What biological factors make women more vulnerable? Researchers believe that women are biologically more susceptible to HIV infection from heterosexual sex than men. The female genital tract has a greater exposed surface area than the male genital tract, therefore, women may be prone to greater risk of infection with every exposure.
Male-to-female HIV transmission is estimated to be twice as likely as female-to-male transmission in a single act of vaginal intercourse. Younger women might be even more biologically vulnerable to HIV infection because they have less mature tissue and are often victims of coercive or forced sex.
TESTING
What types of tests are used to determine the presence of HIV?
health care provider or test counselor about the window period for the test you’re taking: ○ A nucleic acid test (NAT) can usually tell you if you have HIV infection 10 to 33 days after an exposure. ○ An antigen/antibody test performed by a laboratory on blood from a vein can usually detect HIV infection 18 to 45 days after an exposure. Antigen/antibody tests done with blood from a finger prick can take longer to detect HIV (18 to 90 days after an exposure). ○ Antibody tests can take 23 to 90 days to detect HIV infection after an exposure. Most rapid tests and self- tests are antibody tests. In general, antibody tests that use blood from a vein can detect HIV sooner after infection than tests done with blood from a finger prick or with oral fluid (CDC, 2019b). Where can I get tested for HIV infection? Many places provide testing for HIV infection. Common testing locations include local health departments, offices of private doctors, hospitals, and sites specifically set up to provide HIV testing. To find a testing site, visit: gettested.cdc.gov , or call 1-800-CDC-INFO (232-4636). Home testing kits: ● Can be purchased in most pharmacies or online. There is currently only one FDA-approved self-test (Oraquick) (CDC, 2019b): ○ For a self-test, you have to swab your own mouth to collect an oral fluid sample and use a kit to test it. You will be able to get a result in about 20 minutes. It is important to follow the directions as described in the instructions or the test will not work properly. There is a phone number included with a HIV self- test for anyone to call to get help with conducting the test. Rapid tests: ● A rapid test is a screening test that produces very quick results, in approximately 20 minutes. In comparison, results from the other more commonly used HIV antibody screening test, the enzyme immunoassay (EIA), are not available for several days to a few weeks. Both the rapid test and the EIA look for the presence of antibodies to HIV. As is true for all screening tests, a reactive rapid HIV test result must be confirmed with a follow-up confirmatory test before a final diagnosis of infection can be made.
The CDC provides the following information on HIV testing: ● There are three types of tests available: Nucleic acid tests (NAT); antigen/antibody tests; and antibody tests. HIV tests are typically performed on blood or oral fluid. They may also be performed on urine: ○ A NAT looks for the actual virus in the blood and involves drawing blood from a vein. The test can either tell if a person has HIV or tell how much virus is present in the blood (known as an HIV viral load test ). While a NAT can detect HIV sooner than other types of tests, this test is very expensive and not routinely used for screening individuals unless they recently had a high-risk exposure or a possible exposure and have early symptoms of HIV infection. ○ An antigen/antibody test looks for both HIV antibodies and antigens. Antibodies are produced by your immune system when you’re exposed to viruses like HIV. Antigens are foreign substances that cause your immune system to activate. If you have HIV, an antigen called p24 is produced even before antibodies develop. Antigen/antibody tests are recommended for testing done in labs and are now common in the United States. This lab test involves drawing blood from a vein. There is also a rapid antigen/antibody test available that is done with a finger prick. ○ HIV antibody tests only look for antibodies to HIV in your blood or oral fluid. In general, antibody tests that use blood from a vein can detect HIV sooner after infection than tests done with blood from a finger prick or with oral fluid. Most rapid tests and the only currently approved HIV self-test are antibody tests. (CDC, 2019b) How long after a possible exposure should I wait to get tested for HIV? According to the CDC: ● The time between when a person may have been exposed to HIV and when a test can tell for sure whether they have the virus is called the “window period.” The window period varies from person to person and depends on the type of test used to detect HIV. Ask your
RISK FACTORS
Alcohol and HIV/AIDS People with alcohol use disorders are more likely than the general population to contract HIV (human immunodeficiency virus). Similarly, people with HIV are more likely to abuse alcohol at some time during their lives. Alcohol use is associated with high-risk sexual behaviors and injection drug use, two major modes of HIV transmission. Concerns about HIV have increased as recent trends suggest a resurgence of the epidemic among men who have sex with men, as well as dramatic increases in the
proportion of cases transmitted heterosexually. In persons already infected, the combination of heavy drinking and HIV has been associated with increased medical and psychiatric complications, delays in seeking treatment, difficulties with HIV medication compliance, and poorer HIV treatment outcomes. Decreasing alcohol use in people who have HIV or who are at risk for becoming infected reduces the spread of HIV and the diseases associated with it.
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