Positive – Can HIV tests be wrong?

HIV/Aids Q&A

Across the world, Aids is increasing most rapidly in young heterosexual women. Britain has found that young pregnant women under the age of 20 are most likely to be infected – findings similar to South Africa.

The teaching community in South Africa has been slow to rise to the challenges HIV poses for those they teach – the virus is most common in girls aged 13 to 19 and young men aged 15 to 25. But most of all they are not yet facing the challenges the virus poses to them as teachers and as individuals.

Q: Dear Charlene

I went for an HIV test and it was positive. I went back again and this time the result said negative. A few months later I went to the hospital and this time the result came back positive. It was very confusing. However, I can see all the HIV signs in my body – fever, sore throat, skin rash. Do you think I am HIV-positive?

– Zondi, White City, Soweto

A: I cannot say with certainty whether you are positive, but it sounds likely. Aids experts say only about 10% of South Africans who are infected know they are positive. The other 90% are infecting other people and re-infecting themselves with other strains of the virus. Five million people are HIV-positive in South Africa.

HIV shows itself most often as flu-like symptoms, about one to three weeks after exposure. Symptoms can include, fever, sore throat, skin rash, diarrhoea, un- explained and rapid weight loss, swollen glands, ulcers in the mouth or on the genitalia, or excessive tiredness. But as quickly as the symptoms appear, they disappear, and the infected person can put on weight again and appear well for years afterwards.

People who are high risk for HIV are those who have unprotected sex, people who inject drugs, gay and bisexual men, haemophiliacs, those with tuberculosis, people who are raped, a person who already has a sexually transmitted disease, or if you had a blood transfusion before 1985.

The most reliable test is the Elisa (enzyme linked immunosorbent assay). Blood will be taken from your arm and sent to a laboratory, and the results of the Elisa will be given to you within three to seven days.

The PCR (polymerase chain reaction) test can be done to give either a qualitative result (positive or negative) or quantitative (this tests the viral load, if you have HIV in your blood). It also requires blood from you, and the results will be ready in one to three days, but they are not as accurate as the Elisa, which is 99% accurate.

Rapid tests are often done by doctors. Some are very reliable, but some can give a false negative or false positive. Results for these are available in 15 minutes to half an hour.

Never use home-based HIV test kits, as they are not reliable and if you get a positive (which may be false) you have no-one to explain to you how to manage the virus.

Urine tests for HIV are used in China, and have been approved for use in South Africa, but are not yet being used.

In the USA, HIV tests are most often done with mouth swabs – a stick inserted into the mouth takes a very thin layer of skin from the mouth, and it produces quick and reliable HIV results. Or saliva is put onto a blotter – this is being used by some companies in South Africa.

The Western blot test, which is available in South Africa but is not often used, is a further test to confirm an HIV-positive diagnosis. I would suggest you go to the excellent Aids clinic at Chris Hani Baragwanath and meet with a doctor to test your CD4 count, and with a counsellor who can put you in touch with some of the excellent HIV support groups in and around Soweto.

If you have questions for Charlene Smith, or comments, please write to the Teacher/HIV Positive, PO Box 91667, Auckland Park, 2006. All letters will be treated as confidential unless you say you want your name used.

– The Teacher/M&G Media, Johannesburg, August 2001.

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