HIV stands for Human Immunodeficiency Virus — a kind of RNA virus that, if left untreated, may lead to a life-threatening condition called AIDS (Acquired immune deficiency syndrome).
It's important to understand that, at this day and age, with efficient antiretroviral therapy available, HIV in and of itself is not a death sentence; however, an undetected HIV infection that evolves into AIDS can be.
This makes HIV testing, along with timely therapy and contact tracing in the case of a positive result, the most reliable weapons we have to prevent the spread of the virus and lower the mortality associated with AIDS.
In this article, we will explore the value of testing — more specifically, testing with an at home HIV test for curbing the HIV epidemic.
Simply put — the only way to know your HIV status is to take an HIV test . Anyone who has sex with multiple partners and does not use protection with either of them is at risk of contracting HIV. This risk is significantly higher for anal intercourse , and exponentially higher for blood exchange, most commonly in sharing needles for intravenous drug injection.
Because HIV typically takes several weeks to several months (or even over a year) to develop symptoms, it's very frequently transmitted by asymptomatic carriers . In fact, research suggests that HIV may be present in high levels in saliva, and especially in blood and semen, during the early weeks of infection, meaning that these difficult-to-detect infections could actually be major contributors to the epidemic.
This is why regular HIV testing is key to identifying the presence of the virus in the population and taking the necessary steps to treat and contain it. But… Where and how do you get tested?
The first thing that comes to mind when we think of any kind of health check up is finding and visiting a nearby hospital or clinic. However, there are several problems with clinical HIV testing :
Luckily, with the significant advancements in medical technology we've witnessed over the last decade, at home hiv test kits with comparable reliability to clinical tests have become widely available to order online and take quickly, easily, and anonymously in the comfort and privacy of one's home, resolving all the issues plaguing clinical testing.
Let's take a look at some features of these convenient rapid test kits and what you can expect from taking an at home HIV test.
An at home HIV test comes in a small package that typically contains the testing cassette and sample collection tools. Depending on whether the test analyzes saliva or blood , these tools are either a pin prick needle or a swab.
When the sample is collected, it's typically either added to a buffer fluid (saliva) or directly to the testing cassette (blood), to which the buffer fluid is then introduced. This entire preparation process takes only a few minutes, and the results become available within 15-20 minutes.
An HIV test kit usually analyze the provided sample for HIV antibodies. Antibodies are proteins that develop in our organisms as a protective response to unwanted substances. They bind to the substance, in this case the virus particles, and try to eliminate them from our system.
The way these tests work technically is through the simplified application of the enzyme-linked immunosorbent assay (ELISA) or enzyme immunoassay (EIA) method. On the testing strip in the cassette, HIV antigens, which detect HIV antibodies, are placed along the test line and control antigens, which demonstrate that the test was successful, are placed on a control line.
When the blood or saliva sample is added (along with the buffer fluid, which facilitates the dispersion) to the control chamber, it passes over the testing line. If there are sufficient HIV antibodies present in the fluid, they will activate the antigens in the testing line and the line will change color.
The process of mobilization of our immune response — the creation of antibodies — takes time. Specifically, for HIV, the time required to produce these proteins in sufficient levels for rapid tests to be able to detect them is at least 23 days .
This time — from infection to detectability — is commonly referred to as the 'window' period .
However, because everyone's immune system is different, this time can vary widely from person to person. The period that is most commonly accepted as the minimum timeframe for obtaining reliable results from antibody tests is, thus, considered to be 90 days .
In between 23 and 90 days, taking an at home HIV test cannot provide fully accurate results; even if multiple tests are taken, there is a possibility that the antibody levels are just not sufficient for the test to actually detect them.
For this reason, any test result obtained before 90 days since suspected exposure needs to be confirmed by an additional test after the 90-day mark.
When we talk about rapid HIV test reliability, we're talking about two aspects: test specificity and test sensitivity.
In general, HIV tests are near 100% specific, which means that the odds of getting a positive result when there is no HIV infection are extremely unlikely.
Sensitivity is what we commonly mean when we discuss the reliability or accuracy of an HIV test — it is the test's ability to give us a confident negative result.
Nowadays, standard-issue at-home tests, have a relative sensitivity of 99.5-99.8% and a relative specificity of 99.8-100%. This makes them as sensitive as clinical rapid tests , as long as they are performed after the 'window' period.
The only tests capable of reliably detecting HIV sooner than 3 months after infection are lab-based Nucleic Acid Amplification Tests (NATs), which detect the presence of the virus itself, and 4th generation antigen-antibody tests , which can detect antigens (proteins that the virus produces, which trigger antibody creation) before the antibody production begins.
As discussed, at home HIV test kits are about as accurate as antibody rapid tests you can get in a hospital, clinic, or STD testing center. So, the first and most important thing you can expect is reliable results , provided you do the test more than 3 months after suspected exposure.
In the period between 23 and 90 days after suspected exposure, a rapid antibody test, whether clinical or at home, will produce results that cannot be considered as reliable as the test's sensitivity indicates, solely because of idiosyncrasies in immune system responses.
The second thing you can expect from ordering one of our at home HIV test kits is quick delivery — our shipping takes less than 24h for most European countries. Compared to most clinical visits, which may involve making an appointment, a two-way commute, and waiting for sample collection at the test site, having your results within 24h and without the need for leaving your home is a uniquely valuable perk of modern- day self testing.
The third thing rapid HIV tests allow you to do is keep your privacy . Your order is packaged securely and discreetly, and the knowledge of your status is yours to do with as you wish.
Finally, once you receive your at home HIV test, you can expect a quick and easy testing process . Whether you opt for a saliva test or a blood test , all you need to do is swab your gums or prick your finger, add the sample to the testing cassette along with the buffer fluid, and wait for 15-20min until the result becomes available .
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