HIV Counseling and Testing

"I really hope all this anxiety is worth the 40 bucks I paid for this thing." Heather opened the box containing the HIV home test and began reading the instructions. "Well, at least now I'll know," she thought. "I just wish I didn't have to do this alone..."

Zach was early for his appointment. He stood still outside the clinic, staring nervously at the doors. He could think of at least 10 good reasons why he shouldn't be there. The reception desk seemed a million miles away. His heart was pounding and his legs were shaky. At the desk, he leaned way forward and spoke very softly, "I, uh, um have an appointment," Zach stuttered. The receptionist smiled. "I'm here for an HIV test," he said.

This brochure was produced to provide some basic information regarding testing, reasons for testing, as well as counseling and counseling centers.

The HIV antibody test literally tests for your body's response to a potential infection of the Human Immunodeficiency Virus by detecting the presence of antibodies. It doesn't test for HIV itself, nor does it diagnose a person as having AIDS. HIV is the virus that can cause AIDS, Acquired Immune Deficiency Syndrome. HIV can be transmitted through four bodily fluids: blood, semen, vaginal secretions and breast milk. HIV must enter the bloodstream in order for you to become infected. Once infected, HIV slowly weakens the immune system, making you more susceptible to "opportunistic" diseases and illnesses. A person infected with HIV cannot fight off these illnesses as easily, and may require special medications or hospitalization. An illness like chicken pox or the common cold may be life threatening to someone with an HIV infection.

In order to have AIDS, you must be HIV positive and have your T-cell count drop below 200 or have had an opportunistic disease. Currently there is no cure or vaccine for HIV. To prevent HIV and reduce the risk of infection, remain abstinent from sexual intercourse or practice safer sex methods, and never share syringes to shoot drugs (such as steroids.)

Accurate testing for HIV antibodies involves two different tests. The first screening test is called the ELISA. A positive ELISA test is then confirmed by a second test, either the Western Blot, or the IFA. Though the ELISA test is highly accurate, either a "false positive" or a "false negative" can result. A false positive test is one that comes up positive even though the blood does not actually contain HIV antibodies. Because of this potential, you may wish to be tested a second time to confirm your HIV status as positive. A false negative test is one which failed to detect HIV antibodies in a person who is HIV positive. This sometimes occurs during the "window period" of about six months after infection but before antibodies have developed.

Should I get tested?

You might want to consider getting tested if...

You have reason to think you've been infected or you've been engaging in behaviors that place you at risk, such as sharing needles to inject drugs or having unprotected oral, anal, or vaginal intercourse.
You are pregnant or are considering getting pregnant, breast feeding or fathering a child.
You are required to undergo mandatory testing (e.g. for the military or Job Corps). Mandatory results will become part of your permanent medical record, so you first might want to receive anonymous counseling and testing in advance of any such situation requiring HIV testing.
You are fully prepared for the knowledge of your results, either positive or negative.

"If Heather's fist hadn't clenched involuntarily, she probably would have dropped the phone. The HIV counselor's voice sounded like a distant ringing in her ears. She could barely hear the man saying, "please don't hang up!" Heather coughed and clenched her stomach. It was churning with nausea. "No," she stammered, "Check again. You must have read the wrong results! I can't be positive! I can't... I can't..." Heather started crying. "Please, please, no." "I know this is overwhelming," said the counselor," But you are not alone. I am here. I'm going to help you." "Is there any way these results could be wrong?" Heather sounded desperate. "Yes," said the counselor, "it is possible that your results are a 'false positive.' You may want to get tested again to confirm the results." "I want to do that now!" "OK," he answered quickly, "let me give you a number you can call to find anonymous testing in your area. Realize that the results will take at least another week to get back. Please don't do anything drastic, like hurting yourself." Heather was still crying. Her body felt numb with shock. "I'm so scared," she whispered," I just wish I wasn't alone!" "You're not alone," said her counselor."

What is the test?

Confidential

In a confidential test, your results become part of your permanent medical record and are kept confidential along with your other medical data. If you test positive, your name will be reported to the NJ state health department. Confidential testing may be done at a private physician's office, some clinics, and the Rutgers Student Health Services-NB/P. When you get tested at one of the Rutgers University Health Centers, you are counseled by the same clinician before and after the test. Your test is coded with a number when sent to the lab. The results are returned to that clinician, who matches the code with your name. This clinician will then be available to refer you to any outside treatment needed and to follow your progress.

Anonymous

An anonymous test is the only way to guarantee the privacy of your results. At an anonymous test site, your name is not taken and no other personal identifier is used. Usually you are given a unique number or code that you must present to obtain your results. The only people who will know your results are those whom you choose to tell. Anonymous testing is done at some clinics and hospitals, like Robert Wood Johnson University Hospital (New Brunswick), St. Michael's Medical Center (Newark) and Cooper Medical Center (Camden). Make sure you know what the policy is before you get tested at a particular site. Students who receive anonymous testing can still use the Rutgers University Health Services-NB/P for counseling and health care.

There is now a new oral method of testing, called "Oraquick." The oral test is as accurate as the blood test. It involves swiping the inner side of your mouth with something that looks like a cotton swab. A small sample is collected and tested for HIV antibodies. Many sites offer both types of testing. It usually takes about three weeks to receive the results for either method of testing.

There is also an HIV test that may be purchased at a store and performed in the privacy of your own home. "Home Access" is the name of the test that has been approved by the CDC. Follow the instructions carefully. A person must prick their finger and put a drop of blood into the special piece of paper that has been provided. Then wrap up this paper and mail it in for processing. Within three days to a week, you call for your results. This test is completely anonymous. You receive your results using an 11 digit code for identification and speak to an HIV counselor when you call. For more information, call 1-800-448-8378.

"What's all this about counseling?"

Before you decide to get tested, talk to an HIV counselor or health care provider who can give you more information and address any questions or concerns. Many health services and most testing centers provide counseling services. You may also contact a local HIV/AIDS service organization to find other support services in the area. Pre-test counseling can help you decide if you're ready to get tested and exactly what the results will mean. Post-test counseling is extremely important regardless of your HIV status. If your results are negative, post-test counseling can provide you with information and support to help keep you HIV negative. If you are positive, counseling can help you to put things in perspective and deal with the changes and issues that a person infected with HIV may face. It's much easier to make these adjustments when you have caring support from others. Post-test counseling can also help by referring you to the proper medical care and extended support services.

Important points to remember about HIV and the Test

It can take up to six months after infection to develop antibodies. So a negative test result during that period may not accurately indicate whether or not you have been infected.

A positive test result does not mean that you AIDS. It means you have an HIV infection and you should seek medical attention, early treatment and support.

If you are HIV positive, you can infect others. You have a responsibility to yourself and to others not to transmit the virus. Avoid unprotected sexual contact and sharing injection needles.

Safer sex means using a latex condom for every act of intercourse: vaginal, anal and oral (flavored condoms are available for giving a male partner oral sex). Use a "dental dam," or a sheet of non-microwaveable plastic wrap, for protection during cunnilingus and oral-anal sex. Using condoms and lubricant with nonoxynol-9 may also help reduce the risk of infection.

"The HIV counselor walked into the waiting room and looked at Zach. She held a manila folder in her hand. Zach gulped, thinking that his mortality, a possible sentence of death, lay in that folder. "I have your results," said the counselor, "Would you please follow me?" Zach was near tears as he followed the counselor into an office. As soon as the door was closed she said, "You're negative." Zach crumpled into a chair with relief. "But wait," she said, "we still have some things to talk about. Don't take this the wrong way, but I hope I never see you again." Zach burst out laughing. "You've tested negative," she continued, "...and that's wonderful. Now let's discuss what you will do to keep yourself negative.""

Where can I get tested? Whom do I talk to?

The Rutgers University Health Services offers confidential testing.

Busch/Livingston Health Center (732) 445-3250
Hurtado Health Center (732) 932-7401
Willets Health Center (732) 932-9805
Camden Health Center (609) 225-6005
Newark Health Center (973) 353-5231

The following either offer anonymous testing or can help you find anonymous testing in your area.

NJ State AIDS Hotline 1-800-624-2377
Hyacinth AIDS Foundation 1-800-433-0254
Robert Wood Johnson University Hospital, New Brunswick 732-235-7114
East Camden Health Center 609-365-AIDS
St. Micheal's Medical Center, Newark 973-877-5525

These organizations offer general information, referrals, and support services

Gay Men's Health Crisis 212-807-6664
VNA AIDS Resource Center 732-442-6225
Hyacinth AIDS Foundation 732-246-0204
Rutgers Alcohol and Substance Abuse Counseling 732-932-7976, 609-225-6005, 973-353-1236

Last Modified 09/12/2006