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question about testing

Question: 

Hi there I am just wondering that when getting a test done hiv if you have to tell the doctor the type of sex you had. For example is there a different test for unprotected anal vs unprotected vaginal sex or is just the standard blood test for all sexual acts. Do I have to tell the doctor what I engaged in or can I just be confident in requesting a test and not worry about giving full details to the doctor.

Answer: 

Hi there and thank you for reaching out to AIDS Vancouver with your questions. We're happy to help!

Although I can't speak for a doctor or a medical professional, there are very good and respectful about confidentiality. The most important information for them is the date of your exposure, as this affects which test you would be taking. The type of test you receive does not depend on the activity, but on other factors. Time, for example, is one of the factors: with the Rapid Test, you are able to view your results very shortly after taking the test, but for other tests, they are sent to the lab and you would have to wait days before viewing your result. Here is some information about different tests that are available:

Test Name
Method
Window Period
Conditions
Enzyme Immunoassay Antibody (EIA) 3rd Generation (ELISA) Blood test that looks for antibodies. Up to 95% of infections are detectable within 4-6 weeks post exposure. Most people develop detectable antibodies in 21-25 days. Most commonly available testing method. Conclusive at 3 months post exposure.
Test Name
Method
Window Period
Conditions
Rapid or “Point-of-Care” Blood or oral swab test that looks for antibodies. Up to 95% of infections are detectable within 4-6 weeks post exposure. Most people develop detectable antibodies in 21-25 days. Two forms of rapid test available: finger prick blood sample or oral swab. Oral swab test is most common in the U.S. but in Canada it is not approved and blood collection is more likely. Many places in the U.S. and abroad may charge a fee for rapid testing. Conclusive at 3 months post exposure.
Test Name
Method
Window Period
Conditions
Pooled RNA NAAT or “Early Test” Detects viral RNA in blood of people who have yet to develop detectable antibody levels. 10-12 days post exposure This test is in evaluation/research protocols. An antibody follow up test after 12 weeks is sometimes necessary depending on how long after the exposure the test was performed. Conclusive at 3 months post exposure.
Test Name
Method
Window Period
Conditions
NAAT (PCR RNA & DNA) Nucleic-Acid Amplification Testing (NAAT) extracts and amplifies the genetic material of HIV and tests for it with a Polymerase Chain Reaction (PCR) test. NAAT tests generally take two forms: DNA PCR and RNA PCR tests. 2-3 weeks post exposure DNA PCR NAAT tests are usually used for screening babies of HIV+ mothers. RNA PCR NAAT tests are often used to screen blood or organ donations. Both measure the viral load of a positive person’s blood. Conclusive at 3 months post exposure.
Test Name
Method
Window Period
Conditions
P24 Antigen The antigen on HIV that most commonly provokes an antibody response is the protein P24. This test looks for this protein. ONLY within first few weeks after infection. Once the body starts producing antibodies, the antigen is no longer detectable. This test is part of the 4th Generation EIA test, which most specialists agree is conclusive at 6 weeks. Official guidelines recommend re-testing at 12 weeks with an antibody test. Accuracy: see 4th Generation EIA tests.
Test Name
Method
Window Period
Conditions
4th Generation EIA Blood test that looks for antibodies AND p24 protein antigens. Commonly referred to as the "combination," "combo" or "DUO" test. P24 protein is detectable immediately after infection but only for the first few weeks. The antibody (ab) test has a window period of 4-12 weeks post exposure. This test is widely available in North America. Most HIV specialists consider this test to be conclusive at 6 weeks but official HIV testing guidelines still recommend re-testing at 12 weeks for conclusive results. Conclusive at 3 months post exposure.

As you can see, there are many different tests available, and which one you would take is dependant on your region, your personal preference, and the date at which your exposure occurred, but not on the activity itself.

I hope I was able to answer your question, and feel free to contact us with any further concerns.

Regards,

Sierra, Helpline Volunteer

AIDS Vancouver Online Helpline
helpline.aidsvancouver.org
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