Diagnosis of HIV AIDS

Diagnosing HIV/AIDS

If you think you may be infected with HIV, the only way to know for sure is to be tested. Testing is voluntary and can be anonymous. Your results will remain confidential. You can be tested at your physician's office or at a sexual health clinic, many of which are run by local public health units.

HIV testing can involve two types of tests: a preliminary test that detects HIV antibodies and a final confirmatory test. If the rapid test, which requires a finger prick of blood, is reactive to HIV, a second laboratory-based test is required to determine whether someone is HIV positive. However, if the rapid test is negative, then no further testing is required.

If HIV infection is confirmed, your doctor will discuss treatment options as well as support groups and other services to help you cope. You should inform your sexual partners (past, current, and future) to protect them from developing HIV or help them get treatment if they have been infected. The laws about whether partners must be informed vary from province to province, but most provinces have developed services for notifying partners. Your doctor or provincial ministry of health may be able to help your partners get testing and treatment if needed.

Treating and Preventing HIV/AIDS

HIV is usually treated with HAART (highly active antiretroviral therapy), a potent combination of anti-HIV medications. HAART will not cure HIV, but it can reduce the amount of virus in the blood, improve the immune system, and slow the progression of the disease. At least three medications are used together. Using multiple medications that work in different ways helps prevent the virus from becoming resistant to the treatment. The risk of resistance increases when fewer medications are used, when too low a dose is taken, or when a medication is stopped, even if this only happens for a short period of time.

It is very important to take HIV medications exactly as prescribed. If you miss a dose, take less medication than you need, or take doses at the wrong time, the medication will not work as well. Timing the medications around your meals and daily routine can be difficult. Your doctor or pharmacist can help you fit the medications into your day. They may also recommend that you use a beeper or a special medication container to keep track of doses.

Once people develop AIDS, they usually take a range of antibiotic, antiviral, and antifungal medications that other people only take for a short time while they are sick. These medications help fight off opportunistic infections. People with "wasting syndrome" may be offered various treatments according to the cause of significant weight loss. Agents such as growth hormone, anabolic steroids, and appetite stimulants are examples of medications that have been used to treat this condition.

There is a great deal of research on new treatments for HIV. Treatment information changes quickly. To keep up-to-date, talk to your doctor or pharmacist. You can also contact CATIE (the Canadian AIDS Treatment Information Exchange) for free, current, and confidential treatment information. You can reach CATIE by phone (1-800-263-1638) or on the Internet (www.catie.ca). You can also check with your provincial Ministry of Health for information on provincial and local programs.

Anyone can become infected with HIV. Fortunately, it can be prevented. The main ways to prevent HIV infection are:

using condoms during sex (including vaginal, oral, and anal sex)
having fewer sexual partners
not sharing needles or other equipment to take illicit drugs

Unless you are in a mutually monogamous relationship (neither of you is having sex with anyone else), and you are sure neither of you is HIV-positive, make sure to use a condom every time you have sex.

In some cases, couples where one partner is infected may decide to risk infection of the other partner, especially if they are trying to get pregnant. If this is the case, talk to your doctor. Your choice of sexual partner is also important, since condoms do sometimes break or leak. You may know that you practice safe sex and that you haven't used dirty needles, but you must also know that your sexual partners and all their other partners do the same. Sharing needles is very dangerous – it carries a high risk of getting HIV.

People with other sexually transmitted infections (STIs) such as herpes are much more likely to contract HIV during sex, probably because of tiny breaks in their skin or vaginal lining. Keeping free of other STIs will help reduce your risk of HIV infection, but this alone will not protect you from infection. That's why it is important to use condoms.

If you have HIV and become pregnant, tell your doctor. The risk of infecting an infant during birth has been reduced dramatically through the use of medication and caesarean section when appropriate.

What Is Ankylosing Spondylitis?

Ankylosing spondylitis (AS) is a form of arthritis that affects the joints in the spine. Its name comes from the Greek words ankylos, meaning stiffening of a joint, and spondylo, meaning vertebra. Spondylitis causes inflammation (redness, heat, swelling, and pain) in the spine or vertebrae. AS often involves an inflamed sacroiliac (SI) joint, where the spine joins the pelvis.

In some people, the condition can affect other joints. The shoulders, ribs, hips, knees, and feet can be affected. It can also affect places where the tendons and ligaments attach to the bones. Sometimes it can affect other organs such as the eyes, bowel, and very rarely, the heart and lungs.

Many people who have AS have mild back pain that comes and goes. Others have severe, ongoing pain. Sometimes they lose flexibility in the spine. In the most severe cases, the swelling can cause two or more bones of the spine to fuse. This may stiffen the rib cage, restricting lung capacity.


AS usually begins in the teen or young adult years. Most people who have the disease get symptoms before age 30. Only five percent get symptoms after age 45. It affects people for the rest of their lives. And it affects about twice as many men as women.

What Causes Ankylosing Spondylitis?

The cause of AS is unknown. It’s likely that genes (passed from parents to children) and the environment both play a role. The main gene associated with the risk for AS is called HLA-B27. Having the gene doesn’t mean you will get AS. Fewer than 1 of 20 people with HLA-B27 gets AS. Scientists recently discovered two more genes (IL23R and ERAP1) that, along with HLA-B27, carry a genetic risk for AS.

How Is Ankylosing Spondylitis Diagnosed?

To diagnose AS, your doctor will need:

A medical history
A physical exam
X rays or MRIs
Blood tests.
What Type of Doctor Diagnoses and Treats Ankylosing Spondylitis?

Often, a rheumatologist will diagnose AS. This is a doctor trained to treat arthritis and related conditions. Because AS can affect different parts of your body, you may need to see more than one doctor. Some other types of doctors who treat the symptoms of AS are:

An ophthalmologist, who treats eye disease.
A gastroenterologist, who treats bowel disease.
A physiatrist, who specializes in physical medicine and rehabilitation.
A physical therapist, who provides stretching and exercise regimens.
Can Ankylosing Spondylitis Be Cured?

There is no cure for AS. Some treatments relieve symptoms and may keep the disease from getting worse. In most cases, treatment involves medicine, exercise, and self-help measures. In some cases, surgery can repair some joint damage.

What Medicines Are Used to Treat Ankylosing Spondylitis?

Several types of medicines are used to treat AS. It is important to work with your doctor to find the safest and most effective medication for you. Medicines for AS include:

Nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs relieve pain and swelling. Aspirin, ibuprofen, and naproxen are examples of NSAIDs.
Corticosteroids. These strong drugs are similar to the cortisone made by your body. They fight inflammation.
Disease-modifying antirheumatic drugs (DMARDs). These drugs work in different ways to reduce inflammation in AS.
Biologic agents. These are relatively new types of medicine. They block proteins involved with inflammation in the body.
Will Diet and Exercise A healthy diet and exercise are good for everyone, and they may be very helpful if you have AS. There is no specific diet for people with AS, but keeping a healthy weight is important. It reduces stress on painful joints. Omega-3 fatty acids, found in coldwater fish (such as tuna and salmon), flax seeds, and walnuts, might reduce disease activity. This is still being studied.

Exercise and stretching may help painful, stiff joints. It should be done carefully and increased gradually. Before beginning an exercise program, it’s important to speak with a doctor who can tailor exercises to your needs. Two types of exercises may help:

Strengthening exercises
Range-of-motion exercises.
Many people with AS find it helpful to exercise in water.

Will Surgery Be Necessary?

If AS causes joint damage that makes daily activities difficult, joint replacement may be an option. The most commonly replaced joints are the knee and hip.

In very rare cases, surgery to straighten the spine may be recommended. This can only be done by a surgeon with quite a lot of experience in the procedure.

What Can I Do to Help Myself?

These are important things you can do:

See your doctor regularly.
Follow your prescribed treatment plan.
Stay active with regular exercise.
Practice good posture.
Don’t smoke.
What Research Is Being Done on Ankylosing Spondylitis?

Researchers are seeking a better understanding of AS. They are studying:

Lifestyle and other factors that lead to better or worse outcomes.
Genes associated with AS risk.
Development of blood tests to predict AS risk or to aid in early diagnosis.
New drug therapies for AS.