In the United States, approximately a third of those who are HIV-positive don't even realize it. Worldwide, that number can be much higher. Because of this, and because those who don't know their HIV status can play a large role in continuing to spread the virus, in recent years, there has been an increased push for more universal HIV testing, in order to decrease this percentage unaware of their HIV status, and theoretically, reduce spread of the virus. But is this a good idea, and how exactly would and should it be accomplished? This was the topic of discussion at a session titled HIV Testing In the Era of Treatment Scale Up (video at the link).
This is an area of much contention; I'll highlight some of the major issues at AIDS at 25.
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It strikes me that one of the potential problems with universal HIV testing in the US, is the ramifications that such testing might have on people's health insurance. I don't particularly know how private health insurance works in the US (something which I should find out) but it seems to me, with the limited understanding that I have regarding health care in the US, that a lot of people might suddenly find themselves uninsurable following an HIV test.
Mandatory HIV-testing: The ultimate savior of humanity.
HIV and Aids celebrate their 25th birthday this Year of the Lord, 2006. Which means they're grown-ups. Yet many people continue to live with them without even knowing they are there. This must be stopped. Can parents continue to ignore their 25 years old child? Of course not.
Compared to a flu, a bad cough, headaches, diarrhea, a heart attack, etc, etc, which cannot possibly be ignored by the owner, HIV and Aids can be very silent inhabitants of the host, only to be detected through specially designed testing material. Which, in a certain way, is quite natural because, after all, HIV and Aids being constructions of the human mind, they can only be brought into life if you search for them believing very hard they exist.
Mandatory HIV testing may be, and even more: should be, considered as the ultimate savior of mankind. Please, allow me to explain, sit still and carefully read the following.
Although not much is known, nor about the real functioning of tests like Western-Blot, Elisa, PCR, and the like, neither about how results should be interpret, it has become clear over the years that drug addicts and poor and hungry people in general make up the overwhelming majority of the world's HIV hosts. Practice has also taught us that if testing in itself does almost never enable the tester to be sure of the HIV status of the person being tested, subjective judgment of that person by an experienced tester who can tell, by simply looking at somebody's face, who and what that person stands for, always provides the desired result.
If we add to that particular practice the fact that immunity-deficiency is very often simply caused by malnutrition and drug abuse, mandatory testing will make it possible (Finally! Thank God, thank Allah, thank Buddha, thank Shiva, thank every God in the book) to separate the poor, the bad and the ugly from the good.
AZT, ARVs etc. will do the rest, deliver the world from evil and paradise will be ours.
Ours, that is, if you're in it. I'll be in it for sure. Will you? Look at me for some seconds please... hmm... eyes close together... badly shaved... no ironing... I don't know, sorry...
Oh, I forget. This will only work if chemo treatment will become mandatory too. Of course.
js
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http://www.nightsofarmour.com
What exactly is meant when it is said that the serum for the hiv test is diluted 400(?) times and that no other test needs this level of dilution - thus we would all get positive results using the normal dilution?
Sorry, forgot my manners!
Many thanks for your answers and happy new year!
What exactly is meant when it is said that the serum for the hiv test is diluted 400(?) times and that no other test needs this level of dilution - thus we would all get positive results using the normal dilution?
Happy New Year, Sascha! It means that one has been reading dissident/rethinker/denialist literature.
Absolutely! Wow, was ti that obvious?
And as a self admitted moron, and after having changed my underwear, I turn to you et al. to set me straight. I suppose you've answered this question so often you feel you want to push your arm through the copper wire and throttle the benighted fool at the other end who's been playing with fire.
I'm not trying to reopen an old and tired debate, I just wanted to put the monsters under my bed to rest. Looked everywhere for an answer without finding it and thought I'd ask here finally.
Thanks for your time Dale, and again happy New Year.
Absolutely! Wow, was it that obvious?
And as a self admitted moron, and after having changed my underwear, I turn to you et al. to set me straight. I suppose you've answered this question so often you feel you want to push your arm through the copper wire and throttle the benighted fool at the other end.
I'm not trying to reopen an old and tired debate, I just wanted to put the monsters under my bed to rest. Looked everywhere for an answer without finding it and thought I'd ask here finally.
Thanks for your time Dale, and again happy New Year.
Dale unwittingly proves there are no stupid questions only stupid answers.
From Wikipedia: http://en.wikipedia.org/wiki/HIV_test
The ELISA test, or the enzyme immunoassay (EIA), was the first screening test commonly employed for HIV. It has a high sensitivity.
In an ELISA test, a person's serum is diluted 400-fold and applied to a plate to which HIV antigens have been attached. If antibodies to HIV are present in the serum, they may bind to these HIV antigens. The plate is then washed to remove all other components of the serum. A specially prepared "secondary antibody" -- an antibody that binds to human antibodies -- is then applied to the plate, followed by another wash. This secondary antibody is chemically linked in advance to an enzyme. Thus the plate will contain enzyme in proportion to the amount of secondary antibody bound to the plate. A substrate for the enzyme is applied, and catalysis by the enzyme leads to a change in color or fluorescence.
ELISA results are reported as a number; the most controversial aspect of this test is determining the "cut-off" point between a positive and negative result.
So I guess denialists have latched on the 400 dilution (in pure water?) factor to explain away that test.
ELISA testing alone cannot be used to diagnose HIV, even if the test suggests a high probability that antibody to HIV-1 is present. In the United States, such ELISA results are not reported as "positive" unless confirmed by a Western Blot.
When the ELISA test is combined with Western Blot, the rate of false positives is extremely low, and diagnostic accuracy is very high.
With confirmatory Western blot, the chance of a false-positive identification in a low-prevalence setting is about 1 in 250 000 (95% CI, 1 in 173 000 to 1 in 379 000).
Thanks Arthur,
It shouldn't keep me awake anymore.
Happy New Year
Here's another Google find on the subject:
How Immunoassays Work : The Curious Case of AIDS Denialist Roberto Giraldo and his Ignorance of the Basics
by John P. Moore, PhD
http://www.aidstruth.org/howimmunoassayswork.php
It explains why the assay array works well with a 400 dilution, and will certainly give false positive if pure serum is used.
Dilution helps avoid non-specific protein binding (to the plastic walls of the assay array).
Moore also explains that "truly HIV-positive serum samples can often be diluted by as much as 1:100,000, sometimes even more, and still give a positive reaction. "
Covering the plate with goo, of whatever nature, will not give useful results.
"None of this is rocket science; it is absolutely standard operating procedure in designing and using immunoassays, the kind of basic knowledge any professional immunologist or diagnostic specialist would learn in the first few days at work. It is simply shocking that a technician with the experience claimed by Giraldo would not know this."
Dale unwittingly proves there are no stupid questions only stupid answers.
For the record: often unwitty but rarely unwitting.