HIV/AIDS

HIV-1 Antibody Test (ELISA and Western Blot)

noreply@blogger.com (Unknown) — Sat, 16 Aug 2008 20:45:00 +0000

What is the HIV-1 antibody test?

The HIV-1 antibody test checks your blood for antibodies to the most common type of the human immunodeficiency virus (HIV-1). HIV is the virus that causes AIDS (acquired immunodeficiency syndrome), a life-threatening disease. If you are infected with HIV, your immune system makes a type of protein called an antibody to try to destroy or get rid of the virus.

There are different HIV antibody tests. One test is the ELISA (enzyme-linked immunosorbent assay). If the ELISA test is positive, a second test called a Western blot is done to confirm the result. The Western blot takes longer to perform and is more expensive than the ELISA test, but it is more precise.

There is no way to know, without testing, if you are infected with HIV. Learning whether you are HIV positive will help you care for yourself and protect your loved ones.

Why is this test done?

This test is done to see if you are infected with the virus that causes AIDS. This test is also used to screen donated blood for HIV.

How do I prepare for this test?

It is important to get counseling before you have the HIV test. This can help to identify things you do that may increase your risk for HIV infection.

How is the test done?

Usually a small amount of blood is taken from your finger or your arm. Blood from a finger prick is put in a vial of solution and tested with a dipstick. Blood taken from your arm with a needle will be sent to a lab for testing. In some hospitals and clinics a new, faster test is now available. A sample for testing is obtained by swabbing your gums with a cotton swab rather than drawing blood.

Having the test takes just a few minutes of your time. There is no risk of getting AIDS, hepatitis, or any other blood-borne disease from this test.

Home test kits have become available through the Internet. However, some of these tests have been shown to be inaccurate. The only HIV test approved by the FDA is the Home Access HIV testing kit. When you do this home test, first you register by phone. Then you collect a sample of blood and mail the sample to the lab for testing. Toll-free telephone support is available 24 hours a day for test and result questions. You should see your health care provider to confirm any positive results from a home test.

How will I get the test result?

Ask your heath care provider when and how you will get the result of your test. Results from the finger-prick or gum-swabbing HIV tests may be available in 30 minutes or less. You may get results from other HIV tests in 2 to 10 days.

The test results are confidential. Confidential testing ensures that your results will be guarded with care. Positive results may be reported by name to the health department for 2 reasons. The first reason is to provide help with partner notification and referral to care. The second is to provide reports to the federal government so there can be a count of how many people have HIV. The count helps determine how much money each state needs for HIV care.

Some centers offer anonymous testing. Anonymous testing does not use your name at all. Positive results are reported without any personal identifiers. Some people feel this better protects the confidentiality and civil rights of people who test positive for HIV.

What do the test results mean?

In general, a positive HIV test means that you are infected with HIV, and a negative test means that you are not infected with HIV. The test does not directly measure or identify the HIV virus in the blood, however. Instead it measures antibodies that the body makes in response to the viral infection. Because it takes at least a few weeks for the antibodies to appear in the blood after infection by the virus, it is possible to have a negative test if you have been recently infected (this is called a false negative test). In this case, the test will become positive if it is repeated several weeks or months later. If you have a negative test result but you are in a high-risk group, you may need to have another test in 3 to 6 months. Most people test positive 6 weeks after infection.

Although the HIV tests are very precise, sometimes the test result can be positive even though you do not have HIV infection (this is called a false positive test). For this reason, when a positive result occurs, labs perform a second HIV test (Western blot) to check the result.

What if my test result is positive?

If your first test for HIV is positive, you should have more blood tests to confirm the results. If repeat tests are positive, you should seek medical care, even if you have no symptoms. In some cases you may need to start taking medicine to try to stop the HIV infection from developing into AIDS. You need to discuss the test results with your health care provider or an HIV counselor as soon as possible to protect your health and the health of people you love.

AIDS Case Definition

noreply@blogger.com (Unknown) — Sat, 16 Aug 2008 06:59:00 +0000

A person who has tested HIV positive is diagnosed with AIDS when:

• the person’s CD4 cell count falls below 200 cells/ml

• the person is diagnosed with any of the following conditions or diseases:

Candidiasis of bronchi,
trachea or lungs Candidiasis,
esophageal Cervical cancer,
invasive Coccidioidomycosis,
disseminated or extrapulmonary Cryptococcosis,
extrapulmonary Cryptosporidiosis,
chronic intestinal (>1 month duration)
Cytomegalovirus disease (other than liver, spleen, or nodes)
Cytomegalovirus retinitis (with loss of vision)
Encephalopathy,
HIV-related
Herpes simplex: chronic ulcer(s) (>1 month duration) Histoplasmosis,
disseminated Isosporiasis,
chronic intestinal (> 1 month duration) Kaposi’s sarcoma Lymphoid interstitial pneumonitis (in children) Lymphoma,
Burkitt’s (or equivalent term)
Lymphoma,
immunoblastic (or equivalent term) Lymphoma,
disseminated or extrapulmonary Mycobacterium tuberculosis, any site (pulmonary or extrapulmonary) Mycobacterium, other species or unidentified species, disseminated or extrapulmonary Pneumocystis carinii pneumonia Pneumonia,
recurrent Progressive multifocal leukoencephalopathy Salmonella septicemia,
recurrent Toxoplasmosis of brain Wasting syndrome due to HIV A person who is HIV negative or of undetermined serostatus may be diagnosed with AIDS when other causes of immunodeficiency are ruled out and the person is definitively diagnosed with one of the AIDS indicator diseases listed above.

100. Do confidential HIV test results have to be included in a person’s individual medical record?

noreply@blogger.com (Unknown) — Sat, 16 Aug 2008 06:58:00 +0000

Yes. New York State Code, Rules and Regulations, Title X, Part 63 requires that confidential HIV-related information be recorded in the medical record and be easily accessible to provide proper care and treatment.

99. Can people with HIV infection or AIDS be denied health, disability, or life insurance?

noreply@blogger.com (Unknown) — Sat, 16 Aug 2008 06:57:00 +0000

No. In New York State, health insurance – including hospital, medical, and surgical coverage – cannot be denied and a higher premium cannot be charged simply because the applicant has HIV. However, disability insurance and life insurance companies are allowed to ask applicants if they have been diagnosed or treated for AIDS or HIV-related illnesses; they can deny coverage or charge higher premiums for the policy if the person is infected. Insurance companies can also require an HIV test before issuing a policy. A person with HIV can be determined to have a pre-existing condition and may have to go through a waiting period before their coverage begins. After the waiting period (usually 12 months), all HIV-related expenses should be covered. For more information, call the New York State Insurance Department at 1-800-342-3736.

94. Are there laws in New York State that protect the confidentiality of people with HIV and AIDS?

noreply@blogger.com (Unknown) — Sat, 16 Aug 2008 06:56:00 +0000

Yes. Public Health Law, Article 27-F is the section of New York State Public Health Law that protects the confidentiality and privacy of anyone who has:

• been tested for HIV;

• been exposed to HIV;

• HIV infection or HIV/AIDS-related illness; or

• been treated for HIV/AIDS-related illness.

In addition, the law requires that anyone who takes a voluntary HIV test must first sign a consent form. This means the person understands what the test means and agrees to take it. The law also requires that information about a person’s HIV status can only be disclosed (shared with others) if the person signs an HIV release form or if the form is signed by the person’s legally appointed guardian or health care proxy. The law applies to individuals and facilities that directly provide health or social services and to anyone who receives HIV-related information about a person pursuant to a properly executed HIV release form. Also, the law Health care workers who refuse to care for a person with HIV infection or AIDS may be fired or disciplined. Ongoing education is required for all health care workers to ensure that they understand the ways in which HIV is spread and follow recommended safety precautions.

93. What happens if a person who tests HIV positive thinks that a partner will react violently if notified?

noreply@blogger.com (Unknown) — Sat, 16 Aug 2008 06:54:00 +0000

If a person who tests HIV positive is concerned that notifying a partner may seriously affect their health or safety, or the health and safety of someone close to them, such as a child, the person is referred for domestic violence services. Partner notification is delayed until it is safe to proceed. For information about programs providing domestic violence services, call the New York State Domestic Violence Hotline at 1-800-942-6906.

92. Can doctors notify the partners of a patient with HIV without the patient’s permission?

noreply@blogger.com (Unknown) — Sat, 16 Aug 2008 06:53:00 +0000

Yes. If a doctor knows the name of a patient’s partner, the doctor can notify the partner without the patient’s consent. However, the doctor must tell the patient that he or she intends to do this.

91. Are people who test HIV positive required to tell their doctor or counselor the names of their partners?

noreply@blogger.com (Unknown) — Sat, 16 Aug 2008 06:52:00 +0000

No. A person who tests HIV positive may be asked about his or her partners but is not legally required to reveal names. People cannot be punished or have treatment denied if they do not disclose the names of their partners to a doctor or public health worker. However, people with HIV should know the options they have for partner notification and understand how vitally important it is for partners to know of their possible exposure to HIV so that they can get tested and get treatment if they are infected.

90. How are partners of people who test HIV positive notified?

noreply@blogger.com (Unknown) — Sat, 16 Aug 2008 06:51:00 +0000

Persons who test HIV positive can choose from the following options how they would like to have their partners informed that they have been exposed to HIV:

• A counselor from the New York State Health Department PartNer Assistance Program (PNAP) or the Contact Notification Assistance Program (CNAP) in New York City can tell their partners without revealing the identity of the person.

• People can tell their partners with the help of their doctor or PNAP/CNAP counselor.

• People can tell their partners themselves.

Help from PNAP/CNAP is free. For more information, call the New York State Department of Health HIV/AIDS Hotline (see the Resources section). In New York City, call CNAP at 1-212-693-1419.

89. When the name of a person who tests HIV positive is reported to the New York State Department of Health, is that information shared with other gov

noreply@blogger.com (Unknown) — Sat, 16 Aug 2008 06:51:00 +0000

No. Under the law, identifying information about people who have HIV can only be used to help the State Department of Health track the epidemic and for partner notification. Information cannot be shared with other government agencies like the Immigration and Naturalization Service (INS), police, welfare agencies, insurance companies, landlords, or private agencies. The confidentiality of all HIV-related information is protected by New York State Public Health Law.

88. What are the Public Health Law provisions regarding HIV case reporting and partner notification?

noreply@blogger.com (Unknown) — Sat, 16 Aug 2008 06:49:00 +0000

In New York State, HIV reporting means that doctors and laboratories must report all cases of HIV infection to the State Department of Health. Public Health Law requires HIV case reporting by name. Additionally, laboratories must report HIV nucleic acid tests (viral load tests), CD4 lymphocyte tests, and drug resistance and subtype tests to the State Department of Health. Reporting helps the State Department of Health to accurately monitor the HIV epidemic, assess how the epidemic is changing, and create programs for HIV prevention and medical care that best serve affected people and communities. All reported information is protected by strict confidentiality laws (see questions 65 and 67).

Partner notification is important so that people can become aware of their HIV risk and receive HIV counseling and testing. Then they can take steps to protect themselves and their loved ones and get medical care sooner if they are infected. Giving doctors or the Health Department the names of partners is voluntary. While doctors are required to report known partners of their HIV-infected patients to the Health Department for the purpose of partner assistance, doctors are also required to talk with their patients about how they would prefer to let sex partners and needle-sharing partners know they may have been exposed to HIV. See question 90 for more information on partner notification options and assistance available through the PartNer Notification Assistance Program (PNAP) or the Contact Notification Assistance Program (CNAP) in New York City.

The national Centers for Disease Control and Prevention has issued guidelines urging all states to collect and report data on HIV cases to track the epidemic on a national basis. Within the next several years, HIV data will become the basis for funding formulas that allocate federal money for HIV care and treatment under the Ryan White CARE Act.

87. If an adolescent gets tested for HIV, will the parents or guardians be told about the test result?

noreply@blogger.com (Unknown) — Sat, 16 Aug 2008 06:48:00 +0000

Parents or guardians will not be told the test result if the adolescent being tested shows capacity to consent to the HIV test (see question 37). The laws that protect confidentiality of HIV-related information apply, no matter what the person’s age or

whether the person has parental consent or parental involvement (see question 94).

There are certain times when a parent or guardian of an adolescent who gave

informed consent can be told confidential HIV-related information – for example,

if the adolescent is being abused or needs urgent care. If it is best for the adolescent, HIV-related information should be kept strictly confidential.

86. At what age can a person consent to an HIV test?

noreply@blogger.com (Unknown) — Sat, 16 Aug 2008 06:47:00 +0000

According to New York State Public Health Law, individuals may consent to an HIV test without regard to age. Parents or legal guardians generally have the authority to consent to HIV testing for infants and young children who do not have the ability to understand and make an informed decision about testing. Care is taken to assure that young persons seeking HIV testing are able to make informed decisions about the test and are capable of understanding all information provided. Once a person has the capacity to consent – no matter what age – he or she can have an HIV test without parental knowledge or consent

85. Do adolescents/young adults get HIV?

noreply@blogger.com (Unknown) — Sat, 16 Aug 2008 06:41:00 +0000

Yes. HIV infection is an important concern for people of all ages, and young adults are no different. The Centers for Disease Control and Prevention estimate that at least half of all new HIV infections in the United States occur among

people under the age of 25.

The same behaviors that put adults at risk for HIV also put adolescents at risk. These activities include:

• having vaginal, anal, or oral sex without using a condom; or

• sharing drug injection equipment.

Adolescents should also be aware of these high-risk situations:

• Drinking or using drugs. Drugs and alcohol can affect your judgment and lead to unplanned and unprotected sex.

• Injection drug use, including sharing needles, syringes, cotton, spoons, bottle caps, or any other equipment (“works”).

• Experiencing “blackouts” – not being able to remember what happened while using alcohol or drugs.

• Not understanding your own risk of being infected with HIV or your partner’s risk of being infected.

• Having many sex partners, which increases the chances of having sex with someone who has HIV.

• Exchanging sex for money, drugs, food, housing, or other things of value.

• Having sex with older partners, especially partners who use drugs.

• Having sex with partners you do not know well.

• Having a history of sexually transmitted diseases (STDs) or having a partner who has a history of STDs.

• Rape or incest – anyone who has been a victim of rape or incest should seek counseling, including advice about HIV testing.

84. Who should parents and guardians tell about a child’s HIV infection?

noreply@blogger.com (Unknown) — Sat, 16 Aug 2008 06:40:00 +0000

The child’s health care providers need to know that the child has HIV in order to provide the best possible care. Providers include doctors, nurses, dentists, and other medical employees.

The law does not require parents and guardians to share HIV-related information with a child’s school. However, it may be in the child’s best interest for some school employees to know about the child’s HIV infection (for example, if the child needs help taking medicines).

Parents and guardians of children with HIV should also think about whether to share their child’s HIV status with people directly involved in the child’s life, such as babysitters, friends, and relatives. They do not have to tell anyone. However, it may be overwhelming to care for a young person with HIV/AIDS without telling

others and getting support.

Parents and guardians should consider:

• how disclosure would be helpful to the child;

• how disclosure would be helpful to the parents or guardians; and

• whether others can be trusted with this confidential information.

It may also be helpful to talk to the child’s doctor, nurse, social worker, and other people who are involved in the child’s care and sensitive to the child’s needs. They can provide advice about whether to reveal this information, how much you should tell, and who should know.

83. Can a child with HIV infect another child through casual contact, fighting, or contact sports?

noreply@blogger.com (Unknown) — Sat, 16 Aug 2008 06:39:00 +0000

HIV is not passed through casual contact like hugging, touching, or sharing toys It is highly unlikely that a child could get HIV through fighting or contact sports. The external contact with blood that might occur in a sports injury or through a fight is very different from the direct entry of someone else’s blood into your bloodstream that occurs from sharing needles or drug works.

82. Are children in foster care tested for HIV? Who receives the results?

noreply@blogger.com (Unknown) — Sat, 16 Aug 2008 06:39:00 +0000

Foster care agency workers assess all children who enter foster care for their risk of HIV infection. If a child is thought to be at risk for HIV and is not able to make an informed decision about testing, foster care staff get a signed consent from the appropriate guardian and make arrangements to have the child tested for HIV. Children and youth who are at risk for HIV and who are determined by the foster care agency to have the ability to make an informed decision about testing are recommended, but not required, to have an HIV test.

Authorized foster care agencies, foster and adoptive parents, local Departments of Social Services, Family Court, and health care providers have a right to know HIV information about children in foster care. However, they may not disclose HIV-related information to anyone else, unless it is for the care and treatment of the child.

81. Should a child with HIV get regular childhood immunizations?

noreply@blogger.com (Unknown) — Sat, 16 Aug 2008 06:38:00 +0000

Yes. Immunizations are important for all children. However, the schedule of immunizations is different for children with HIV, so it is important to tell the health care provider that the child has HIV. Also, vaccines given to an infant or child with HIV may become less effective over time as the child’s immune system gets weaker. So, a child with HIV who is exposed to any childhood disease should receive medical attention, even if the child has been vaccinated.

80. Do health care providers need to know if a child has HIV?

noreply@blogger.com (Unknown) — Sat, 16 Aug 2008 06:37:00 +0000

Yes. Health care providers need to know the HIV status of anyone who they treat in order to give the best possible health care. Children with HIV may develop infections and illnesses that require special medical attention. They may need medicines to fight HIV or to prevent HIV-related illnesses. Children with HIV also have a special childhood vaccination schedule .

79. Do children get HIV?

noreply@blogger.com (Unknown) — Sat, 16 Aug 2008 06:36:00 +0000

Yes. A woman can pass HIV to her baby during pregnancy, delivery, or breastfeeding (see question 20). However, there are medicines that a pregnant woman can take to greatly reduce the chance of her baby being born with HIV . These medicines have resulted in a large reduction in the number of babies infected with HIV in the United States.

The New York State Department of Health AIDS Institute and the State Office of Children and Family Services have published a manual, Caring for Children with Special Needs. The manual provides parents, foster parents, and other caregivers with information and support to meet the challenges of raising children with HIV. It is available online at http://www.health.state.ny.us/nysdoh/hivaids/child/index.htm.

78. How should parents talk to their children about HIV and AIDS?

noreply@blogger.com (Unknown) — Sat, 16 Aug 2008 06:35:00 +0000

Children and Adolescents/Young Adults

Parents should talk with their children about HIV and AIDS for many reasons, including:

• to make sure their children are getting accurate information that is appropriate for their age; and

• to help their children learn skills to reduce the risk of becoming infected

with HIV and protect themselves later in life.

Parents should look for chances to discuss HIV and AIDS directly with their children before their children are sexually active or experiment with drugs. A good way to approach the subject is to ask children what they are learning about HIV and AIDS in school. Or, parents can use news articles or stories on television, radio, or in the newspaper to start a conversation.

Parents should learn the facts about HIV and AIDS before talking with their children. Health departments, school health teachers, clinics, physicians, AIDS-related community organizations, libraries, and the Internet are good resources.

For a listing of HIV/AIDS educational materials written specifically for parents, call the New York State Department of Health AIDS Institute at (518) 474-9866 or

visit the website at http://www.health.state.ny.us/nysdoh/aids/index.htm for an order form; or call the National AIDS Information Clearinghouse at 1-800-4585231. Parents of children with HIV should refer to question 79 below.

77. How can I learn about experimental treatments for people with HIV?

noreply@blogger.com (Unknown) — Sat, 16 Aug 2008 06:34:00 +0000

For information about clinical trials or experimental treatments for HIV in New York State and nearby areas, contact the AIDS Community Research Initiative of America (ACRIA). ACRIA can help locate a specific clinical trial and provide treatment education and information on community services.

For more information, contact ACRIA at (212) 924-3934, ext. 121 or by e-mail:

treatmented@acria.org. The group’s website address is: www.acria.org. ACRIA provides detailed information on many federally and privately sponsored clinical trials. Call 1-800-TRIALS-A.

76. Do prisoners have access to up-to-date HIV treatments?

noreply@blogger.com (Unknown) — Sat, 16 Aug 2008 06:33:00 +0000

All people with HIV, including those in prison, should have access to healthcare and appropriate HIV treatment. For more information, speak with the medical staff at the prison or contact the New York State Prison HIV Hotline at (716) 8545469, Monday – Friday,12pm-8pm; Saturday – Sunday, 10am-6pm; collect calls are accepted from inmates in New York State Correctional Facilities

75. Are people with HIV who receive Medicaid required to join a managed care program?

noreply@blogger.com (Unknown) — Sat, 16 Aug 2008 06:32:00 +0000

No. People with HIV/AIDS who are on Medicaid do not have to join a managed care plan and can continue to get health care as they have in the past. However, this may change in the future, and people with HIV/AIDS who are on Medicaid may have to choose between a regular managed care plan or an HIV Special Needs Plan (SNP). SNPs are special health care plans for people with HIV or AIDS who are on Medicaid. People who join an HIV SNP choose a primary care doctor who is an HIV specialist – a doctor with special training and experience in treating people with HIV. SNPs pay for the same services as regular Medicaid, plus special services that are important for people living with HIV/AIDS. For more information about SNPs and managed care choices for people receiving Medicaid, call the New York Medicaid CHOICE HelpLine at 1-800-505-5678 or 1-888-329-1541 TTY/TDD

74. How can people with HIV and AIDS pay for their medical care?

noreply@blogger.com (Unknown) — Sat, 16 Aug 2008 06:29:00 +0000

Care for patients with HIV infection and AIDS is generallypaid for in the same way as other forms of medical care:• by the government (Medicaid, Medicare, and theHIV Uninsured Care Program, which includes the AIDS Drug Assistance Program, known as ADAP); or

• by private insurance companies. Most group health insurance plans cover HIV and AIDS medical treatment, although some have a maximum amount they will cover. People with HIV who are on Medicaid can now choose an HIV Special Needs Plan (SNP). SNPs are special Medicaid Managed Care Plans that allow people with HIV to choose HIV specialists as their primary care doctors and give patients access to special services.

The New York State Medicaid Program pays for drugs for persons on Medicaid. In addition, the New York State Department of Health operates the HIV Uninsured Care Program, including ADAP, which offers free drugs, primary care, and home care for people who do not qualify for Medicaid and who meet income requirements. ADAP can help people with no insurance or partial insurance. The program includes these services:

• ADAP pays for medicines for the treatment of HIV- and AIDS-related conditions.

• ADAP Plus (Primary Care) pays for primary care services at participating clinics and hospital outpatient programs, drug treatment programs, and private doctors’ offices.

• The HIV Home Care Program pays for a person’s home care services that are identified by their doctor. The maximum lifetime Home Care benefit per person is $30,000.

• APIC (ADAP Plus Insurance Continuation) pays for the health insurance of people with HIV who meet certain income and insurance criteria.

• AHIP (AIDS Health Insurance Program), operated by Medicaid, also pays for the health insurance of people with HIV who meet certain employment, income, and insurance criteria. But the criteria are slightly different from those of the APIC program. People who do not qualify for AHIP may qualify for APIC.