HIV – Lyall Clinic

Human Immunodeficiency Virus (HIV) Screening

Overview

HIV attacks the immune system.
AIDS is the most advanced stage of HIV.
HIV targets white blood cells, weakening the immune system.
Increases risk of diseases like tuberculosis, infections, and some cancers.
Spreads through blood and body fluids.
Not spread by kisses, hugs, or sharing food.
Can be transmitted from mother to baby.
Treatable and preventable with antiretroviral therapy (ART).
Untreated HIV can progress to AIDS over many years.

Risk Factors :

Having condomless anal or vaginal sex
Having another sexually transmitted infection (STI)
Engaging in harmful use of alcohol and drugs in the context of sexual behaviour
Sharing contaminated needles, syringes, and other injecting equipment and drug solutions when injecting drugs
Receiving unsafe injections, blood transfusions, tissue transplantation, and medical procedures involving unsterile cutting or piercing
Experiencing accidental needle stick injuries, including among health workers

Why we screen applicants for HIV?

Identification of clients with HIV infection.
Completion and grading of an IME for a client with positive HIV testing.
HIV screening usually required for clients 15 years and older undergoing an IME.

HIV screening may be requested for clients under 15 with any of the following risk factors:

HIV symptoms
History of sexual activity
History of STIs (e.g., syphilis, herpes, chlamydia, gonorrhea)
History of sharing contaminated needles
Unsafe injections, blood transfusions, or unsterile medical procedures
Accidental needle stick injuries
Suspected active TB, Hepatitis B, or Hepatitis C
Unprofessional Tattoos, piercings, or acupuncture done non-aseptically
Born to an HIV-positive mother
Failure to thrive

Counselling and Consent

Panel physician will provide Pre- and post-test counselling to explain the following

Means of HIV transmission and prevention
Description of testing procedure.
Confidentiality of HIV testing, reporting, and record handling
Meaning of HIV screening test results, including the possibility of false positive or false negative results
Need to inform anyone at risk of infection if the test is positive
Client’s consent to undergo testing.

Results and Reporting

1. Initial Test:

A non-reactive negative test requires no further testing
An indeterminate or reactive (positive) result is automatically retested with a different assay.

2. Discordant Results:

If the first test is reactive and the second is non-reactive, a third different assay is used on the same specimen.
A positive result confirms HIV seropositivity.

3. Indeterminate Results:

If the initial specimen remains indeterminate, a second blood specimen must be tested.
If this second test is also indeterminate, reports are submitted with the IME.

4. Post-Test Process:

If positive the post-test counseling form is completed by the panel physcian.
IME results and all laboratory test results are sent directly to embassy.

Post-Test Counselling for Positive Results

For an applicant with a confirmed positive HIV result, the following information may be required:

IGRA testing for tuberculosis screening
CD4 count
HIV viral load
Hepatitis B screening (HBsAg)
Hepatitis C screening (HCV Ab)
A signed and dated Acknowledgement of HIV Post Test Counselling form, even if the applicant is already aware of their HIV status
Antiretroviral medication regimen details, including drug names, doses, and frequency.

If this is a new HIV diagnosis or the applicant is not currently on antiretroviral therapy, the RMO may request an HIV Expert report from a specialist or a physician knowledgeable in HIV treatment.

Prevention

Barrier contraceptives
Contaminated syringes & needles should not be shared
Blood should be screened for HIV
Early detection & treatment
Control of infection is high risk groups
NO VACCINE AVAILABLE
There is no cure for HIV infection.
It is treated with antiretroviral drugs, which stop the virus from replicating in the body.
Without treatment, people with HIV infection can also develop severe illnesses
HIV is a preventable disease.
Reduce the risk of HIV infection by:
using a male or female condom during sex
being tested for HIV and sexually transmitted infections
having a voluntary medical male circumcision
using harm reduction services for people who inject and use drugs.