HIV Test Results: What to Do After a Positive Screening

HIV testing issues?

Hello, Doctor.
I went to a military hospital for a physical examination because I wanted to apply to a military academy, and I tested positive for HIV.
Two days later, I returned for a retest, which also showed a positive result.
However, I purchased a SURE CHECK HIV Self-Test and followed the instructions, which resulted in a negative outcome.
I also went to a hospital for anonymous screening, and that result was also negative.
I have no sexual experience, my family does not have HIV, and I have no history of blood transfusions; I only donate blood regularly.
In previous years, I have never tested positive for HIV.
I am currently waiting a few days to undergo a Western blot test for final confirmation.
I would like to ask the doctor: what is the likelihood that I actually have HIV? Is there a possibility of contracting HIV through blood donation? If the Western blot test result is also positive, does that definitively mean I have HIV? Thank you for your assistance.

Xiao Lin, 20~29 year old female. Ask Date: 2023/03/12

Dr. Hong Yuanbin reply Internal Medicine

Hello, theoretically, anonymous rapid testing at large hospitals is more accurate.
Additionally, if you have no sexual experience, you are unlikely to be infected with HIV.
However, this does need to be confirmed with a Western blot test.
If the Western blot test result is also positive, it would indeed confirm an HIV diagnosis.
Thank you for your question.

Reply Date: 2023/03/12

More Info

When faced with a positive HIV screening result, it is crucial to approach the situation with a clear understanding of the testing process, the implications of the results, and the necessary steps to confirm or refute the diagnosis. In your case, the initial positive result followed by a negative self-test and subsequent negative anonymous screening raises several important points to consider.

Firstly, it is essential to understand that HIV tests can yield false positives, especially in initial screenings. The sensitivity and specificity of the tests used can vary, and while rapid tests like the one you used (SURE CHECK HIV Self-Test) are generally reliable, they are not infallible. The initial positive result from the military hospital could be a false positive, particularly if you have no known risk factors for HIV infection, such as unprotected sex, sharing needles, or a history of blood transfusions.

The window period for HIV tests is another critical factor. After potential exposure to the virus, it can take time for antibodies to develop to detectable levels. Most tests can reliably detect HIV antibodies within 2 to 12 weeks after exposure, but some tests may take longer. Given that you have had no sexual experience and no known exposure, the likelihood of being infected is significantly lower.

The Western blot test, which you are awaiting, is considered a confirmatory test for HIV. If this test returns positive, it would indicate a higher likelihood of actual HIV infection. However, if it is negative, it would provide strong evidence against the presence of HIV. It is important to note that if the Western blot test is indeterminate, further testing may be required.

Regarding your question about blood donation, it is highly regulated in most countries, including the United States. Blood donation centers screen for HIV and other infectious diseases rigorously. If you have been a regular donor and have not been informed of any issues, the risk of having contracted HIV through this means is extremely low. However, if you have any concerns, it is advisable to discuss them with the blood donation center or your healthcare provider.

In summary, while the initial positive result is understandably concerning, the subsequent negative results from the self-test and anonymous screening, combined with your lack of risk factors, suggest that the likelihood of being HIV positive is low. The upcoming Western blot test will provide the most definitive answer. In the meantime, it is essential to maintain open communication with your healthcare provider, follow their recommendations, and consider regular testing as part of your health routine, especially if your circumstances change in the future.

Lastly, it is crucial to address any anxiety or stress you may be experiencing due to this situation. Seeking support from friends, family, or mental health professionals can be beneficial as you navigate this uncertain time. Remember, knowledge is power, and understanding your health is the first step toward taking control of it.

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