HIV: diagnosis and assessment, HIV pre-test discussion, Risk assessment, positive HIV testEarly diagnosis allows monitoring with pre-symptomatic HAART, Implications of testing, antibody test is serum Assess patient knowledge,
I work in the epicentre of HIV - the middle of sub-Saharan Africa. This is our approach. HIV: diagnosis and assessment HIV pre-test discussion: HIV infection is usually diagnosed by detecting antibodies in a serum sample. However, in suspected infections or 2 to 4 weeks after a specific high-risk incident (e.g. needle-stick injury) plasma should be tested for HIV p24 antigen and RNA by a nucleic acid amplification technique (e.g. PCR). Testing should always be done with informed consent and assurance about the confidential nature of the process. Points to cover include: Risk assessment: e.g. sex practices, travel, drug use, occupation, blood/blood products exposure Very high risk: unprotected sexual contact with an HIV infected partner receipt of infected blood products sharing injecting equipment with HIV infected person. If risk within 72 hours consider post-exposure prophylaxis High risk: unprotected anal sex (especially receptive) sex or sharing injecting