‘No HIV Certificate’
I recently saw a patient who came in for follow up after being treated for sexually transmitted disease. He wanted copies of his medical records - more importantly he wanted a copy of his HIV status!!
This guy who I will call Mr. X had had multiple sexual partners in the past few months and wanted the HIV medical report because he was HIV negative. On inquiring, Mr. X revealed that he wanted to “prove†to his girl friends that he was HIV negative so that he could have unprotected intercourse. I spent about 1 hour explaining to him the limitations of the HIV test and his chances of re-infection after unprotected sex. I hope he understood.
This encounter set me thinking. How many people are there in the world who use the “No HIV certificate” as proof of not having AIDS and thus running the risk of infecting themselves and others after having unprotected sex.
It is even more concerning in countries where most of the people are illiterate and have only heard that AIDS is a deadly disease. These people do not understand the significance of the test and most doctors do not take the trouble of explaining the test results and its limitations.
So I decided to write up the limitations of this HIV test and the risks of this “No HIV certificate.” And they are:-
1. ELISA test for HIV is not 100% sensitive. This means that even if the test is negative you still have the chance of having the infection.
2. Western Blot test is used to confirm HIV status after ELISA is positive.
3. After a patient is infected with HIV there is a window period of about 3 months when both the ELISA and western blot will be negative (this happens because the body has not made any antibodies against the virus and both the ELISA and western blot are unable to detect these antibodies)
4. You could become infected the next day after having an HIV negative test if you have unprotected intercourse (a factor to consider if someone shows you the “No HIV certificate”)
The most important take home message is that a negative HIV test indicates that probably you were not infected with the virus at that point in time. It does not say anything about your current HIV status.
Going back to our physician community - how many of us actually explain the limitations of the HIV test to our patients especially those who test negative.
Technorati Tags: AIDS, Certificate, ELISA, HIV, Western Blot
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September 28th, 2007 at 1:34 pm
ELISA and Western Blot test only for antibodies that are presumed to be specific for HIV, though “positive” test results have been obtained for other medical conditions, including recent flu vaccinations. Neither of these antibody tests actually isolate an HIV virus, but are used as surrogates for any attempt to isolate HIV due to the great difficulty and expense of even attempting to isolate HIV in the bloodstream, especially in an uncultured form. While ELISA and Western Blot tests are often regarded as highly reliable means of testing for HIV, the extent of such reliability has apparently never been properly tested and validated, with the use of isolated HIV in the bloodstream as a gold standard of verification, and with the results published in a peer-reviewed medical journal. As a result, even a positive result on an HIV antibody test does not necessarily mean a patient should be regarded as infected with an HIV virus–let alone that such a patient should be poisoned with deadly toxins such as AZT, which has resulted in the deaths of many supposedly HIV-positive patients.