HIV and AIDS

HIV Infection

HIV infection usually goes through several phases, starting with the acute phase. Some people will experience flu-like symptoms such as fever and swollen lymph glands for 2-4 weeks after infection. This stage has a high viral load and a high risk of transmission. This is followed by a clinical incubation phase, which may last for several years and in which the patient usually has no visible symptoms, but the virus continues to replicate in the body and gradually destroys the immune system. The final stage is AIDS, which can be diagnosed when the CD4+ T-cell count drops below 200 or when opportunistic infections occur. At this time, patients are susceptible to a variety of infections and have a significantly reduced quality of life. Symptoms of HIV infection vary from individual to individual, with common symptoms including fever, fatigue, swollen lymph glands, persistent diarrhea, weight loss, and oral candida infections. As the disease progresses, patients may experience more serious opportunistic infections such as Pneumocystis pneumonia and tuberculosis.

Figure 2. HIV infection and AIDS
(Source: Deeks SG, et al. 2015)

HIV Testing Near Me

HIV testing is an important part of the AIDS response. For individuals, early detection and diagnosis can help HIV-infected patients receive effective treatment in a timely manner, thereby reducing serious opportunistic infections, co-morbidities, and mortality rates, as well as alleviating the financial burden of the treatment process. For groups, HIV-infected individuals tend to voluntarily change their high-risk behaviors after diagnosis, thereby reducing the risk of HIV transmission.

Institution-based testing

Institution-based testing refers to HIV testing counseling services provided in health care facilities, including general hospitals, clinics, and the Centers for Disease Control and Prevention. There are two main types of testing services in health facilities, Voluntary Counseling and Testing (VCT) and Proactive HIV Testing and Counseling (PITC) by medical staff. VCT emphasizes the individual's voluntary choice of whether or not to undergo an HIV test after counseling and ensures confidentiality of the testing process.

Community-based testing

Community-based HIV testing is recommended by the World Health Organization as a complementary strategy due to cumbersome institutional testing procedures and time and location constraints for testing. Community-based HIV testing not only plays an important role in testing key populations, but is also able to reach groups that have been difficult to reach in previous testing efforts. Community-based HIV testing is mainly done through mobile testing, home testing and co-testing.

Mobile testing refers to the direct provision of HIV testing counseling services through community venues such as transportation stops, parks, markets, shopping centers, sports venues, and residential areas. Compared with institutional testing, community-based testing services are more flexible and can reach out to those who are less aware of previous testing or have limited access to testing by going to the places where the clients gather for their activities. Home testing refers to the provision of HIV testing counseling services at home, a strategy designed to increase HIV testing coverage through factors such as transportation costs, time savings, and reduction of stigma as well as discrimination. For the hard-to-reach populations mentioned above, some regions have experimented with the strategy of co-testing, which reaches hard-to-reach groups such as males and adolescents through community health campaigns with joint screening for several diseases and home testing for those who do not participate in the campaigns. This strategy has dramatically increased the proportion of HIV test acceptance and coverage, especially the proportion of first-time tests.

HIV self-testing has become an option for more people as testing kits and testing technology continue to advance. HIV self-testing is the process by which an individual collects a sample of oral mucous membrane exudate, blood or urine for HIV testing and interprets the results. This process usually takes place in a private setting and is characterized by convenience, speed and privacy. People can access self-testing reagents from the community, institutions, the Internet, and retail stores and pharmacies. However, there are still some problems with the implementation of this method, such as the high cost of self-testing kits, the inability to reach areas with limited economic resources and populations of lower socio-economic status, possible inaccuracies in the test results that may lead to misclassification of the results, and inappropriate disposal of the reagents after use.

HIV Vaccine

Currently, most HIV vaccines in development focus on the prophylactic type, which prevents the virus from invading by producing antibodies and T-cell responses against HIV. There are also a number of therapeutic vaccines in development that are designed to activate the immune system to help infected individuals slow the progression of the disease and reduce the risk of transmission. HIV vaccine development faces a number of challenges, starting with the variability of HIV, which has an extremely high level of genetic variability, making it difficult to design a vaccine that can cover all forms of variability. Viruses evade the surveillance of the immune system through constant mutation, which adds to the complexity of vaccine development. In addition, the lack of validated animal models makes clinical trials and evaluations more difficult. Second, there is the immune escape mechanism, whereby HIV is able to rapidly mutate and hide within host cells, thereby evading the host immune system. This ability to escape makes it more difficult to mount an effective immune response against HIV.