregnancy is sexually transmitted -- as is HIV. If you are pregnant, it means that you have had unsafe sex, and are therefore at risk for having contracted HIV. Furthermore, up to 33 percent of HIV-positive women end up transmitting HIV to their baby. With medication, though, the risk of transmitting HIV to your baby can be reduced to 8 percent or less. If you are pregnant, getting an HIV test not only helps you -- it could save your baby from contracting HIV.

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