Testing HIV Positive: What You Should Know

Since you are reading this, your doctor or a health department counselor has probably told you that your blood test for HIV (the virus which causes AIDS) is positive. In other words, you are infected with the virus, and now you may have many questions about what this means.

This will answer some of those questions and give you suggestions about "What do I do now?" There are also phone numbers for agencies that will offer more help (often free of charge) and answer other questions you may have. All of the agencies are sensitive to your need to keep this information private.

What Is HIV?

The complete name for HIV is the Human Immunodeficiency Virus. After a person is infected with HIV, the virus begins to attack the T-cells, types of white blood cells that make up part of the body's immune system.

How Does the Immune System Work?

The "immune system" is many different parts of the body working together to fight germs, viruses, and other organisms which can make us sick.

T-cells and B-cells are types of blood cells that are part of the immune system. When a germ or virus enters the body, each of these cells has different jobs to keep us from becoming ill.

1. T-cells (also called T4, T-helper, or CD4 cells) are the first cells to respond to a germ or virus. They identify the type of germ or virus that has invaded the body. They then send a message to a second type of cell (a B-cell) that actually fights the germ or virus.

2. B-cells fight the invader by creating proteins called "antibodies," which attack the particular type of germ or virus identified by the T-cell. Basically, antibodies act like bullets which will only strike particular targets. however, the antibodies against HIV are not strong enough to kill the virus; and, since we do not yet have a medicine which will kill HIV, it continues to live in the blood.

What Happens to the T-Cells?

HIV can live in the blood for up to ten years or more before you feel sick. Once HIV begins to cause problems, it actually kills the T-cells, causing the immune system to become too weak to fight illnesses to which we are exposed. Why HIV destroys the T-cells is not fully known yet. For many people who are infected, HIV will enter the T-cell and begin to multiply. This continues slowly until the cell wall breaks and new HIVs enter the blood and attack more T-cells. As the T-cells are killed, the body is unable to "tell" the B-cells to fight off the common germs and viruses to which we are exposed. Eventually, most people become ill.

AZT and ddI are medicines used at this point because they act as a barrier between HIV and the T-cell. They slow down the destruction of T-cells and let the body and the immune system regain strength.

How is HIV Transmitted?

HIV is spread in only a few ways:

• Sexual intercourse (vaginal, oral, or anal).

• Blood, such as sharing drug or steroid needles or "works."

• From an infected pregnant woman to her baby. There is about a 30% chance she will pass the virus to her baby before the baby is born, during birth, or (rarely) through breast-feeding.

Once HIV enters the blood, it attaches to the T-cells. HIV may live like this without causing any noticeable medical problems for up to ten years or more. However, during this time HIV also attaches to other T-cells found in semen (cum) in men and vaginal secretions in women. Any behavior that allows these three fluids infected with HIV into the body of another person puts the second person at risk of infection. If someone is infected with HIV, they can infect others, even during all the years they look and feel healthy.

What Are the First Symptoms?

Symptoms can be very similar to having a cold or the flu, and only a doctor can tell the difference. Some people get very tired, lose weight, or develop a low, constant fever. Others might get white, patchy spots in the mouth or on the tongue. Some people develop blurred vision, mental confusion, or chronic (long-term) diarrhea. Obviously, some of these are problems we all have at one time or another. The difference for someone with HIV is that symptoms continue a long time and are hard to treat.

What Does the "AIDS Test" Do?

The "AIDS Test" is NOT a test for AIDS, but for the antibodies to HIV. A specific test to find the HIV itself is not yet available for regular use.

Two separate tests, the ELISA and the Western Blot, are run from one blood sample. The ELISA is very sensitive and can confuse other proteins for HIV antibodies. Therefore, any positive ELISA test is immediately re-checked with a Western Blot (a more specific test) to be sure that only HIV antibodies are identified. This makes sure the test is as accurate as possible.

NOTE: Some medical providers may run only the ELISA test. You should ask if a Western Blot was done when you are given a "positive" result. (If your test was performed at the health department, a Western Blot has been done.)

When antibodies are found, it means HIV is also in the blood. Research shows that, from the time a person is infected with HIV, it takes about 6 to 12 weeks for antibodies to develop and be found in the blood. This is why you were probably asked about the last time you had any "high risk behavior" (usually sexual intercourse or needle-sharing), or you were asked to return at a later date for a second test. This allowed the antibodies time to form in the blood if you were recently infected.

Having a "positive" HIV test does NOT mean you have full AIDS. AIDS is a severe medical condition which is more serious than just HIV Infection alone.

What Happens Next?

Once you learn HIV is in your blood, it is very important to find a doctor or clinic that understands HIV. Your main goal is to stay as healthy as possible, because your good health can help keep HIV from killing the T-cells. The following list describes things you can do to keep healthy longer.

• Stop all "high risk" behavior, such as sharing needles or having sex without using latex condoms (and even condoms aren't 100% foolproof.) If you are reinfected with HIV or get other STDs like gonorrhea or syphilis, you can weaken your immune system. Syphilis is harder to treat in someone with HIV. And you can infect your partner.

• Try to avoid all drugs, alcohol, and cigarettes. All of these can weaken the immune system.

• Eat food that is healthy and that you enjoy. Brochures can help you plan healthy meals. Be careful to avoid raw eggs, raw seafood, and undercooked meat.

• If you are an infected woman, you should know the possible dangers of becoming pregnant. You risk infecting your baby and its father, and you can further weaken your immune system.

• Don't let dental problems get worse. There is a connection between your teeth and a healthy immune system. Some people develop HIV-related periodontal disease which causes tooth and gum loss.

• Don't spend too much time in direct sun or tanning beds; the rays can react with HIV. Wear heavy sun-screens or lotions.

• Be very careful when cleaning cat boxes, bird cages, and aquariums. Animal droppings contain germs which can make you sick.

What Else Should I Do?

Talk to your doctor or clinic about getting a TB skin test and a special blood test to check your T-cell count. The more T-cells your blood loses, the greater your risk of developing more serious diseases that lead to full AIDS.

Most of all, remember that there are many people who care about you, your questions, and your health. Please call the agency listed below if you are in Tennessee or call CDC hotline at 800-CDC-INFO (open 24 hours). You are not alone.