SPEAK OUT

AIDS
HIV tests.
While some people have an AIDS test every year as a gesture of responsibility toward their partner, most of us go for a test when we have a nagging suspicion that we might be at risk, or when an insurance company demands it. AIDS experts say only about 10 percent of South Africans who are infected know they are positive. The other 90 percent are infecting other people and re-infecting themselves with other strains of the virus. Already more than four million people are known to be infected in South Africa.

WHAT ARE THE FIRST SYMPTOMS OF HIV?

HIV begins showing itself, most often as flu-like symptoms, about one to three weeks after exposure. Symptoms can include, fever, sore throat, skin rash, diarrhea, unexplained and rapid weight loss, swollen glands, ulcers in the mouth or on the genitalia, or excessive tiredness. But as quickly as the symptoms appear, they disappear, and the infected person can appear well for years afterward.

WHO SHOULD GO FOR A TEST?

Remember that night when you had too much to drink and had unprotected sex with that goodlooking stranger? That's called a high risk exposure, go now for a test. Other high risk categories are people who inject drugs, gay and bisexual men, haemophiliacs, those with tuberculosis, a person who already has a sexually transmitted disease such as gonorrhea or syphillis, or if you had a blood transfusion before 1985. Doctors recommend that all pregnant women get tested.
If you have been raped you need to go for a test on the day of the rape and for a year afterward - at 6 weeks, 3 months, 6 months and one year - because in a small percentage of cases people seroconvert (become HIV+) a year after sex with an infected person.

MYTHS:

* Don't go out with thin people, they might have AIDS. False, people with HIV are often plump and healthy until the last few months before they die.
* You can get HIV by people breathing over you in a taxi. False, HIV cannot be spread in this way, it is most often spread through sex without a condom.

WHEN SHOULD I GO FOR A TEST?

Preferably around six weeks after the HIV exposure, it is unlikely that the virus will show itself in your blood before then.

WHAT SORT OF TESTS DO YOU GET?

The most reliable test is the Elisa (enzyme linked immunosorbent assay). Blood will be taken from your arm and sent to a laboratory and the results of the Elisa will be given to you within three to seven days.
The PCR test (polymerase chain reaction) test can be done to give either a qualitative result (positive or negative) or quantitative (this tests the viral load, if you have HIV in your blood). It also requires blood from you and the results will be ready in one to three days, but they are not as accurate as the Elisa, which is 99% accurate.
Rapid tests are often done by doctors, but they are far less reliable than an Elisa or PCR, rather don't have one because the risk of getting a false negative or false positive is high.
Home based HIV kits - are you crazy? These are not reliable and if you get a positive (which may be false) you have no-one to explain to you how to manage the virus. And the key to HIV infection is knowing how to manage the virus.
Urine tests for HIV are being used in China, and have been approved for use in South Africa, but the company distributing them locally failed to give any details of the test despite repeated requests.
In the USA, HIV tests are most often done with mouth swabs - a small stick inserted into the mouth takes a very thin layer of skin from the mouth, it produces quick and reliable HIV results. Or saliva is put onto a blotter. The Western blot test which is available in SA but is not often used is a further test to confirm an HIV+ diagnosis.
In 1998, the annual SA Health Review showed that fewer than 58% of clinics nationally offer voluntary counselling and testing facilities. There are voluntary counselling and testing services in six of 15 AIDS Training and Information Centres (ATICS), or you can contact the national AIDS Helpline for a place to obtain a free test near where you live.
If you have to pay for an HIV test through a doctor or hospital, it will set you back around R300. However, the cost to government for Elisa's is only R10,50 or R4,50 for a PCR - which gives you some idea of the profit private pathology labs are making on these tests.
If you go for a test and have a negative result, stay that way by practising safe sex, and never sharing razors or toothbrushes. But if you are the one in five of South Africans who is infected, there are lots of AIDS support organisations where people just like you will give you the help, advice and strength you need to live positively with HIV and to extend your life.

WHO TO CONTACT FOR MORE INFORMATION:

Most cities and towns have organisations that do free HIV tests. The counselling is often not good, but if you have prepared yourself with sufficient information, then all you need as one counsellor put it, "is you and your veins."
Major hospitals such as Groote Schuur, Addington, Coronation, Chris Hani Baragwanath and others do free HIV tests in their AIDS clinics.
The AIDS Consortium can tell you of the best testing facility close to you, (011)403-0265.
In Johannesburg contact AIDS Information, Esselen st, Hillbrow (011)725-6710; they do Elisa's for free, it takes seven days to get the results; or contact the nearest ATIC to where you live.
Good websites to access information include the World Health Organisation site http://www.who.org United Nations AIDS http://www.unaids.org
And a South African site http://www.speakout.org.za
A good book to read if you want detailed information on how to manage HIV is Primary AIDS Care by Dr Clive Evian, published by Jacana Press, phone (011)648-1157 if you can't find a copy in your local bookstore.