An HIV test can only be carried out with informed consent. The person to be tested has a right to know what the test implies and should agree to be tested.
Based on situations that may have led to infection, the individual and the doctor will consider the possibility of a positive test. Even so, a positive test can still come as a shock.
What does a positive HIV test mean?
When infected with HIV, the body produces antibodies against the virus. In 2003, HIV tests were introduced that detected both antibodies and components of the virus, so-called HIV combo tests. They can detect HIV infection as early as 1-2 weeks after being in a situation with a risk of infection. In some cases, it may take longer before the test can detect infection, so anyone who has been at risk of infection should be monitored for up to 12 weeks to confirm the test result.
The time from infection to the HIV test showing a positive result is called the “window period”. Although the HIV tests that are used routinely are very reliable, they can sometimes show a false positive result. This means that the test detects other substances in the blood than HIV. Samples that give a positive result will be examined with another test, Western Blot, to give a final confirmation that the test is positive.
As an extra precaution, a new blood sample is taken to rule out any mistakes in handling the samples. A positive HIV test result only confirms that a person is infected with HIV. It provides no information about when or how the person was infected or how far the illness has progressed.
Other HIV tests
Rapid tests have also been developed for HIV. With a regular HIV test, blood samples are sent to the laboratory and it takes about a week before the results are available. With a rapid test, the sample is examined immediately and the result is ready after 15-20 minutes. Even with rapid tests, it takes 12 weeks after infection exposure before the result is certain.
PCR tests are used in special situations, for example for babies born to HIV positive mothers and during check-ups after needle-stick injuries.
When a virus becomes resistant, this means that immunosuppressant medicines no longer have any effect. This has been seen with HIV. Blood samples are taken from all people who are newly diagnosed as HIV positive to study the prevalence of the resistant virus. Resistance tests are also carried out when treatment is necessary. This will help when evaluating the appropriate choice of medicine.
A positive HIV result - what now?
Many different feelings will arise when being told that the HIV test is positive and it often takes time to adjust to a new situation. Modern medical treatment means that the prospects for people living with HIV are now very good compared to the past. However, life will still be different, even for those living without symptoms or ailments. HIV infection is a lifelong infection, which means that HIV positive people should be aware that they can infect others. Medication cannot yet cure or eradicate HIV and when treatment starts it must continue.
People who test HIV positive will be referred to a doctor with a good knowledge of HIV. Treatment for HIV infection is usually handled by a specialist health service in the hospital. For people who live far from a hospital, the local doctor can collaborate with the specialists to give the best possible local support.
People who are HIV positive and who want contact with a psychiatrist or psychologist have a right to referral to free treatment.
Treatment of HIV infection
HIV treatment is lifelong and consists of combinations of various drugs. Treatment should begin as soon as possible after diagnosis.
Illustration: Johnér Bildbyrå AB
Positiv HIV tests among immigrants in Norway
HIV tests are not required for entry or residence in Norway. This applies to tourists, students and people seeking work or asylum. Upon arrival to the country, asylum seekers will often be offered HIV tests usually at 3 months after arrival. They are entitled to information and must give their consent for the test to be taken. An asylum seeker can decide whether information about a positive test should be provided to the immigration authorities.
A positive test has no negative impact on a subsequent application for residence, but does not automatically grant asylum or the right to permanent residence in Norway.
Everyone staying in Norway is entitled to medical treatment if they are ill. If a HIV-related disease is discovered that requires treatment, everyone living in Norway is entitled to treatment. For many asylum seekers it may be difficult to obtain medication and continue their treatment if they must return to their homeland. This may therefore be relevant in the overall assessment when applying for permanent residence. However, each case will always be considered individually.
Who needs to be informed?
A person who has an HIV infection has a responsibility not to infect others. Condoms should always be used when practising occasional sex. If you have a regular sexpartner, you should inform your partner of your hiv status. Together you should decide whether to use condoms or pre–prophylaxis treatment (PreP). This will depend on if you are on successful treatment or not. You are advised to talk to your doctor who is handling your treatment.
Tracing contacts is a necessary step in the fight against the HIV epidemic. Contacts that may be infected should be contacted and offered a test. Either the infected person or health personnel can inform the contacts about the possible risk of being infected. Health personnel will inform the contacts without disclosing the name of the person with HIV infection. The contact will be offered advice, counselling and an HIV test.
How open the individual wants to be about their HIV status towards family, friends and acquaintances, is a personal choice. Consider who should be informed and why. Experience shows that most people who choose to tell their closest friends or family members that they have an HIV infection find this to be a good support.
Neither the employer nor colleagues have a right to know if an employee is infected with HIV. This also applies to schools and places of education. Some people choose to be open with colleagues and their employer. People with HIV can have a variety of professions. The exception is infected healthcare workers who perform procedures (operations, etc.) where the risk of needle-stick injury is particularly high. If an HIV positive person is unsure if their work involves a risk to themselves or others, they can discuss this with their doctor.
Your doctor and your dentist should be informed about your HIV status. If you are receiving any form of treatment at hospital it is also appropriate to inform them. Healthcare professionals need to be able to assess your health status and provide the best possible treatment. Health professionals have a duty of confidentiality.
Some vaccines may be dangerous for a person with HIV infection with suppression of the immune system and is not under successful testament. If you need vaccines, e.g. when travelling, you should inform the person who is administering the vaccine about your HIV status.
Many of the medicines used to treat HIV can affect, or be affected by, medicines used to treat other diseases (allergy medicines, certain antibiotics and herbal medicines). There may be interactions between medicines that may have adverse or severe consequences for health. Never start to take other medicines without consulting the doctor who is handling your treatment.
Insurance policies / agreements entered into before receiving an HIV diagnosis will be valid and will continue. For new agreements for individual life and health insurance, information should be disclosed about health conditions. The insurance will be invalid if a person with HIV fails to do so.
It is possible to sign individual life insurance on specified terms after being tested as HIV positive. Each insurance company will decide if they choose to offer such a scheme.