HIV Antibody Testing

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=82 BGCOLOR="#006699" TEXT="#080000" bgproperties="fixed" background="05bfd523.jpg"> <div> <FONT SIZE="5" COLOR="#000000" FACE="Arial" ><B>Cape Fear Regional Bureau For Community Action, Inc.</B></FONT><B>     |     </B><A HREF="index.htm" TARGET="_top" TITLE="Cape Fear Regional Bureau For Community "><U><B>home</B></U></A></div> <div> <A HREF="id39.htm" TARGET="_top" TITLE="Our Services"><U><B><IMG SRC="04e0e0e0.png" border=0 width="14" height="14" ALT="up" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A><B>  </B><IMG BORDER="0" SRC="1x1.gif" HEIGHT="14" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" WIDTH="14"><B>    </B><A HREF="id43.htm" TARGET="_top" TITLE="Prevention Case Management"><U><B><IMG SRC="04d0e0e0.png" border=0 width="14" height="14" ALT="previous" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A><B>  </B><A HREF="id45.htm" TARGET="_top" TITLE="Syphilis Testing"><U><B><IMG SRC="04f0e0e0.png" border=0 width="14" height="14" ALT="next" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A></div> <div> <A HREF="http://www.capefearregionalbureauforcommunityactioninc.org/mf.htm" TARGET="_top" TITLE="http://www.capefearregionalbureauforcomm"><U><B>Click Here For Site Map</B></U></A></div> </td> </tr><tr> <td valign="top" width=210 BGCOLOR="#FFCC66" TEXT="#080000" bgproperties="fixed" background="23fd2993.jpg"> <div> <IMG SRC="0a8c6920.jpg" border=0 width="198" height="146" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <div> <B>OraSure HIV Antibody Testing at Satellite Office on Old Wilmington Road, Fayetteville, NC</B></div> <bR> <DIV ALIGN="LEFT"></DIV> <div> <B><IMG SRC="178b67a0.jpg" border=0 width="182" height="122" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></div> <div> <B>Blood Drawing for HIV Antibody Test</B></div> </td> <td valign="top" height=398 BGCOLOR="#FFFFFF" TEXT="#080000"> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">The Bureau has two counseling, testing and referral sites: main office -- 110 1/2 Gillespie Street and satellite office -- 221 Old Wilmington Road, Fayetteville, NC.</div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">OraSure and Blood Drawn Antibody and Syphilis Testing is conducted during non-traditional hours: evenings, late night and weekends at both sites.</div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">The majority of counseling, testing and referral is conducted on street corners/alleys.</div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">From July 1 through December 31, 2002 the Bureau OraSure/Blood Drawn HIV Antibody Tested 203 Cumberland Countians, yielding a 3.4% positivity rate and an 85% post-test return rate.</div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Seven Cumberland Countians were reactive/positive for HIV Antibodies.</div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">125 Cumberland Countians were tested for Syphilis; 5 positive RPRs were identified as previous Syphilis cases.</div> <bR> <div> <I><B>HIV Antibody Testing</B></I></div> <div>  <A NAME="top_of_page"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A>Below we talk about HIV antibody testing. Follow a link from the alphabetical list, then click the up arrow to bring you back to this point if you want to look at another link. Or, you can read straight through the entire document. </div> <DIV ALIGN="LEFT"></DIV> <div>  <A NAME="top"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></div> <div> <TABLE BORDER="2" CELLPADDING="1" CELLSPACING="1" WIDTH="515" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BOX" RULES="ALL" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP BGCOLOR=#FFFFFF HEIGHT= 38 WIDTH="164"><div> <A HREF="#accuracy" TITLE="HIV Antibody Testing"><U><U>Accuracy of test</U></U></A></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFFF WIDTH="166"><div> <A HREF="#indeterminate" TITLE="HIV Antibody Testing"><U><U>Indeterminate test results</U></U></A></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFFF><NOBR><div> <A HREF="#rapid" TITLE="HIV Antibody Testing"><U><U>"Rapid" tests for HIV</U></U></A></div> </NOBR></tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFFF HEIGHT= 38 WIDTH="164"><div> <A HREF="#conf_test" TITLE="HIV Antibody Testing"><U><U>Confidential test</U></U></A></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFFF><NOBR><div> <A HREF="#military" TITLE="HIV Antibody Testing"><U><U>Military personnel</U></U></A></div> </NOBR></tD> <tD VALIGN=TOP BGCOLOR=#FFFFFF WIDTH="165"><div> <A HREF="#orasure" TITLE="HIV Antibody Testing"><U><U>Saliva test for HIV antibodies</U></U></A></div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFFF HEIGHT= 19 WIDTH="164"><div> <A HREF="#partner" TITLE="HIV Antibody Testing"><U><U>Contact tracing</U></U></A></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFFF WIDTH="166"><div> <A HREF="#names" TITLE="HIV Antibody Testing"><U><U>Names reporting</U></U></A></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFFF WIDTH="165"><div> <A HREF="#test_results" TITLE="HIV Antibody Testing"><U><U>Test results</U></U></A></div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFFF HEIGHT= 38 WIDTH="164"><div> <A HREF="#elisa" TITLE="HIV Antibody Testing"><U><U>ELISA test</U></U></A></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFFF><NOBR><div> <A HREF="#children" TITLE="HIV Antibody Testing"><U><U>Newborns and children</U></U></A></div> </NOBR></tD> <tD VALIGN=TOP BGCOLOR=#FFFFFF WIDTH="165"><div> <A HREF="#urine" TITLE="HIV Antibody Testing"><U><U>Urine test for HIV antibodies</U></U></A></div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFFF HEIGHT= 19 ><NOBR><div> <A HREF="#home" TITLE="HIV Antibody Testing"><U><U>Home antibody test</U></U></A></div> </NOBR></tD> <tD VALIGN=TOP BGCOLOR=#FFFFFF><NOBR><div> <A HREF="#orasure" TITLE="HIV Antibody Testing"><U><U>OraSure HIV test</U></U></A></div> </NOBR></tD> <tD VALIGN=TOP BGCOLOR=#FFFFFF><NOBR><div> <A HREF="#wb" TITLE="HIV Antibody Testing"><U><U>Western Blot test</U></U></A></div> </NOBR></tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFFF HEIGHT= 38 WIDTH="164"><div> <A HREF="#ifa" TITLE="HIV Antibody Testing"><U><U>IFA test</U></U></A></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFFF><NOBR><div> <A HREF="#partner" TITLE="HIV Antibody Testing"><U><U>Partner Notification</U></U></A></div> </NOBR></tD> <tD VALIGN=TOP BGCOLOR=#FFFFFF WIDTH="165"><div> <A HREF="#why" TITLE="HIV Antibody Testing"><U><U>Why be tested: Pro and Con</U></U></A></div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFFF HEIGHT= 19 WIDTH="164"><div> <A HREF="#immigrant" TITLE="HIV Antibody Testing"><U><U>Immigrants</U></U></A></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFFF WIDTH="166"><div> <A HREF="#pregnant" TITLE="HIV Antibody Testing"><U><U>Pregnant women</U></U></A></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFFF WIDTH="165"><div> <A HREF="#window_period" TITLE="HIV Antibody Testing"><U><U>Window period</U></U></A></div> </tD> </tR> </TABLE></div> <bR> <div> <B>What Are HIV Antibody Tests?</B></div> <div> As the body fights viruses, it creates antibodies to that virus. HIV antibody tests measure the presence of antibodies to HIV. They do not measure or detect the virus itself. There are three commonly used antibody tests.</div> <bR> <div> <I> <A NAME="why"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></I><B>Why Should You Be Tested:</B></div> <div> <B>Pros And Cons </B><A HREF="#top_of_page" TITLE="HIV Antibody Testing"><U><B><IMG SRC="16e14140.gif" border=0 width="20" height="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A></div> <div> Pros</div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">If you know you are HIV-positive, you can take advantage of immune system monitoring and early treatment and intervention.</div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">By taking the test, you can find out whether or not you can infect others. </div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Regardless of the result, testing often increases your commitment to overall good health habits. </div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">If you test negative, you may feel less anxious after testing. </div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Women and their partners considering pregnancy can take advantage of treatments that potentially prevent transmission of HIV to the baby. </div> <div> Cons:</div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">If you test positive, you may show an increase in anxiety and depression. </div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">When testing is not strictly confidential, you risk job and insurance discrimination. You can prevent this by ensuring that you test at an anonymous testing site. </div> <bR> <div> Whether or not to take the antibody test is an extremely personal decision. We cannot make that decision for anyone. We can only advise you of the implications of a positive and a negative result in your life. The decision is yours.</div> <bR> <bR> <div> <I> <A NAME="window_period"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></I><B>Window Period </B><A HREF="#top_of_page" TITLE="HIV Antibody Testing"><U><B><IMG SRC="16e14140.gif" border=0 width="20" height="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A></div> <div> The "window period" is the time it takes for a person who has been infected with HIV to <I>seroconvert</I> (test positive) for HIV antibodies. </div> <div> The Centers for Disease Control (CDC) says about the window period:</div> <div> "Antibodies generally appear within three months after infection with HIV, but may take up to six months in some persons."</div> <bR> <div> This CDC definition of a three to six month window period has been commonly used for a number of years and is most often used. </div> <div> What does this mean for you? </div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">The three month window period is normal for most of the population. Many people will have detectable antibodies in three or four weeks. Very, <I>very</I> rarely (i.e., only a few cases <I>ever</I>), a person could take six months to produce antibodies. </div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">You may be anxious to be tested soon after an encounter which you perceive to be risky (and in many cases, the encounter actually <I>isn't</I> risky). You want to know: can I be antibody tested without waiting three months? How accurate is the test after, say, six weeks? </div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Unfortunately, we don't know.</div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Think about this: if you got a negative test at six weeks, would you believe it? Would it make you less anxious? If so, go for it. But to be certain, you will need to be tested again at three months. </div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">You may have "heard" that AIDS/HIV can take years to be detectable. Here's the clarification: <I>AIDS</I>, or the clinical symptoms that define it, takes many years to develop after exposure. <I>HIV</I> -- the virus that causes AIDS -- is usually detectable within three months after exposure, and does not cause symptoms in most people. </div> <bR> <bR> <div> <I> <A NAME="test_results"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></I><B>Interpretation Of Test Results  </B><A HREF="#top_of_page" TITLE="HIV Antibody Testing"><U><B><IMG SRC="16e14140.gif" border=0 width="20" height="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A></div> <div> A <B>positive</B> result means:</div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">You are HIV-positive (carrying the virus that causes AIDS).</div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">You can infect others and should try to take precautions to prevent doing so. </div> <bR> <div> A <B>positive</B> result does <B>NOT</B> mean:</div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">You have AIDS. </div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">You will necessarily get AIDS.</div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">You are immune to AIDS, even though you have antibodies. </div> <bR> <div> A <B>negative</B> result means:</div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">No HIV antibodies were found in your blood at this time.</div> <bR> <div> A <B>negative</B> result does <B>NOT</B> mean:</div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">You are not infected with HIV (you may still be in the "<FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><A HREF="#window_period" TITLE="HIV Antibody Testing"><U><U>window period</U></U></A></FONT>"). </div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">You are immune to AIDS. </div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">You have a "resistance" to infection. </div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">You will never get AIDS. You may wish to consider avoiding unsafe activities to protect yourself. </div> <bR> <div>  <A NAME="indeterminate"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A>An <B>indeterminate</B> result (which is rare) means: <A HREF="#top_of_page" TITLE="HIV Antibody Testing"><U><B><IMG SRC="16e14140.gif" border=0 width="20" height="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A></div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">The<A HREF="#wb" TITLE="HIV Antibody Testing"><U> </U></A><FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><A HREF="#wb" TITLE="HIV Antibody Testing"><U><U>Western Blot</U></U></A></FONT> (WB) result is unclear. The entire HIV test must be repeated with a new blood sample, usually several weeks after the first blood test.</div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Indeterminate results usually occur if the test is performed just as the person begins to seroconvert. </div> <bR> <bR> <div> The Three Kinds of HIV Antibody Tests</div> <bR> <div>  <A NAME="elisa"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A><B>ELISA  </B><A HREF="#top_of_page" TITLE="HIV Antibody Testing"><U><B><IMG SRC="16e14140.gif" border=0 width="20" height="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A></div> <div> The ELISA is almost always the first screening tool; it is inexpensive and very sensitive. In most cases, a blood sample is tested, but other types of ELISAs that use <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><A HREF="#orasure" TITLE="HIV Antibody Testing"><U><U>saliva</U></U></A></FONT> and<A HREF="#urine" TITLE="HIV Antibody Testing"><U> </U></A><FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><A HREF="#urine" TITLE="HIV Antibody Testing"><U><U>urine</U></U></A></FONT> have also been developed. The actual ELISA takes 3.5 to 4 hours, but most test sites send samples to outside labs, where they are tested in batches, so you may have to wait one to two weeks for results.</div> <div> Beyond the "<FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><A HREF="#window_period" TITLE="HIV Antibody Testing"><U><U>window period</U></U></A></FONT>," discussed above, ELISA tests are <I>very rarely</I> "false negative." This means if you have a negative test result, and you were tested at least six months after the last potential exposure, you are really HIV negative. An ELISA test may <I>rarely </I>be "false positive." False positive ELISA results can occur if someone is tested right after events that <I>temporarily</I> stimulate the immune system, such as viral infections or immunizations. They could also occur because of lab error, or because of the test's very high <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><A HREF="#sensitivity" TITLE="HIV Antibody Testing"><U><U>sensitivity</U></U></A></FONT>, discussed below.</div> <bR> <div> For these reasons, positive ELISA results must always be confirmed with a Western Blot or IFA (below), and at reputable test sites this is commonly done automatically -- meaning you don't have to come for another blood draw. </div> <div> A relatively new test, called a <I>detuned</I> ELISA, which has been used in research settings, will soon become more widely available to other test sites. The detuned test, which is used only <I>after </I>HIV antibodies are confirmed by a Western Blot, can determine if the HIV infection is recent (within the last six months), which may be useful for deciding upon possible early treatment options.</div> <bR> <div>  <A NAME="wb"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A><B>Western Blot (WB) assay  </B><A HREF="#top_of_page" TITLE="HIV Antibody Testing"><U><B><IMG SRC="16e14140.gif" border=0 width="20" height="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A></div> <div> The WB is a <I>confirmatory</I> test: it is only performed if the ELISA is positive. The WB can be positive, negative, or <I>indeterminate</I>. Indeterminate tests are neither positive nor negative. An indeterminate result usually means that a person has just begun to seroconvert at the time of their test. In the rare cases in which this occurs, the person will need to be retested, usually about one month later. False positive results are <I>extremely rare</I> with the WB, so it confirms (proves) that HIV antibodies are present. </div> <bR> <div>  <A NAME="ifa"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A><B>Indirect immunofluorescence assay (IFA)  </B><A HREF="#top_of_page" TITLE="HIV Antibody Testing"><U><B><IMG SRC="16e14140.gif" border=0 width="20" height="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A></div> <div> The IFA can be used instead of the WB to confirm ELISA results. Like the WB, it uses a blood sample. Because it is faster than a WB, some labs that use it can get results to the client more quickly.</div> <bR> <bR> <div> <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><I><U> <A NAME="accuracy"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></U></I></FONT><B>"Accuracy" Of Antibody Tests   </B><A HREF="#top_of_page" TITLE="HIV Antibody Testing"><U><B><IMG SRC="16e14140.gif" border=0 width="20" height="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A></div> <div> The accuracy of a medical test is a combination of two factors: <I>sensitivity </I>and<I> specificity</I>. The ELISA is extremely  <A NAME="sensitivity"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A><I>sensitive</I> (about 99.5%), which means it will detect very small quantities of HIV antibody. This high sensitivity reduces the odds of reporting a "false negative" when HIV antibodies are present. Assuming you are being tested beyond the six month "<FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><A HREF="#window_period" TITLE="HIV Antibody Testing"><U><U>window period</U></U></A></FONT>," discussed above, <I>if the ELISA is "negative," there is virtually no chance you have HIV</I><B>. </B></div> <bR> <div> The high sensitivity of the test creates a slightly lower  <A NAME="specificity"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A><I>specificity</I>. This means the result could (infrequently) be "false positive." To compensate for this, confirmatory tests are <I>automatically </I>performed after a positive ELISA. The WB and IFA are highly specific for HIV antibodies, so they rule out false positive ELISAs nearly every time.</div> <bR> <div> <B>The CDC states that the </B><I><B>combined accuracy</B></I><B> of the ELISA plus either the WB or IFA is greater than 99%.</B></div> <bR> <div> The CDC recommends retesting any positive ELISA twice; if either retest is positive, then a confirmatory test is performed. Only when the confirmatory test is also positive is the result reported as HIV positive. Again, reputable test sites automatically follow this procedure, so results reported to you can be relied upon completely.</div> <bR> <div> What does this mean for you?</div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">If you are beyond the window period and were <I>reported HIV negative</I> by an ELISA, and you are not subsequently at risk for HIV, you should consider yourself <I>HIV negative</I>. You may have a great deal of anxiety about the remote chance that you may be infected, yet test HIV negative. Although this is technically possible, and has in fact been documented in several people, the <I>probability is so small</I> that it stretches the imagination. Think about the tens of millions of HIV tests that have been administered, and only a <I>handful</I> of people with HIV have not had detectable antibodies.</div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">If that tiny probability is still bothering you, think about whether there may be other issues you're facing. Are you feeling guilt over an experience that may have placed you at risk -- or one that you <I>feel </I>put you at risk, even though it did not? Or are there other sources of anxiety that cannot be alleviated by further HIV testing?</div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">If you want to discuss these issues further -- for example, you want to find out if a certain activity put you at risk for getting HIV -- call an AIDS hotline.  <B>800/342-AIDS</B>.</div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Some individuals, seizing on this tiny probability of a "false negative" antibody test, or perhaps wanting results without waiting for the window period, may be curious about PCR or other types of <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><A HREF="http://www.sfaf.org/aids101/viral_testing.html" TARGET="_top" TITLE="http://www.sfaf.org/aids101/viral_testin"><U><U>viral testing</U></U></A></FONT>, but <I>viral testing is not appropriate in this situation because it was designed for other purposes</I><FONT SIZE="3" COLOR="#FF0000" FACE="Arial" >.</FONT> Viral testing allows physicians to track with greater accuracy than ever before the progression of HIV in the body -- thus helping their HIV-infected patients make choices about appropriate treatment strategies. Most people concerned about HIV do <B>not</B> need viral load testing. The antibody test is still the cheapest, easiest, and overall most reliable way for individuals to learn their HIV status. </div> <bR> <bR> <bR> <div> <I> <A NAME="conf_test"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></I><B>Confidential HIV Testing, Names Reporting, And Partner Notification / Contact Tracing   </B><A HREF="#top_of_page" TITLE="HIV Antibody Testing"><U><B><IMG SRC="16e14140.gif" border=0 width="20" height="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A></div> <div> What is confidential HIV testing?</div> <bR> <div> HIV antibody testing can also be ordered through a private physician, some clinics, and hospitals. <I>If you give your name</I>, even if the test site says your name is known only to them and not the lab, <I>the test is confidential</I>, not anonymous. Confidential antibody testing means that you and the health care provider know your results, which may be recorded in your medical file. And if you use Medi-Cal or insurance to pay for an HIV test, the results (and even the fact that the test was ordered) will be available to insurance companies through interconnected computer networks. There are also testing sites that offer confidential testing.</div> <bR> <div> Some physicians might agree to omit the test results from the medical file. In some cases, doctors have been known to keep separate files, one for the insurance companies and one for private use with the patient. However, this is probably risky for the doctor.</div> <bR> <div> Some reasons for confidential testing are:</div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">A written result is required for immigration purposes or for some international travel visas. </div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">A pregnant woman who is clearly at risk might choose to be tested through her doctor, rather than anonymously, since the result is of key importance to the course of her medical care. </div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Potentially faster linkage to medical care. </div> <bR> <div> You may simply choose to not go to the anonymous testing site, and that is certainly your option.</div> <bR> <div> Some people may want written results for the wrong reasons, e.g. to be a "card-carrying HIV-negative sexual partner." We discourage this reasoning, as no written test result can accurately indicate a person’s negative HIV status: remember the three to six month<A HREF="#window_period" TITLE="HIV Antibody Testing"><U> </U></A><FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><A HREF="#window_period" TITLE="HIV Antibody Testing"><U><U>window period</U></U></A></FONT>, and the fact that someone could have been exposed to HIV after being tested.</div> <bR> <div> <FONT SIZE="2" COLOR="#000000" FACE="Arial" > <A NAME="names"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></FONT><B>Names reporting   </B><A HREF="#top_of_page" TITLE="HIV Antibody Testing"><U><B><IMG SRC="16e14140.gif" border=0 width="20" height="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A></div> <div> There is growing political pressure to require names reporting for HIV. <I>AIDS</I> (and many other communicable diseases, such as tuberculosis and syphilis) is "reportable" by name in all 50 states; i.e., doctors must report to their county or state department of public health all clinical diagnoses of AIDS. <I>HIV infection </I>is not reportable in many states. Some public health agencies, scientists, and organizations have lobbied for names reporting for HIV in all states. They believe it will increase the accuracy of statistics that track the epidemic, which are used for public policy decisions, prevention and education, etc.  Name reporting is required in North Carolina.</div> <bR> <div> <I> <A NAME="partner"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></I><B>Partner notification / contact tracing   </B><A HREF="#top_of_page" TITLE="HIV Antibody Testing"><U><B><IMG SRC="16e14140.gif" border=0 width="20" height="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A></div> <div> Voluntary partner notification programs allow individuals who have tested positive in a confidential HIV test to ask for help in notifying previous sex or needle sharing partners that you may have exposed them to HIV. You can receive counseling about how to notify partners yourself, or you can have a Disease Intervention Specialist (DIS) do it for you. The DIS will ask the name, address, and phone number of other people ("contacts") with whom you have had sex. The DIS will try to locate each contact to tell them that they have been exposed to someone with HIV and could be at risk. They will advise these contacts to be tested for HIV. The DIS does not disclose the name of the person who has tested positive, but in some cases, it will be obvious to the contact, particularly if they have had sex with only one or few other people.</div> <bR> <div> Partner notification (or contact tracing) programs are not new; they have been used for years with tuberculosis and syphilis, other potentially dangerous, communicable diseases. What is different about HIV is that outside of a few protected areas, such as the San Francisco Bay Area, knowledge of someone's HIV status may be used as a basis for discrimination and termination of a person's job or rental housing. Although a recent Supreme Court decision making even asymptomatic HIV a "protected class" under the Americans with Disabilities Act (ADA) should, in theory, prevent this type of discrimination, in practice it remains to be seen how much real protection is available for HIV-positive people under ADA. </div> <bR> <bR> <div> <I> <A NAME="home"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></I><B>Home HIV Antibody Test   </B><A HREF="#top_of_page" TITLE="HIV Antibody Testing"><U><B><IMG SRC="16e14140.gif" border=0 width="20" height="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A></div> <div> <B>What</B>: One company, Home Access, offers an FDA-approved in-home antibody test. This test costs about $45 to $70, depending on whether you pay for 72-hour results (they give you a pre-paid express delivery envelope to expedite shipping your sample to the lab) or standard 7-10 day results. </div> <bR> <div> <B>How</B>: Home Access uses a blood sample from a finger prick, which is sent to a certified laboratory for testing. You must call a toll-free number to register your sample prior to shipping. Enclosed in the test kit is an identifying number. Results take three days to one week. To obtain results, you give the operator the ID number, they will look up the result of the test.</div> <bR> <div> <B>Accuracy</B>: They use traditional <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><A HREF="#elisa" TITLE="HIV Antibody Testing"><U><U>ELISA</U></U></A></FONT> and <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><A HREF="#wb" TITLE="HIV Antibody Testing"><U><U>Western Blot</U></U></A></FONT> procedures, so the results are as accurate as one would receive at anonymous testing sites discussed above.</div> <bR> <div> Some agencies endorses the concept of home collection kits in order to enhance broader access to testing, but are concerned that consumers may not receive adequate, accurate and effective phone counseling and support. There is no automatic prevention education or pre-test counseling with this method of testing (although you can specifically request it with Home Access). Testing companies may also offer post-test counseling for some results, but not others. Also, they have a concern that consumers may not always be able to take the test in privacy if they live with others.</div> <bR> <div> However, the speed of the test may offer an advantage, although more and more anonymous testing sites are offering one week (or less) results, at no cost. The privacy of the home test offers some consumers more comfort than going to a public test site.</div> <bR> <div> Remember, as with testing at an anonymous or confidential site, you must wait three to six months after HIV exposure to take the at-home test.</div> <bR> <bR> <div>  <A NAME="rapid"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A><B>"Rapid" Tests for HIV    </B><A HREF="#top_of_page" TITLE="HIV Antibody Testing"><U><B><IMG SRC="16e14140.gif" border=0 width="20" height="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A></div> <div> <B>What</B>: A rapid test, the Murex-SUDS (Single Use Diagnostic System), has been approved by the FDA since 1996. It is currently the only "rapid" test approved. The SUDS is more expensive than ELISA testing, so it is not likely to be used by public health sites, and most private clinics that offer it will charge.</div> <bR> <div> <B>How</B>: The SUDS requires a blood draw and centrifuge equipment; it is therefore not available at mobile test sites and clinics that don't already have a moderately sophisticated lab on-site. Results are available in 10-30 minutes. Like the traditional <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><A HREF="#elisa" TITLE="HIV Antibody Testing"><U><U>ELISA</U></U></A></FONT>, a positive SUDS <I>must </I>be confirmed by <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><A HREF="#wb" TITLE="HIV Antibody Testing"><U><U>Western Blot</U></U></A></FONT> or <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><A HREF="#ifa" TITLE="HIV Antibody Testing"><U><U>IFA</U></U></A></FONT>, as discussed above. This may actually create more anxiety for the person being tested, since the confirmation must be done at a lab; this will typically take at least one more week. However, some individuals may be more likely to take an HIV test if they can get the results as quickly as possible.</div> <bR> <div> <B>Accuracy</B>: This <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><A HREF="#sensitivity" TITLE="HIV Antibody Testing"><U><U>sensitivity</U></U></A></FONT> of the SUDS is comparable to a traditional ELISA, but if positive, it must be confirmed by traditional Western Blot.</div> <bR> <bR> <div> <I> <A NAME="urine"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></I><B>Urine Test For HIV    </B><A HREF="#top_of_page" TITLE="HIV Antibody Testing"><U><B><IMG SRC="16e14140.gif" border=0 width="20" height="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A></div> <div> <B>What</B>: A test that detects HIV antibodies in urine was approved by the FDA in 1996, and is beginning to be marketed. <I>This test is not generally available to consumers</I>. It generally will be marketed to insurance companies and to other countries. (Note: urine has <I>antibodies</I> for HIV, <I>not HIV itself</I>, so HIV is <I>not transmitted</I> by urine.) Manufactured by Seradyn, it is called the "Sentinel" test. </div> <bR> <div> <B>How</B>: A sample of urine is tested at a certified lab, using a modified ELISA procedure. This test must be ordered by a physician; a person cannot "self-refer" like they can with traditional HIV antibody tests. This means the <I>urine HIV test</I>, by definition, is <I>confidential</I>, not anonymous<I><B>.</B></I></div> <bR> <div> <B>Accuracy</B>: Because it is <I>less </I><FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><A HREF="#sensitivity" TITLE="HIV Antibody Testing"><U><I><U>sensitive</U></I></U></A></FONT><I> than a blood test</I>, positive results must be confirmed by a traditional blood sample (<FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><A HREF="#elisa" TITLE="HIV Antibody Testing"><U><U>ELISA</U></U></A></FONT> plus <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><A HREF="#wb" TITLE="HIV Antibody Testing"><U><U>WB</U></U></A></FONT>). </div> <bR> <bR> <div> <I> <A NAME="orasure"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></I><B>OraSure Test For HIV    </B><A HREF="#top_of_page" TITLE="HIV Antibody Testing"><U><B><IMG SRC="16e14140.gif" border=0 width="20" height="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A></div> <div> <B>What</B>: The OraSure HIV antibody test method, also approved by the FDA in 1996, uses a sample of oral mucus obtained with a specially treated cotton pad that is placed between the cheek and lower gum for two minutes. (Note: the saliva and oral mucus contain <I>antibodies</I> to HIV, <I>not HIV itself</I>, so HIV is <I>not transmitted</I> through these fluids.) Some public test sites are beginning to offer this test as an alternative to blood testing. It is somewhat more expensive, so the client may be asked to pay for it.</div> <bR> <div> <B>How</B>: The sample is sent to a lab, where it undergoes an <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><U>ELISA</U></FONT> procedure. All positive ELISA samples undergo a <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><U>Western Blot</U></FONT> confirmatory test (using the same pad). Because an outside lab is required to process the pad, this is not a "rapid test" for HIV, since it will take from a few days to a few weeks to get results, depending on the test site's choice of lab.</div> <bR> <div> <B>Accuracy</B>: The combined accuracy of OraSure ELISA and WB procedures is comparable to traditional blood testing, i.e., very high.</div> <bR> <bR> <div> <B>For-Profit Test Sites</B></div> <div> There are various for-profit sites that offer HIV testing, but we cannot confirm that they are all offering counseling (which we feel is essential). In addition, many of these companies offer the initial test at a certain publicized fee, but do not tell the consumer that any additional tests (including confirmatory tests) may cost extra. </div> <bR> <div> Most businesses charge a premium because they offer faster results. <I>(Remember, standard ELISA tests take only 3.5 hours to do, but most non-profit sites send samples away to central labs to lower costs (which is why their tests are free or low-cost). It is the transit (turnaround) time, not the actual test, that takes longer.) </I>Some people with high anxiety about exposure may be tempted to use this faster service. Many of those people with high anxiety are not appropriate for HIV testing, either because it is too soon after the exposure, or they are not even at risk for HIV.</div> <bR> <bR> <div> <B>Testing Issues For Specific Populations</B></div> <div> <FONT SIZE="2" COLOR="#000000" FACE="Arial" ><U> <A NAME="pregnant"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></U></FONT><B>Pregnant women    </B><A HREF="#top_of_page" TITLE="HIV Antibody Testing"><U><B><IMG SRC="16e14140.gif" border=0 width="20" height="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A></div> <div> The antibody test may not be appropriate for a pregnant woman who has had recent exposure to HIV. If she is trying to decide whether to continue or terminate her pregnancy, she cannot afford the three to six month waiting period the antibody test requires. In such cases, the <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><A HREF="http://www.sfaf.org/aids101/viral_testing.html" TARGET="_top" TITLE="http://www.sfaf.org/aids101/viral_testin"><U><U>viral load test</U></U></A></FONT><A HREF="http://www.sfaf.org/aids101/viral_testing.html" TARGET="_top" TITLE="http://www.sfaf.org/aids101/viral_testin"><U> </U></A>may be ordered by a physician to help the woman make more informed decisions. Research presented at the 12th World AIDS Conference conclusively indicates that even short-term AZT therapy during the late stages of pregnancy and delivery reduces mother-to-child HIV transmission. Knowledge of one's HIV status can help a pregnant woman make informed decisions about her care. See the section on <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><A HREF="http://www.sfaf.org/aids101/transmission.html#mother_to_child" TARGET="_top" TITLE="http://www.sfaf.org/aids101/transmission"><U><U>perinatal transmission</U></U></A></FONT> for additional information.</div> <bR> <div>  <A NAME="children"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A><B>Newborns and children    </B><A HREF="#top_of_page" TITLE="HIV Antibody Testing"><U><B><IMG SRC="16e14140.gif" border=0 width="20" height="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A></div> <div> During pregnancy a mother transfers her immunities to the child. If she is infected, her antibodies to HIV are transferred. Therefore, after a child is born and for the first 12 to 18 months, the child will test positive with an antibody test. This may not mean that the child is infected. After 12 to 18 months, the child will shed the mother's antibodies. If it is infected, the child will continue to test positive with an antibody test.</div> <bR> <div> The recently developed IgA antibody test may offer a cheaper alternative than the viral load test for determining infant infection as early as six months after birth. Unlike HIV, IgA antibodies do not travel across the placenta to the fetus. This simple and relatively inexpensive test, which costs about $50, appears to reveal the child's, rather than the mother's, response to HIV.</div> <div> HIV testing presents special problems for children under 12 years old and infants under 18 months old. </div> <bR> <div> <B><IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Infants under 18 months</B><I>.</I> When an HIV-positive mother gives birth, her child may be HIV-negative yet still have the mother's <I>antibodies</I> in its bloodstream. For this reason, the antibody test is not a reliable indicator of HIV status for children under 18 months. In cases such as these, the <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><A HREF="http://www.sfaf.org/aids101/viral_testing.html" TARGET="_top" TITLE="http://www.sfaf.org/aids101/viral_testin"><U><U>viral load test</U></U></A></FONT> may be used to provide additional information about the child's immune system. </div> <bR> <div> <B><IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Children under 12</B><I>.</I> California's Anonymous Testing Sites will not perform an antibody test on children under 12. Children under 12 have to be tested through a private physician or clinic. </div> <bR> <div> <B><IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Youth 12 to 25</B> may schedule individual youth appointments at the anonymous testing sites. This means they will receive more personalized counseling from the same counselor before and after the test.</div> <bR> <div> <FONT SIZE="2" COLOR="#000000" FACE="Arial" ><U> <A NAME="immigrant"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></U></FONT><B>Testing for immigrants   </B><A HREF="#top_of_page" TITLE="HIV Antibody Testing"><U><B><IMG SRC="16e14140.gif" border=0 width="20" height="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A></div> <div> <I>[adapted from </I><FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><A HREF="http://www.sfaf.org/policy/immigration/" TARGET="_top" TITLE="http://www.sfaf.org/policy/immigration/"><U><I><U>HIV and Immigrants: A Manual for AIDS Service Providers</U></I></U></A></FONT><I>, published by the National Lawyers Guild with support from the SF AIDS Foundation Policy Dept.]</I></div> <bR> <div> All applicants for U.S. residence must take an HIV antibody test as part of the compulsory medical exam. Those who test positive are denied residence automatically. This measure also applies to all people requesting change in residence status, including citizenship applications.</div> <bR> <div> Let's say you are an immigrant who has tested HIV positive. Besides worrying about testing HIV positive, you also fear what will happen to you because you are not a US citizen. You may wonder whether your immigration status will change the kind of services you can get. You may ask: Will I be deported? Will I lose my immigration status? Can I work or get public benefits to help me if I need them? Will getting benefits make it hard to get another immigration status? If I can't work or get benefits, is there anything I can do to get another immigration status that will help me?</div> <bR> <div> <B><IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Do not go to the INS by yourself</B>. No one should speak to INS or go to INS before talking to an immigration law expert. If non-citizens go to INS by themselves, INS may arrest them and remove them from the US before they have had the chance to talk to a lawyer. </div> <bR> <div> <B><IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Become informed about confidential versus anonymous testing</B>. Before taking an INS medical exam, a non-citizen should get tested at a local clinic. Anonymous testing will give them the results without connecting those results to a name. </div> <bR> <div> <FONT SIZE="2" COLOR="#000000" FACE="Arial" ><U> <A NAME="military"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></U></FONT><B>Military personnel   </B><A HREF="#top_of_page" TITLE="HIV Antibody Testing"><U><B><IMG SRC="16e14140.gif" border=0 width="20" height="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A></div> <div> The Defense Department requires annual HIV testing for all military personnel on active duty, all members of the reserve and National Guard, and all men and women seeking to join the armed services.</div> <div> A military doctor can notify the spouse of a reservist if that reservist has tested positive.</div> <bR> <div> <FONT SIZE="3" COLOR="#000000" FACE="Arial" >It is recommended that you read the article, </FONT><FONT SIZE="4" COLOR="#0000FF" FACE="Arial" ><A HREF="id92_hiv_antibody_testing_indications_and.htm" TARGET="_top" TITLE="HIV Antibody Testing"><U><B>HIV Antibody Testing: Indications and Interpretation</B></U></A></FONT><B>, </B>it will also explain, for some, the information contained above.</div> <bR> <div> Having this understanding of the HIV Antibody Test, one should be able to better understand the work the Bureau is conducting.</div> <bR> <div>  <A NAME="orasure_1"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A>The Bureau first starting taking OraSure HIV Antibody Test in the community.  <FONT SIZE="3" COLOR="#000000" FACE="Arial" >OraSure technology is unique in that it does not test saliva, but rather an oral sample called oral mucosal transudate (OMT), which contains high concentrations of antibodies and is free of most of the contaminants found in saliva.</FONT></div> <bR> <div> "An OraSure sample is not saliva -- that's the key to the technology and to its high level of accuracy," said John Fitchen, MD, Chief Operating Officer/Medical Products, Epitope. "Like traditional blood tests, it tests for HIV antibodies, not the virus. Unlike any other tests, it draws out HIV antibodies from the tissues of the cheek and gum."</div> <bR> <div> <B>HIV Antibody Testing and OraSure Technology</B></div> <div> A specially treated pad attached to a handle is placed by the patient between the lower cheek and gum for two minutes. The pad is then placed in a vial with a preservative and sent to a clinical laboratory for testing for the presence of HIV antibodies, the same way blood samples are tested.</div> <bR> <div> Analysis of the oral sample is done with an enzyme-linked immunosorbent assay (ELISA), a highly sensitive screening test that detects HIV antibodies. Reactive results (those that are positive in the initial screening test) are automatically re-tested with a second OraSure ELISA. If the second ELISA results are also reactive, the sample is tested with the OraSure Western Blot, which confirms HIV infection. A single OraSure sample is adequate for the entire testing procedure.</div> <bR> <div> <FONT SIZE="3" COLOR="#000000" FACE="Arial" >Individual samples are recorded by number to help ensure confidentiality; results will be available to the healthcare provider within three days.  (Recently the FDA approved an</FONT> <A HREF="id76_20_minute_hiv_test.htm" TARGET="_top" TITLE="FDA Approaves 20Minute HIV Test"><U><U>OraSure 20-Minute HIV Antibody Test</U></U></A><FONT SIZE="3" COLOR="#000000" FACE="Arial" >.</FONT></div> <bR> <div> We test individuals at our main office at 110 1/2 Gillespie Street, Fayetteville, NC and our Non-Traditional Test Site 221 Old Wilmington Road, Fayetteville, NC.  However, we are not limited to testing just in these sitting.  Due to the portable nature of the OraSure HIV Antibody Test, the test can be administered on a street corner, in a crack house, a juke joint, a bootlegging house or deep within the secrecy of a hidden field used by substance abusers.  We also, are afforded the opportunity to test in the individual's private residence, if they desire.  This has allow the Bureau to conduct more HIV Antibody Testing within the community and become more effective in our <A HREF="id42_community_street_outreach_program.htm" TARGET="_top" TITLE="Community / Street Outreach"><U>Community/Street Outreach Service</U></A>.</div> <bR> <div> The last quarter of 2002 the Bureau entered into a collaborative relationship with <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><A HREF="http://publichealth.southernregionalahec.org/cumBERLAND/index.html" TARGET="_top" TITLE="http://publichealth.southernregionalahec"><U><U>E. Newton Smith Public Health Center</U></U></A></FONT> to conduct <A HREF="id45_how_it_is_done_.htm" TARGET="_top" TITLE="Syphilis Testing"><U>blood drawn</U></A> HIV Antibody Testing within the community.  Due to the demand for the <A HREF="#orasure_1" TITLE="HIV Antibody Testing"><U>OraSure HIV Antibody Testing</U></A> there are times we are out of the test kits, and now with the ability to conduct blood drawn HIV Antibody Test, even more individuals may be tested.  A blood drawn HIV Antibody Test is where a syringe is used to withdraw blood directly from an individual's vein into a collection vial, where the blood is marked for identification and transported to a laboratory for testing.  This procedure is more invasive than the OraSure HIV Antibody Test.</div> <bR> <div> The Bureau conducts HIV Antibody Testing as a normal part of its <A HREF="id42_community_street_outreach_program.htm" TARGET="_top" TITLE="Community / Street Outreach"><U>Community/Street Outreach Program</U></A>.  There is also special emphasis placed on testing during <A HREF="id89_parties.htm" TARGET="_top" TITLE="Community Empowerment"><U>street rallies and block parties</U></A> throughout the community conducted by the Bureau.</div> <bR> <div> An individual may come to the office, or call the office, and arrange for a HIV Antibody Test, free of charge.  An appointment, when necessary is made, pre test counseling conducted, test administered, results returned, person contacted by a <A HREF="id33_community_street_educators.htm" TARGET="_top" TITLE="Community / Street Educators"><U>Community/Street Outreach Educator</U></A> and given the test results and post test counseling along with the development of a behavior modification plan to help them practice safer sex and learn to reduce the risk for additional infection or an initial infection with HIV or any other <A HREF="id68_std.htm" TARGET="_top" TITLE="What Are STD (Sexually Transmitted Disea"><U>sexually transmitted diseases</U></A>.</div> <bR> <div> A review of our Quarterly Narrative Report for our <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><U>Outreach Program</U></FONT> and <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><A HREF="id50_nts_narrative_report.htm" TARGET="_top" TITLE="Quarterly Narrative Report for Nontradit"><U><U>Non-Traditional Testing</U></U></A></FONT> will provide you with an insight to the depth of our labor in reaching out to our community.</div> <bR> </td> </tr></table></body>