What are the symptoms of HIV infection?

Many people do not develop any symptoms when they first become infected with HIV. Some people, however, get a flu-like illness within three to six weeks after exposure to the virus. Some people who contract HIV experience very strong symptoms, but others experience none at all. Those who do have symptoms generally experience fever, fatigue, and, often, rash. Other common symptoms can include headache, swollen lymph nodes, and sore throat. These symptoms can occur within days or weeks of the initial exposure to the virus during a period called primary or acute HIV infection.

The symptoms of early infection can also be similar to the symptoms of other sexually transmitted diseases and other infections such as "mono" or hepatitis, which are much more commonly and more easily transmitted. Stress and anxiety can also produce symptoms in some people, even though they do not have HIV. Some of these symptoms can start to appear as late as 10 years after infection or more.

Once the primary or acute infection is over, most people do not experience any visible symptoms for another 8-10 years. Left untreated, the immune system becomes increasingly weaker and the disease progresses to AIDS. The next symptoms experienced by individuals infected with the virus are often associated with the "opportunistic infections" that target individuals with AIDS such as pneumonia, tuberculosis, and toxoplasmosis.

Because of the nonspecific symptoms associated with primary or acute HIV infection, symptoms are not a reliable way to diagnose HIV infection. Testing for HIV antibodies is the only way to know whether you have been infected.

People living with HIV may feel and look completely well but their immune systems may nevertheless be damaged. It is important to remember that once someone is infected they can pass on HIV right away, even if they feel healthy.

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What is an HIV antibody test?

When HIV enters the body, it begins to attack certain white blood cells called T4 lymphocyte cells (helper cells). Your doctor may also call them CD4 cells. The immune system then produces antibodies to fight off the infection. Although these antibodies are ineffective in destroying HIV, their presence is used to confirm HIV infection. Therefore, the presence of antibodies to HIV result from HIV infection. HIV tests look for the presence of HIV antibodies; they do not test for the virus itself.

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Am I at risk?

The following are known risk factors for HIV infection. If you answer yes to any of these questions, you should definitely seek counseling and testing. You may be at increased risk of infection if any of the following apply to you since 1978.

• Have you injected drugs or steroids or shared equipment (such as needles, syringes, cotton, water) with others?
• Have you had unprotected vaginal, anal, or oral sex with men who have sex with men, multiple partners, or anonymous partners?
• Have you exchanged sex for drugs or money?
• Have you been diagnosed with or treated for hepatitis, tuberculosis (TB), or a sexually transmitted disease (STD), like syphilis?
• Have you received a blood transfusion or clotting factor between 1978 and 1985?
• Have you had unprotected sex with someone who would answer yes to any of the above questions?

If you have had sex with someone whose history of risk-taking behavior is unknown to you or if you or they may have had many sex partners, then you have increased the chances that you might be HIV infected.

If you plan to become pregnant, counseling and testing is even more important. If a woman is infected with HIV, medical therapies are available to lower the chance of passing HIV to the infant before, during, or after birth. 

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How do I know if I am infected?

The HIV-antibody test is the only way to tell if you are infected. You cannot tell by looking at someone if he or she carries HIV. Someone can look and feel perfectly healthy and still be infected. In fact, an estimated one-third of those who are HIV positive do not know it. Neither do their sex partners.

When HIV enters the bloodstream, it begins to attack certain white blood cells called T4 lymphocyte cells (helper cells). The immune system then produces antibodies to fight off the infection. Therefore, the presence of antibodies to HIV result from HIV infection. Testing can tell you whether or not you have developed antibodies to HIV.

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If I think I have been exposed to HIV, how soon can I get tested?

The tests commonly used to detect HIV infection actually look for antibodies produced by your body to fight HIV. Most people will develop detectable antibodies within 3 months after infection, the average being 20 days. In rare cases, it can take 6-12 months.

To make certain that you receive a reliable test result, it's necessary to wait at least three months (13 weeks) after your last possible exposure to the virus before being tested. During the time between exposure and the test, it is important to avoid any behavior that might result in exposure to blood, semen, or vaginal secretions.

Getting tested before three months may result in an unclear result or a false negative. Some testing centers may recommend testing again at six months.

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What has been the routine test for HIV antibody testing?

The standard screening test for antibody to HIV is the enzyme immunoasssay (EIA), which is widely used in the United States and around the world. This test requires serum or plasma, so a blood specimen must be drawn from a vein. Because EIA requires specialized equipment, the specimen must be sent to a laboratory, and test results are usually available several days to several weeks later. A negative screening test means a person is not infected with HIV, and does not require further testing. However, a diagnosis of HIV infection cannot be based on a reactive screening test alone. Thus, a reactive EIA is repeated, and repeatedly reactive EIA results are confirmed by a supplemental HIV antibody test --Western blot or immunofluorescence assay (IFA).

Until now, testing required two visits. During the first visit, a client receives pretest counseling, and blood is drawn for HIV testing. During the second visit, test results are communicated to the client, additional counseling is provided, and clients who need them are given referrals for additional services.

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What are rapid HIV tests?

A rapid test for detecting antibody to HIV is a screening test that produces very quick results, usually in 5 to 30 minutes. In comparison, results from the commonly used HIV-antibody screening test, the EIA, are not available for 1-2 weeks.

The availability of rapid HIVtests may differ from one place to another. These rapid HIV blood tests are considered to be just as accurate as the EIA. As is true for all screening tests (including the EIA), a positive test result must be confirmed with an additional specific test before a diagnosis of infection can be given.

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What is the difference between a rapid HIV test and an EIA?

The rapid HIV test is easier to use and produces results more quickly than the EIA does. The sensitivity and specificity of the rapid HIV test are just as good as those of the EIA.

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Are rapid HIV tests more accurate or less accurate than EIAs?

The rapid HIV test is just as accurate as an EIA. As is true of all screening tests (including the EIA), a reactive rapid HIV test result must be confirmed. Studies in countries where more than one type of rapid HIV test is available show that specific combinations of two or more different rapid HIV tests can provide results as reliable as those from an EIA and Western blot or IFA, the combination that is currently used in the United States. A second rapid HIV test for persons whose first rapid HIV test is reactive could significantly improve the predictive value of rapid HIV testing.

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My HIV test is negative (-). Do I need to retest?

A negative antibody test result, whether it is from a rapid HIV test or an EIA, does not require a confirmatory test. You need to retest in case you are in the "window period", the time between exposure to HIV and the presence of detectable antibody to HIV in the blood. This can take from 3 to 12 weeks for the majority of people, and occasionally, as long as 6 months. We suggest you do 2 tests 40 days apart if you have any concerns. 

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If I test HIV negative, does that mean that my partner is HIV negative also?

No. Your HIV test result reveals only your HIV status. Your negative test result does not tell you whether your partner has HIV.

HIV is not necessarily transmitted every time there is an exposure. Therefore, your taking an HIV test should not be seen as a method to find out if your partner is infected. Testing should never take the place of protecting yourself from HIV infection. If your behaviors are putting you at risk for exposure to HIV, it is important to reduce your risks.

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What if I test positive for HIV?

It is recommended that all positive tests be repeated immediately, by using the another One Step HIV Test™ kit. Repeated positive tests are then further confirmed, by using a different test on the same blood specimen.

Being infected with HIV does not necessarily mean you have AIDS. It does mean you will carry the virus in your body for the rest of your life. It also means you can infect other people if you do things - such as have unprotected sex - that can transmit HIV. You can infect others even if you feel fine and have no symptoms of illness.

If you test positive for HIV, immediate medical treatment and a healthy lifestyle can help you stay well. There are now many drugs that treat HIV infection and AIDS-related illnesses. Prompt medical care may help delay the onset of AIDS and prevent some life-threatening conditions.

You can immediately take a number of important steps to protect your health:

• See a doctor, even if you do not feel sick. Try to find a doctor who has experience in treating HIV.
• Have a TB (tuberculosis) test done. You may be infected with TB and not know it. Undetected TB can cause serious illness, but it can be successfully treated if caught early.
• Smoking cigarettes, drinking too much alcohol, or using illegal drugs (such as cocaine) can weaken your immune system. Cessation programs are available that can help you reduce or stop using these substances.
• Have a screening test for sexually transmitted diseases (STDs). Undetected STDs can cause serious health problems. It is also important to practice safe-sex behaviors so you can avoid getting STDs.

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What is a false positive HIV test?

Occasionally, a person will get a positive (+) blood test to a disease which he or she does not have. Science has a name for this--"biological false positive". This is why it is so important that a positive (+) HIV test be followed by more HIV tests by a doctor to confirm whether the person is infected or not.

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How does One Step HIV Test™ kit work?

You stick your finger with the one-time use lancet and allow one drop of blood to fall into the sample well. Then 2 drops of a developer solution are added. Over the next few minutes, your blood migrates up into the test area. If your blood contains the antibody to HIV (present only if you have been exposed to and infected by HIV), it will attach at an area marked "T" for "test". A pink line appears to show that this has occurred. If there is no pink line next to "T", then there is no HIV detected in the blood at that time.

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How accurate is One Step HIV Test™ kit?

National Institute for Communicable Diseases in South Africa, a WHO Collaborating Center evaluated the One Step HIV Test™ Kit to be 100% Sensitive, 99.6% Specific, and an overall accuracy of 98% .

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What is the significance of the pink line next to the "C"?

"C" stands for "Control". The purpose of the control line is to let you know that you have a functional test and that you have performed the steps correctly. If there is no pink line next to "C", then the test is invalid and should be repeated using another Rapid HIV test device.

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What do I do with the "Invalid" test?

You may mail the invalid test back to us for replacement or refund.

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May I use any parts of the One Step HIV Test ™ kit more than once?

• The lancet is for one-time use only. It has an instantly retracted point to insure no accidental sticks to others.
• The test device is for one-time use only.
• The developer solution is good for two years at room temperature and may be used for future tests.

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How long may I store the components at room temperature?

• Test device, inside its sealed foil packet has an 18 months shelf-life. Expired, unused test devices will be replaced free of charge.
• Developer solution - 2 years
• Blood sampling device - 3 years

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Is One Step HIV Test™ kit FDA Approved?

The US FDA does not approve any self-performed blood tests for HIV.
This is the reason the test cannot be sold in the U.S. at this time.

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Where can I get tested for HIV infection in the US?

Many places offer HIV testing including local health departments, private doctors' offices, hospitals, and sites specifically set up to provide HIV testing. It is important to get tested at a place that also provides counseling about HIV and AIDS. Counselors can answer any questions you might have about risky behavior and ways you can protect yourself and others in the future. In addition, counselors can help you understand the meaning of the test results and tell you about AIDS-related resources in your area.

The CDC National AIDS Hotline can answer questions about testing and can refer you to testing sites in your area. You can also search this Web site for a list of sites in your area. You may call the CDC National AIDS Hotline 24 hours a day, 365 days a year at:

• 1-800-342-AIDS (1-800-342-2437)
• 1-800-AIDS-TTY (1-800-243-7889) TTY
• 1-800-344-SIDA (1-800-344-7432) Spanish

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