Testing

Testing is a very important tool in addressing HIV. Regular testing, as a routine part of personal healthcare, can significantly help reduce the number of new infections in the community. Also, the sooner a person finds out he or she is living with HIV, the better the options for treatment, support and healthy lifestyle choices.

Where to go

Testing is available through a doctor’s office or the following:

  • Sexually Transmitted Infection Clinic  The STI Clinic is located on the 5th floor of the Sheldon M. Chumir Health Centre (1213 4 Street SW). Free, confidential HIV/STI testing is available on a drop-in basis. No Alberta Health Number or referral is required.
  • Safeworks  Safeworks is a mobile van that can bring testing right to your doorstep, 7 evenings per week. No appointment required, phone: (403) 850-3755. Safeworks also offers services at three outreach sites: Calgary Drop In Centre, Centre of Hope and the Sheldon M. Chumir Health Centre.

What to expect

HIV is diagnosed through a blood test. The test is looking for HIV antibodies in your system. Test results take approximately one week to come back.

The period of time from when you contract HIV to when antibodies appear in your blood is often called the window period. During the window period, an HIV test may give a negative result even though you have HIV. Currently, the window period is three weeks to three months, however it is important to talk to your health care provider about the window period for the type of test being used.

Who’s going to know

Positive HIV tests are reported to the public health authorities in Alberta. Three types of tests are available:

  • Nominal – Test results are linked to the person being tested by a name. Full personal information, test results and any demographic information provided are reported to public health authorities.
  • Confidential (non-nominal) – The nurse/doctor knows the identity of the person being tested, but keeps it confidential. The name of the person testing positive is not reported to public health authorities, only the test results and any demographic information provided.
  • Anonymous – Safeworks offers anonymous testing. This means a person does not have to provide their name when being tested.

Positive, Now What?

You are not alone. Start here and find out where to turn next, who can help & what you need to know.

We’re here to help. Call us today at (403) 508-2500 ext. 202.

 

HIV Community Link’s Position on Enhanced Access to HIV Testing

HIV testing is an essential strategy to reduce new HIV infections and improve health and wellness for those living with HIV. Based on strong evidence demonstrating the need for enhanced access to HIV testing, HIV Community Link supports the expansion and/or introduction of emerging technologies and practices including: Community-Based Rapid Testing, Routine HIV Screening, Home Testing for HIV, and Anonymous Testing.  Opportunities for education, support and linkage to services are best practices in all testing settings. Informed consent and voluntary participation remain foundational tenets of all HIV testing strategies.

Rapid HIV Testing and Community-Based Testing

Standard HIV testing requires a waiting period of one to two weeks and, in most situations, a return trip to the healthcare setting to receive results. In contrast, rapid HIV testing takes approximately 20 minutes including pre and post-test counseling. Access to rapid testing is rare in Alberta and only offered to specific populations or in limited situations at designated healthcare settings.

Rapid HIV testing has been available in Canada for over 15 years. Specificity, sensitivity and cost-effectiveness are well supported by a large body of research. Strong evidence also indicates that: rapid testing is favoured among target populations; availability increases motivation and uptake of HIV testing; and clients are substantially more likely to receive results with rapid testing than with standard HIV testing.(2,9,10)

Based on the evidence, HIV Community Link calls for enhanced access to rapid HIV testing in both traditional healthcare settings and community-based settings such as AIDS service organizations and/or outreach sites.  While most commonly performed by health care professionals such as nurses, evidence also supports consideration of community-based rapid HIV testing performed by other appropriately trained personnel.(11,12,13)  Examples from the literature include staff or peer volunteers at community organizations. Testing and counseling offered by these groups can be more acceptable and accessible to target populations.

Routine HIV Screening

Routine screening for HIV, also known as routine testing or universal testing, involves offering HIV testing to a wide cross-section of the population.  Routine screening can involve offering testing to everybody, but in most cases it is defined as all adults or those between the ages of 15 and 65. As with all testing strategies, informed consent and voluntary participation are imperative.

Routine screening is contrasted with targeted or risk-based approaches, where HIV testing is only encouraged or offered to those identified as most at risk based on behaviour or demographic profile. This often means that if the healthcare provider does not perceive risk, the individual must be aware of and understand personal risk, self-advocate for testing, and be prepared to disclose risk behaviours to their healthcare provider.  Risk-based testing can miss a substantial proportion of HIV infections and increase the likelihood of late-stage diagnoses where the immune system is significantly damaged and complicated opportunistic infections have developed.(1,4) Risk-based testing is an important and effective strategy in certain settings, but it must be complemented with broader reaching approaches.

Evidence illustrates numerous benefits of routine screening including avoiding late stage diagnosis, preventing forward transmission, and uncovering advanced HIV infection in individuals considered low-risk.(1,4)  Routine testing is highly acceptable when offered and can play an important role in normalizing HIV testing.

Evidence also shows that routine screening strategies significantly exceed the cost effectiveness threshold, meaning significant savings to public health spending.(4-8) In 2012, the Public Health Agency of Canada recommended that “consideration and discussion of HIV testing be made a component of periodic routine medical care”.(14)

Home Testing for HIV

Home testing kits for HIV are currently not approved for sale in Canada. However, with two types of licensed HIV home testing kits available in the United States, it is not difficult for Canadians to access these products cross-border or online.

A number of concerns around home HIV testing exist. Common examples include: the potential for coercive or non-voluntary testing; the lack of support services such as pre and post-test counseling or linkage to care in the case of a positive result; the possibility of false negative results if someone is recently infected and in the window period; and the inability to collect demographic data about HIV incidence.

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