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Did you know that 27% of the 58,000 Canadians living with HIV are unaware they are infected?
That means that 15,000 people in Canada are not receiving the treatment they need to improve the quality and length of their lives—15,000 mothers, fathers, brothers, sisters, friends and partners may die prematurely because they found out too late that they had HIV.
The HIV/AIDS Epi Updates 2006 Report* released in August, 2006 by the Public Health Agency of Canada shows that the number of people living with HIV in Canada continues to rise.
Symptoms of HIV may not appear for years
Many people infected with HIV don't know they have it because specific symptoms may not appear for years. When they are first infected, some people will have noticeable flu-like symptoms, but others will have no symptoms at all.
The only way to be sure whether or not you have HIV is to get tested.
Getting tested is more important than ever
If you get tested and find out that you have HIV, then you can:
- get the counseling and critical information you need
- find out about your treatment options
- if you are pregnant, receive medical support to greatly reduce the chances of your baby getting infected.
With improved treatment options, people infected with HIV are now living much longer. It has become a chronic disease that can be managed by antiretroviral medications and other therapies.
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What is the difference between HIV and AIDS?
HIV—the Human Immunodeficiency Virus—is a virus that attacks the immune system, resulting in a chronic, progressive illness that leaves people vulnerable to infections and cancers. When the body can no longer fight infection, the disease is known as AIDS, which stands for Acquired Immunodeficiency Syndrome. On average, it takes more than 10 years to progress from initial HIV infection to AIDS.
There is no cure for AIDS, and no vaccine against HIV infection.
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Top reasons to get tested
- You are having sex
Some sexual activities have no risk, while others have a high risk. Unprotected sex where there is an exchange of bodily fluids and/or blood should always be considered a risk, although some activities have a greater risk than others. For example, vaginal or anal penetration without a condom can allow HIV to be passed from one person to another through abrasions in the skin.
Even if we think we know whether or not the person we engage in sexual activities with has HIV, we can't always be certain. This is true for both casual and long-term relationships. Getting tested can be important for your own peace of mind.
- You are using drugs or alcohol
Injection drug use has high risk for HIV infection
Almost half of all new HIV infections in Canada are now due to injection drug use. People who are sharing a needle to inject drugs are at great risk of getting infected by HIV. Infected blood remaining on a needle can be transferred to another person using the same needle. It is a direct route from one infected person's bloodstream to another person's bloodstream. If you inject drugs, you should always use a clean needle—either a new one or one properly disinfected with bleach.
Alcohol and recreational drugs can also mean risk
Alcohol or drugs won't infect you with HIV, but taking risks while you're drunk or high might. When you drink too much or use recreational drugs, such as marijuana, you may not make the same decisions as you would when not intoxicated. For example, you may take the risk of having unprotected sex—and a person can become infected after just one single sexual encounter. If you are using alcohol or drugs and think you might have engaged in a risky behaviour, even just one time, consider getting tested.
- You are pregnant or thinking of having a baby
According to HIV/AIDS Epi Updates 2006, a pregnant woman who is HIV positive and does not receive medical attention has between a 15 - 30% chance of passing the virus on to her baby during pregnancy and delivery, and a 10 - 20% chance while breastfeeding. This is true even if she has no symptoms.
These rates can be greatly reduced through preventive measures. Over the last 10 years, mother-to-child HIV transmission in Canada has decreased significantly, from 20% in 1997 to 4% in 2005.
Because HIV transmission during pregnancy, delivery or breastfeeding is highly preventable and no opportunity to prevent it should be missed, the recommendation contained in the HIV/AIDS Epi Updates 2006 (p. 46)
is that all pregnant women be offered confidential HIV testing and counseling as part of routine prenatal care.
In Canada, some provinces provide a voluntary HIV test (the opt-in approach) which includes HIV counseling to all pregnant women as part of their prenatal testing, with written consent required before the test is done. In other provinces, doctors may choose to do routine HIV testing on pregnant women without counseling or explicit written consent (the opt-out approach).
To find out about the practices in your province or territory, consult the table Prenatal HIV Testing Approaches across Canada, p 43 of the HIV/AIDS Epi Updates 2006.
About testing
Getting tested for HIV is a simple procedure. The results, however, can be life-altering. What if your HIV test is positive, meaning you have HIV? If you decide to get tested for HIV, then you should be prepared for this possibility.
Counseling before getting an HIV test is an option you should consider. Any local AIDS service organization will be able to tell you where you can get tested anonymously or receive counseling.
| "Symptoms may not appear for years." |
How is testing done for HIV?
The most common HIV test done in Canada is called ELISA. This test does not actually detect the virus; it looks for antibodies that your body makes to fight the virus. It is done through a blood sample or in some cases, using an oral fluid sample (mucous and saliva from inside the cheek or on the gums) or a urine sample. It can take up to three months from the time you are infected for your body to produce enough antibodies to be detected by this HIV test. In order to have an accurate result, therefore, you need to be tested at least three months after you last had unprotected sex or shared a needle.
If HIV antibodies are detected, a second test is done to confirm the positive result. This test is called the Western Blot. If the first test was done using an oral fluid or urine sample, a new sample is taken (a blood sample this time) to confirm the positive result. If the first test was a blood test, some labs will re-test the original sample, while others will take a new blood sample.
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When to get tested—and retested? Timing is critical
You may be anxious to get tested soon after a risky encounter. Can you get tested without waiting three months?
Think about this: if you got a negative test at six weeks, would it be accurate? It is best to wait until at least three months after the risky encounter before getting tested so that it is entirely accurate.
If testing will make you less anxious then go ahead and get tested. But remember: to be certain, you will need to get tested again three months after the risky encounter.
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Your testing options
The Canadian HIV/AIDS Legal Network advocates that HIV testing policies and practices must respect people's human rights, so HIV testing should include:
- informed consent... to understand that you are being tested for HIV and to give permission to do so.
- pre-and post-test counseling... to prepare for the possibility of a positive result and to learn how to cope with it.
- guaranteed confidentiality of test results... to ensure that your results are not shared unless you give permission.
In Canada, there are four forms of HIV testing with test availability varying from one province to another:
- Anonymous testing
Having an anonymous test means that only you will know that you took the test and what your test results are. When you make an appointment for an anonymous test, you can give a false name so that the nurse can call you in the waiting room.
Anonymous testing clinics are generally located inside another clinic where people go for all kinds of reasons other than HIV testing. Your test is only identified by a number that is given to you during the test. This number is used during your second visit to confirm your test results. It cannot in any way be linked to your identity.
- Nominal testing
Nominal tests are not anonymous because your name will appear on the test forms and the test results, and the test results will be made available to your doctor or health care provider and recorded in your medical record.
- Non-nominal testing
These tests are similar to nominal tests except that a code is used instead of your name. Only you and your doctor know this code refers to you.
- Rapid testing
Recently, rapid testing has become available in Canada. Rapid tests are administered by health professionals at specific clinics or doctors' offices, and you can get your results on-site within a few minutes. They are currently available in a limited number of locations.
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If your test is positive, who else will know?
HIV infection is reported to health authorities in all provinces and territories, although each has a different practice for reporting HIV infection. All provinces and territories in Canada offer at least one of the forms of HIV testing; anonymous HIV testing, however, is only available in seven provinces at this time, and rapid testing in only two.
To find out about the practices in your province, consult the chart HIV Testing and HIV Reporting by Province/Territory on page 15 of the HIV/AIDS Epi Updates 2006.
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If you are at risk of HIV or think you are, take the time to learn about the importance of HIV testing. You can protect your own health and help to stop the rise of HIV in Canada.
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This article was prepared by the 
