HIV

Human Immunodeficiency Virus (HIV) is a virus that is passed through blood and body fluids, such as vaginal fluids, semen, pre-ejaculate, anal fluids and breast/chest milk. HIV harms the body’s immune system, by replicating within immune cells. HIV is treatable with antiretroviral medications.

HIV testing in BC is free and convenient. You and your partners can access an HIV test at the following locations:

• Sexual Health Clinics
• Primary Care Clinics
• GetCheckedOnline - Confidential online STI testing available at participating LifeLabs
• I'm Ready to Know - Rapid self-testing (will need a confirmatory blood test)

Symptoms of an HIV infection are hard to tell apart from other viral symptoms. You cannot rely on symptoms alone to tell you if you have HIV, confirmatory testing is always required.  Many people have mild and unnoticed symptoms; therefore, regular STI/HIV screening is recommended. See routine intervals here.  However, people typically experience a number of the listed symptoms at the same time.

Commonly reported symptoms:

• fever
• fatigue, tiredness, or lethargy
• a skin rash, typically on the trunk or face
• muscle aches and pains
• headache

Less common symptoms include:

• sore throat
• tender and swollen lymph nodes, typically in the neck or armpit
• joint pain
• oral ulcers
• genital or anal ulcers
• weight loss
• nausea
• diarrhea
• night sweats
• cough
• lack of appetite

Standard testing

Testing for HIV is done through serology blood work. A blood sample is taken from a person at a lab or clinic and sent for laboratory analysis. Results can take up to 5 days. HIV blood testing (from a vein) is highly accurate and is considered the gold standard for confirming HIV infection. HIV blood testing should be considered for any recent (within 3-4 weeks) risks, such as unprotected sex or sharing of drug use or injection equipment such as needles.

Rapid testing

There are two types of rapid HIV tests available in VCH: the point-of-care (POC) test and self-test kits available for purchase online. A POC test is administered in a clinic and requires a few drops of blood from a finger prick. The test looks for HIV antibodies 1 & 2 and provides results within one minute. A POC test has a window period of 3-4 weeks, which means it will only be able to detect HIV results for an encounter that occurred 3-4 weeks ago. The test does not detect the HIV virus directly, and it looks for the body’s immune response (antibody response) to the virus, which can take more than 3-4 weeks to show on a test.

Self-testing

HIV self-tests allow people to test themselves using a POC (finger prick test) in their home or other locations.

With POC tests (self test or in clinic) a negative test does not require any additional follow up (HIV has been ruled out) retesting should be done every 3 months. All positive results should be followed up urgently with a clinic visit and HIV serology to confirm diagnosis and start treatment.

HIV is a chronic condition that is fully manageable with daily medications. Your physical health and immune system will remain strong.   Early treatment is key, and it consists of daily oral antiviral (ARV) medications to keep the virus from reproducing in the body. ARVs are extremely effective and have minimal side effects (which typically subside within the first few weeks). Treatment is monitored by bloodwork that checks the level of virus in the body, referred to as a viral count. The goal of treatment is to reach an ‘undetectable level’, meaning less than 40 copies of HIV virus per 1 ml of blood. The viral count lets us know two things. First the ARVs are effective at stopping viral replication, and your immune system will remain strong because HIV is no longer harming your immune cells in its replication process. Second, HIV cannot be passed on to partners if the viral count remains stable at an undetectable (<40 copies/ml).

HIV Factsheet: Undetectable = Untransmittable (U=U)

Need help finding an HIV treatment provider in BC? Check out the BC CfE Drug Treatment Program for more information, or call public health at (604) 675-3900 for help getting connected to care.

Public health can support anyone living with HIV to talk to their partners about their status and can also assist with anonymous partner testing at any time in the course of your HIV care and treatment. You do not need to be newly diagnosed with HIV to connect with public health. Call us at (604) 675-3900. Please reach out if you are looking for support for yourself or your partners. We can provide testing, treatment, PrEP and PEP referrals.

PrEP = Pre-exposure prophylaxis

PrEP is an oral ARV medication (typically Truvada or Descovy) that is taken once daily or ‘on demand’ in certain circumstance to help prevent getting HIV if you have an exposure. The medications are well tolerated and very effective. If you are interested in getting on PrEP, visit the SmartSexResource clinic finder.

PEP = Post-exposure prophylaxis

PEP is an ARV regimen that can be started up to 72 hours after having an HIV risk exposure (e.g. unprotected sex with an HIV positive individual, or needle sharing risk). A full course of PEP is 28 days long and there is monitoring bloodwork to be done at two and four weeks. A five day started kit of PEP is available at every emergency room in British Columbia, please proceed to your nearest emergency room for assistance. Additionally, a list of Vancouver clinics that offer PEP can be found here.