What is HIV?

HIV (Human Immunodeficiency Virus) is a virus that affects the body’s immune system and reduces the body’s ability to fight infection. HIV can be treated to prevent ongoing immune system damage. Without treatment, HIV can cause progressive damage to the immune system leading to late or advanced HIV infection, previously known as AIDS (acquired immunodeficiency syndrome). This can result in a range of infections and illnesses which occur when the immune system is weakened. With early diagnosis and continued treatment people living with HIV do not develop AIDS and can expect to live as long as people without HIV. Likewise, treatment can allow people with late HIV infection to recover and live healthy lives.

How does someone become infected with HIV?

HIV can be transmitted from an infected person to a non-infected person by:

• vaginal or anal sex without a condom
• sharing drug injecting equipment
• blood to blood contact such as through piercings and tattoos with equipment that is not sterilised properly
• from mother to child during birth or breastfeeding without having HIV treated
• sharps or needlestick injuries

HIV is rarely transmitted by:

• oral sex without a condom
• splashes to broken skin with HIV infected body fluids

HIV has never been reported as being transmitted by:

• shaking hands or social contact including kissing and cuddling
• sharing cutlery or crockery
• toilet seats
• mosquito bites

What is an HIV test?

A standard HIV test is a blood test which is processed in a laboratory. The test checks if you have HIV antigens and antibodies in your blood. Antigens are small proteins which make up parts of the HIV virus and antibodies are produced by your immune system in response to antigens. If you have HIV, you will have these antigens and antibodies in your blood.

What does a positive HIV test result mean?

A positive test means that you may be infected with HIV. A positive test is followed by different and more accurate tests to confirm the result.

What does a negative HIV test result mean?

A negative test usually means you have not been infected with HIV, unless you have very recently been exposed and antigens and antibodies are not yet at detectable levels. This is why it is important to consider your sexual history and when you were last at risk. It can take 6 to 12 weeks from the time you were exposed to HIV for the test to be accurate. This is called the ‘window period’, so you may need another blood test in 6 weeks to 3 months. Your clinician will provide advice on this.

What does an indeterminate HIV test result mean?

Sometimes a result is not positive or negative. This can be due antigens and antibodies to other infections cross-reacting with your test. More testing is needed to confirm the result.

What is HIV rapid testing?

HIV rapid tests use blood from a fingerpick and provide a result in about 20 minutes. Rapid tests can be used for self-testing and for testing with partners. Reactive rapid test results need confirmation with further testing by a clinician who will collect blood for laboratory tests. HIV rapid tests are available through some GPs, sexual health clinics and community organisations and can be purchased at most pharmacies. Rapid tests are not as accurate as laboratory tests in early HIV infection. If you are unwell and think you have been exposed to HIV, please see your GP or sexual health centre for advice and blood testing.

Is there treatment for HIV?

HIV is not curable but is managed with treatment. HIV treatment involves taking tablets every day or regular injections to reduce the amount of the HIV virus in your body. HIV treatments dramatically improve the length and quality of life for people with HIV.

U=U: Undetectable equals un-transmittable

Treatment for HIV reduces the amount of HIV virus in the blood to very low levels. HIV levels are checked by a test called a viral load. Very low levels of HIV virus give an “undetectable” viral load result which indicates well controlled HIV infection. The virus is still there, but continued treatment keeps it at such low levels that HIV cannot be passed on to sexual partners.

If you are living with HIV, discuss this with your health care provider to be confident about your test results and know when you can have sex without condoms without exposing your partner(s) to HIV.

What are the advantages of having an HIV test?

It can take years before HIV causes noticeable symptoms. Most people acquire HIV from someone who doesn’t know they have HIV, either here in Australia or overseas. Regular testing will identify HIV early and protects your health and the health of others.

My HIV test was negative. How can I protect myself against HIV?

Condoms, HIV PrEP (pre-exposure prophylaxis) and PEP (post exposure prophylaxis) reduce your risk of HIV (see websites below). Have open and honest conversations with your partner(s) and make sure you are each tested before stopping condoms or PrEP. Any doctor or nurse practitioner can prescribe PrEP, which is available for everyone at risk of HIV.

I have been diagnosed with HIV:

• Receiving a positive HIV result is distressing and can be overwhelming, with fears of stigma and feelings of anger and shame. Your health care provider will discuss support and counselling to help you through this time, including linkage with peer workers (people living with HIV who work for community organisations supporting health and wellbeing)
• HIV care and treatment is available across Australia. Medications are low cost or free with or without Medicare
• With treatment, your health will improve and you can stay well and live a long life
• Insurance and visas for some countries are restricted for people with HIV and it is important to know before you travel – see Homepage | Smartraveller
• There are legal requirements around sex in some Australian states and territories for people with HIV – see Guides to HIV and the law (halc.org.au)

Where can I get more information and support?

Meridian is a support organisation for people living with or impacted by HIV in the Canberra region. Staff at Meridian can talk with you about having an HIV test or provide support and advocacy for those living with HIV. You and can contact them on (02) 6257 2855 or visit Meridian (meridianact.org.au)

If you need more information or have any questions, please contact Canberra Sexual Health Centre on (02) 5124 2184 or talk to your GP. We are all here to help.

Other resources:

• HIV - STI Testing and Prevention - Stay STI Free (also in other languages)
• HIV Factsheet - long version (youngdeadlyfree.org.au)
• Unstoppable, Unashamed, Undetectable: U=U | Ending HIV
• PrEP HIV Prevention | Pre-Exposure Prophylaxis | Ending HIV
• PEP Medication | HIV Treatment Post Exposure | Ending HIV

References:

• HIV | STI Guidelines Australia