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HIV Testing and Counseling:

By: James F. Taylor


"Knowledge is power and knowing what is going on with your health and body is a responsibility that you owe to yourself and those who care about you. "

HIV Testing/Prevention Counseling . . .
Why do I need it?

Ok, so you have decided its time to get an HIV test. You feel it’s a no-brainer until you begin to ask yourself a few simple questions, and THEN you come to realize, this is serious business that takes preparation and consideration. True, getting tested can be one of the most empowering things you can do for your health. So keeping that in mind; choose an informed structured process that can give you all the information you need to engage in a useful test experience.

Many professionally trained Public Health sites use a client centered counseling approach that helps to make the test (and the decision of whether to take one or not), a well thought out plan for each individual. This may include; walking through the client’s perception and understanding of HIV/AIDS, discovering personal concepts of risk for infection, exploring ways to reduce that risk, and executing a plan to implement risk or harm reduction in the most realistic way possible. Each case should be confidential, client focused, and achieve a non-judgmental open dialogue between counselor and client.

In this installment, let’s look at some of the most basic questions that may come to mind when thinking about testing:

1) What is HIV Testing?

As with many medical diagnostic tools, the test looks for the presence of antibodies to the HIV-1 virus, not the virus itself. It takes the human body a time period of up to 6 months from the first point of infection to produce antibodies to HIV.

This time frame is referred to as “the window period” and demonstrates the actual duration of time needed to be monitored or tested to determine any chance of infection.

2) What kinds of test are available and how accurate are they?

There are several methods currently being used to test for HIV: the basic venipuncture blood test, an oral enzyme test (Ora-Sure) – methods which take about a week to get final results - or the Ora Quick Rapid Test (done with a finger stick) – in which a result may be determined in 20-40 minutes and delivered on the same day.

Many sites are also now offering the Ora Quick Advance (which can be done with a finger stick or oral swab) which checks for antibodies to both HIV types l and 2. As with the standard Ora Quick test a confirmatory test must be run if a preliminary positive result is obtained.

All methods show a high percentage rate of accuracy and have secondary confirmatory tests run in the event of a reactive first result.

3) What does an HIV Positive Result mean?

A positive result, once confirmed, means that you have been infected with the HIV virus. It must be understood that this does not mean you have AIDS. We now surmise that HIV is the virus that can lead to AIDS when left untreated. HIV attacks and destroys important lymphocyte t-cells of the immune system that fight infection. When the immune system sustains damage over a period of time and t-cell counts fall below a certain level (around 200), there is a possibility of developing certain opportunistic infections to which the immune system can no longer respond. At this point in time, the diagnosis would move from being HIV positive to fully developed AIDS.

The timeline in which this occurs is uncertain and can differ from individual to individual. Many times it is difficult to know you are infected, based on symptoms alone, until reaching advanced stages. This is another important argument for knowing your HIV status through testing.

Great strides have been made to keep the infection under control for longer periods of time, empowering clients to work towards making good health decisions and improve the length and quality of their lives. Most testing and counseling facilities will have a list of referral services to address the multiple questions or issues you may have once receiving this type of result.

The most important piece of information a positive test gives is that you now MUST strongly consider the options of taking precautions in order to prevent infecting others. Taking serious but reasonable harm reduction plans into account can help you navigate through the personal challenges that face you being HIV positive. Above all, respect yourself and know that in protecting others you are protecting yourself as well.

4) What does an HIV Negative Result mean?

A negative result means that at this time, your body is not showing any antibody development to HIV. Yes this is good news, but you need to take certain factors under consideration. Earlier we spoke of how it can take up to 6 months for antibodies to be produced after a time of infection. To make a negative result more meaningful, it is important to assess your last high risk contact (i.e. – the time when you could have engaged in behaviors that would cause you to be infected) and calculate six months past that point. After that 6-month window, you may wish to repeat the test to add further validity to the result.

To make an honest risk assessment, one needs to base their appraisal on facts and decide for themselves. Considering what we know about HIV transmission here are a few points to review:

bulletHIV can be transmitted by infected blood and body fluids through unprotected sex (when no barrier - i.e. condoms, dental dams, etc. - is used).
bulletAny form of skin puncture, needle sharing - whether through tattooing, piercing, or IV drug use - can pass the virus.
bulletHIV can be transmitted mother-to-child during childbirth or through mother’s milk when breastfeeding.

It is extremely important to understand that having the test does not prevent you from becoming infected in the future. For example, if you go out and participate in high-risk behaviors the day after the test, you have just set a brand new ‘window period” of six months in which you could develop antibodies and test positive. It is for this reason that if you receive a negative result, you investigate harm reduction methods that you can implement to prevent you from becoming infected at all. Realistically this is a true challenge but there are many support services available to make it so.

5) If I am HIV positive, should I still practice safer sex?

I find it hard to use the word “should” in any of my counseling, however, I feel that it is important to have as much correct information on hand in order to make a valid decision based on facts. The time has come for all of us to take responsibility for our actions. Keeping that in mind I offer the following information for you to consider when making those choices.

We do know that HIV is transmitted through unsafe sexual practices. True there is the “luck of the draw” and some may find escape the first time around. But as with most games of chance, eventually the wheel of fortune can turn against you. Being HIV positive, one needs to maximize health and healthy behavior to protect from other multiple infections that can weaken the immune system. Sexually Transmitted Diseases (syphilis, gonorrhea, chlamydia, herpes, genital warts, etc.) and Hepatitis (especially Hepatitis C) can cause serious complications in managing HIV. Therefore it remains a logical choice to be safe in sexual situations for more than just the threat of HIV.

Another much debated component is the possibility of transmitting resistant strains of virus. Every individual has their own genotype of HIV depending on the length of time they have been infected and the medications that they have been exposed to for HIV treatment. It is possible to transmit drug resistance from one individual to another. This may cause the loss of certain treatment options in the future. I have seen this happen in research situations and therefore tend to agree that it is very feasible.

6) So . . . why should I get tested?

The choice is ultimately yours. Keep in mind that there is still no cure for HIV and the treatments, although promising, are difficult and toxic over long periods of time. Knowledge is power and knowing what is going on with your health and body is a responsibility that you owe to yourself and those who care about you.

Take the time to learn all that you can about how HIV is transmitted, how to prevent additional exposure to other STD’s, and other actions that can put you at risk. Then, take a hard honest look at yourself and your behavior. Do you fall into any of those categories, even once? If so, then taking the test may be an important option. It is an act of respect and a sign of courage for you and for others. By working together, prevention can become a reality. By knowing your status you can take a pro-active approach in living out your life safely and productively. Above all else, be gentle with yourself and know that you are not alone.

Additional Resources for HIV and testing and counseling:


Testing sites in Connecticut:

STD Facts:

National testing sites:

James F. Taylor is a long time survivor of HIV, and now works as a research assistant at YALE University, as well as doing HIV Prevention Counseling. 






HIV Glossary:

Acquired Immune Deficiency Syndrome. The CDC defines AIDS as the presence of at least one of several opportunistic diseases (such as Pneumocystis carinii pneumonia, toxoplasmosis, tuberculosis or cervical neoplasms) and/or a CD4 cell count of less than 200 along with infection by the HIV.

Antibodies are special proteins that are part of your body's immune system. White blood cells make antibodies to neutralize harmful germs or other foreign substances, called antigens. Antibodies are "good guys" that fight inside your body, protecting you from "bad guys" like bacteria, viruses, pollen grains (that make you sneeze) and other foreign substances. Antibody production is just one immune response that protects our bodies.

An antigen is a substance that can trigger an immune response, resulting in production of an antibody as part of the body's defense against infection and disease. Many antigens are foreign proteins (those not found naturally in the body).

Center for Disease Control

Human Immunodeficiency Virus, the virus that causes AIDS


Sexually Transmitted Disease

drawing blood with a needle from a vein usually in the forearm.


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