CARNAL NATION

Happy National HIV Testing Day!

A day (June 27) devoted to getting tested for HIV might sound like an odd thing to commemorate, but the Centers for Disease Control and Prevention (CDC), the National Association of People with AIDS (NAPWA), and their partner organizations are sparing no effort to emphasize the importance of knowing your status.

The CDC recommends testing for people age 13 to 64 as part of routine medical care, and advises that those at risk—including sexually active men and women who are not in a long-term, mutually monogamous relationship—should be tested on a yearly basis.

According to the HIV Medicine Association (HIVMA), about one-fifth of HIV positive people in the U.S. don't know they're infected. Just how many people this might be is unclear, since estimates about the total number of people with HIV or AIDS are notoriously imprecise.

Last summer, based on a new testing method and mathematical modeling, CDC researchers reported that HIV incidence—or new infections—was about 40% higher than previously believed. This was not attributable to a big jump in new cases, but rather that the old estimate had been too low all along.

"It's important to note that the new estimate does not represent an actual increase in the number of new infections, but reflects our ability to more precisely measure HIV incidence and secure a better understanding of the epidemic," said Dr. Kevin Fenton, director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, when the number were released. "These new findings emphasize the importance of reaching all HIV-infected individuals and those at risk with effective prevention programs."

Getting an HIV test no longer requires a blood draw followed by two weeks of anxious waiting. The OraSure test uses a swab to collect a sample from the inside of the cheek, and results are available within an hour.

The standard ELISA test measures antibodies the immune system produces to attack the virus. There is a "window period" of a few weeks to several months when a person may be infected but not yet have enough antibodies to test positive. A negative HIV test is considered highly reliable, but a positive test will be confirmed by another antibody test called a Western blot. It's also possible to directly measure HIV genetic material in the blood to get quicker results without a window period —this is the type of assay the adult industry uses for monthly testing of porn actors—but it's not commonly used for screening.

Until recently, the number of new HIV infections in the U.S. has not been measured directly. Standard antibody tests can show whether a person has the virus, but can't tell how long ago they got it (that is, it can be used to estimate prevalence, or total infections, but not incidence, or new infections). But now, a method called STARHS using a "detuned" antibody test can determine whether an infection occurred within the past six months.

According to the latest estimates, there were approximately 56,300 new HIV infections in the U.S. in 2006, for an incidence rate of 23 cases per 100,000 people. Just over half of these new infections still occur in men who have sex with men (gay and bisexual men, as well as those who do it but don't adopt the labels). Another third of new infections are in people exposed through heterosexual sex and just over 10% are injection drug users (a decrease from previous years). About one-quarter of newly infected people are women.

The disproportionate number of new infections among people of color underlines the need for more targeted prevention efforts. According to the latest figures, 45% of newly infected people in 2006 were African-American, even though blacks account for just 12% of the total U.S. population. Of the remaining newly infected people, 35% were white, 17% were Latino/Hispanic, and a very small percentage were Asian, Pacific Islander, or Native American.