HIV refers to the viruses that spread in the body during an infection: human immunodeficiency viruses. The abbreviation AIDS (“Acquired Immune Deficiency Syndrome”), on the other hand, refers to the final stage of the disease, which can be triggered in the long term by HIV viruses. The HIV viruses weaken the immune system until it can no longer defend itself against pathogens.
Some of these have been in the body for years without causing any problems. Only when the immune system is at its lowest do they become active and trigger so-called opportunistic infections. Opportunistic because the pathogens use “the favorable opportunity” to multiply - namely the weakness of the immune system. Pneumonia, tuberculosis, inflammation of the esophagus or abscesses are typical. These diseases can be life-threatening. Therapy with antiretroviral drugs delays the onset of AIDS by many years and often prevents it altogether.
The population groups most commonly affected vary from country to country. In Germany, most infections occur in homosexual men, while in South Africa they occur in heterosexual women. The type of sexual intercourse only plays a minor role: Although the risk of infection is slightly greater with anal sex than with vaginal intercourse, it is not enough to explain the significant differences in this country.
According to the Deutsche Aidshilfe, the decisive factor is the number of partners and, above all, how frequently they are changed. In the first few weeks after an infection, the viral load in the blood is particularly high - which means you are particularly contagious. However, many people do not yet know about their illness. Anyone who has sex with multiple partners during this time, possibly even without a condom, can potentially easily infect others.
An HIV test usually looks for antibodies to HIV viruses in the blood. Antibodies are specific protective substances that form in the blood after a pathogen has invaded. In HIV, they can be detected around 22 days after infection.
There are also tests that look for specific proteins (antigens) or components of the virus itself. These show up in the blood more quickly than the antibodies. However, in order to be able to rule out infection with certainty, you have to wait longer and, ideally, use several test procedures. With an antibody test, for example, a negative result is only really certain 12 weeks after a suspected infection. Tests that look for antigens in addition to antibodies only need six weeks to provide a reliable result.
Bei Gesundheitsämtern, Aidshilfen und in sogenannten Checkpoints kann man sich anonym auf HIV testen lassen. Eine Übersicht der Teststellen gibt die Deutsche Aidshilfe. Anonym heißt, das Ergebnis landet in keiner Krankenakte. Die Durchführung des Tests ist oft kostenlos, manchmal fallen geringe Gebühren an. Auch der Hausarzt kann einen HIV-Test durchführen. Hier übernimmt die Krankenkasse die Kosten aber nur, wenn eine Indikation besteht – es also einen triftigen Grund gibt, den Test durchzuführen. Das Ergebnis kommt in die Patientenakte.
HIV self-test
Viele Menschen trauen sich nicht, den Test beim Arzt machen zu lassen, obwohl sie zu einer Risikogruppe gehören. Der HIV-Selbsttest, den es seit Herbst 2018 gibt, könnte hier helfen. In einem Tropfen Blut sucht der Test nach Antikörpern, die der Körper als Reaktion auf eine HIV-Infektion bildet. Innerhalb einer Viertelstunde zeigt er ein Ergebnis an – das ist aber wieder nur verlässlich, wenn seit der möglichen Ansteckung 12 Wochen vergangen sind.
The self-tests are available in pharmacies, drugstores, through local AIDS charities, the German AIDS Help Center and can even be ordered online. The Paul Ehrlich Institute recommends only using tests with a CE mark; others are not safe. The following are considered certified tests:
- Atomo HIV Self Test(Hersteller: atomo diagnostics)
- Biosure HIV Self Test (Biosure)
- Exacto Pro HIV (Biosynex)
- INSTI HIV Self-Test (bioLytical)
The HIV self-test has one disadvantage: it can show an infection even though the person in question has not been infected with HIV. This is then referred to as a false positive result. This affects around 1 to 2 people tested in 1000. The test can be influenced, for example, if there are many antibodies in the blood of the person being tested - this is the case, for example, with rheumatism patients or after flu vaccinations. Anyone who receives a positive result from an HIV self-test should definitely consult a doctor and have their blood tested again in the laboratory.
Condoms traditionally protect against HIV, but now also medication. A lot has happened since the disease was discovered - it is no longer a death sentence.
