HIV Counseling, Testing and Referral
HIV stands for human immunodeficiency virus. It is the virus that can lead to AIDS or acquired immunodeficiency syndrome. Myths persist about how HIV is transmitted. In the United States, HIV is spread mainly by having sex or sharing injection drug equipment such as needles with someone who has HIV. Only certain fluids—blood, semen (cum), pre-seminal fluid (pre-cum), rectal fluids, vaginal fluids, and breast milk—from an HIV-infected person can transmit HIV.
One in seven people in the United States who have HIV do not know they are infected. Sexual behaviors that put you at risk for HIV include having vaginal or anal sex without a condom. If you have unsafe sex or share injection drug equipment, you should get tested at least once a year or more. It is recommended that sexually active gay and bisexual people may benefit from more frequent testing (e.g., every 3 to 6 months). You should also get tested for HIV if you have been sexually assaulted or are a person who is planning to get pregnant or who is pregnant.
HealthQuarters provides confidential HIV testing. Confidential HIV testing means that only you and your healthcare provider will know the results of the test. If the result is positive, it is reported confidentially to the MA Department of Public Health. HealthQuarters offers 2 types of HIV tests:
For a rapid HIV test, a few drops of blood will be taken from your finger. The results are usually available in about 10 minutes and you will get the results at that visit. This test is able to detect HIV by 6 to 8 weeks after someone gets infected with HIV. If the result is positive, a blood sample is taken and sent to a lab for confirmation. You will need to return to HealthQuarters for your final results 1 week later.
Instead of the rapid test, you can choose to have a blood draw test that gets sent to the laboratory. You will need to come back to HealthQuarters to get your results 1 week later. This test can detect HIV 2 weeks after someone gets infected with the virus. You may want this test if you feel you have had a recent risk of getting HIV.
Both the rapid finger-stick and the 7-day blood test are more than 99% accurate.
PrEP (Pre-exposure Prophylaxis)
Pre-exposure prophylaxis, or PrEP, is a way for a person who does not have HIV but who is at substantial risk of getting it to prevent HIV infection by taking a pill every day (brand name Truvada). When someone is exposed to HIV through sex or injection drug use, PrEP works to keep the virus from establishing a permanent infection. When taken consistently, PrEP has been shown to reduce the risk of HIV infection in people who are at high risk by up to 92%. People who use PrEP must commit to taking the drug every day and seeing their health care provider for follow-up every 3 months. HealthQuarters has recently expanding its HIV services and now offers PrEP.
Who should use PrEP?
PrEP is appropriate for people who are HIV-negative and at very high risk for HIV infection. This includes anyone who is in an ongoing relationship with an HIV-positive partner. It also includes anyone who:
- Is not in a mutually monogamous relationship with a partner who recently tested HIV-negative, and
- gay or bisexual person who has had anal sex without a condom or been diagnosed with a sexually transmitted infection within the past 6 months; OR
- heterosexual person who does not regularly use condoms during sex with partners of unknown HIV status who are at substantial risk of HIV infection (e.g., people who inject drugs or people who have bisexual partners).
PrEP is also recommended for people who have injected drugs in the past 6 months and have shared needles, or works or has been in drug treatment in the past 6 months.
If any of these criteria fit your lifestyle, or if you have a partner who is HIV-positive and are considering getting pregnant, talk to your doctor about PrEP. It may be an option to protect you and your baby.
Side Effects of PrEP
Minor side effects include headache, abdominal pain and/or weight loss. These usually go away after 6-8 weeks. More serious side effects are uncommon and include: liver problems, nausea, light colored stool, dark urine, lactic acidosis (too much lactic acid in your blood), weakness, muscle pain, breathing problems, lightheadedness, kidney problems, loss of bone density, and changes in body fat (you may lose fat from legs and arms and gain fat in the middle of your body)
If you are on PrEP, you should tell your healthcare provider if you are experiencing any of these symptoms so they can monitor your health and response to PrEP appropriately.
Some people in clinical trials had abnormal changes on blood tests that looked at kidney function. With this particular side effect, there were no physical symptoms, so it is important to remember that if you take PrEP, you need to get routinely checked every 3 months by your healthcare professional to make sure your kidneys are working properly.
To learn more about PrEP talk to the nurse practitioners at Health Quarters or your personal health care professional.