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
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
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
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
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
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:
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
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:
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.