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Ask Dr. Craig!: Could My Fiancé Have HIV?

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BellaNaija is pleased to announce a new column for our special readers – ‘Ask Dr. Craig!Dr. Craig is a BellaNaija columnist and one of the doctors who writes for BN Doctors’ Lounge {Get familiar here}. The idea behind ‘Ask Dr. Craig!’ is for BN readers to get quick sharp answers to niggling medical issues that they have. This does not in anyway mean that readers should not go to their doctors. However, sometimes you just need a human face to give answers to those fast, burning medical concerns our readers have.

Send your questions for Dr. Craig to features(at)bellanaija(dot)com stating your full name and where you are writing from. (Your name will never be published) The editor reserves the right to edit submissions for content brevity and clarity. We regret that we cannot provide individual answers to questions sent in and cannot state at which exact date answers would be published.
We hope that people will find help by reading and sharing. We look forward to reading your emails and tweets with questions for Dr. Craig.

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Dear Dr. Craig,

I read a post on Bella Naija (HIV+ Ghanaian Singer/Actress speaks on Contracting Virus, Challenges & Finding Love) where the actress said “At the moment, medically both of us are negative to HIV virus. This is because we have been on (Anti Retro Viral) medication for (a) long (time)”

1. Is her statement true? Can ARVs change a person’s HIV status?
2. What is the essence of having pre-marriage medical to determine if one’s partner is positive when he or she might have been on ARV for a long time?

Miss Getting –Married- Soon, Lagos.

——-

Dear Miss Getting- Married- Soon,

It does seem pretty counterintuitive to rely on tests that may turn out a false negative report, especially seeing that a lot of churches insist on it. However, this tendency to have a negative HIV screening result after prolonged ARV use is actually a documented and well known phenomenon.

To best understand this we must first look at how the HIV virus is tested for.

Rapid Test Kits (ELISA)
When a person gets infected by any virus, the body responds by producing antibodies to the virus. These antibodies are part of the body’s defence system and are specific to each virus. So for example, if a person gets infected with Measles, their body produces measles antibodies to fight the infection.

Most common rapid test kits for detecting HIV check for the antibodies produced in response to the virus and NOT the virus itself. These tests are used for screening purposes only and not for diagnosis.

Because it takes about 2 weeks to 6 months for there to be a detectable quantity of antibodies in the blood, there is what we call a ‘window period’. This is a time where even though a person is infected, screening test results would return negative. However, after the body has had enough time to produce the antibodies, a further test will be positive and this now shows the true screening status of the patient. This is why patients are advised to do a repeat screen every six months.

It is also important to note that antibody production is determined by the immune system of the patient and persons whose immune systems are weak will be unable to mount a suitable antibody response. Tests done on such persons may also be negative.

(After one positive result with ELISA, another is done to double check. If still positive the patient is referred for a confirmatory test called Western Blot.)

PCR or Polymerase Chain Reaction test
The PCR or Polymerase Chain Reaction tests for the actual virus itself. In this test the patient’s blood is put in a machine that replicates the virus DNA/ RNA and can accurately detect the presence of the infection in a patient’s blood.
The PCR test is not only able to detect categorically the presence of the HIV virus but can also determine what is called a ‘Viral Load’. The Viral load test measures the numbers of copies of the virus that are present in a millimetre of the patient’s blood. Viral loads can be as high as 1 million or more and the higher the viral load, the more infective a person is.

In addition to Western Blot, the PCR is the only confirmatory/diagnostic test for HIV

Why don’t we do PCR for everyone then? Why bother with ELISA when we know it may return unreliable results.
Well, PCR is a technical test and requires highly skilled technicians to conduct. It is also many times more expensive than ELISA and as such it would neither be economical nor feasible to test everyone if this were the only test available

CD4 Count
CD4 is the name given to a type of cell in the body that plays a key role in immunity. The HIV virus attacks the CD4 cells and kills them off. As they decrease in number, the immunity of the patient steadily declines. It is this loss of CD4 cells that makes patients with HIV prone to many opportunistic infections like TB, Varicella, Pneumonia and various skin diseases.
CD4 count is a test done to quantify the number of CD4 cells in a person’s blood.

For persons who have been diagnosed with HIV, the CD4 count is a useful tool for measuring the progression of the disease. The lower the CD4 count, the more likely the person is to develop full blown AIDS

Summary
It is important to note that it is quite possible for persons to test negative after first of all testing positive to HIV. If the replication of the virus is being controlled by ARVs then theoretically there would be a reduction in the production of antibodies. This can create a similar situation as is encountered in the window period where the virus exists but is undetectable by antibody tests.
Even the PCR test can return ‘negative’ when there are undetectable levels of HIV in a known HIV patient who is on ARVs. What this means is that the viral load has gone below 500 (for the older less sensitive machines) or 20 (for the newer more sensitive machines)

In conclusion
I personally feel that couples should be upfront and honest with each other. Have the talk about STDs and HIV with your partner long before your wedding date. Even things like past infections with herpes, gonorrhoea, chlamidia and syphilis are all relevant and must be discussed thoroughly before hand.
If you are waiting until the premarital STD/HIV screening, then you are waiting too long. Undiagnosed persons in the window period as well as confirmed cases with a low or undetectable viral load can still infect others.
It is possible for a HIV positive mother to have a HIV negative baby if the baby is born by Caesarean Section. A couple who both have HIV are still advised to use protection during sexual intercourse to prevent cross infection.

I hope you found this useful.

Disclaimer: This column is written for patient education. It is not intended to diagnose or prescribe treatment and does not replace the advice of your physician. It in no means attempts to cover the full medical scope of this condition.

David Olamide Craig is a Pastor, Physician, Sex Therapist and Relationship Expert. Dr. Craig is double certified in Occupational Medicine and Family Medicine. He graduated Bachelor of Medicine and Bachelor of Surgery from the University of Ibadan, holds a Masters in Occupational Health from the University of Birmingham and is a Member of the Royal College of General Practice UK. When he is not seeing patients or helping people find true love, Dr. Craig spends his time stretched out on his favourite couch, reading books, magazines, and blogs. Follow him @RevDrCraig or visit www.OlamideCraig.com

34 Comments

  1. Ginika

    September 8, 2014 at 3:51 pm

    Superb!!!

  2. Flames

    September 8, 2014 at 3:56 pm

    Tank u, very educating and can I say dat dis doc is 1 fyn looking man

  3. SassyJ

    September 8, 2014 at 4:00 pm

    /cuteness!!

  4. bruno

    September 8, 2014 at 4:08 pm

    In conclusion also, no amount of prayer can cure someone with HIV, no pastor or daddy can heal someone with HIV. Thank you.

    • Miss Thing

      September 9, 2014 at 6:40 am

      i know a lot of people who were cured from HIV. My God can cure all diseases and viruses, if your god(s) cannnot do it, it doesn’t mean MY God cannot. If you want proof, email me.

  5. baboushka

    September 8, 2014 at 4:10 pm

    BN why do you keep saying “pleased to announce a new column” when Dr.Craig has been here several times before? Good Doc thank you for this information.

  6. Dd

    September 8, 2014 at 4:20 pm

    BN dis Doc. Craig is so cute and smart. Since I dnt hav any questn dat is health related, can I atlist ask 4his phone number? *wide grin*

    • IsThatWhyWeAreHere?

      September 8, 2014 at 7:35 pm

      Oh…i see…where exactly are you planning to start from when you finally get the number…Some female species shaaa smh!!!

  7. nkem

    September 8, 2014 at 4:37 pm

    i see you.pls relax ur lips abeg.nIt is not cute

  8. Babi

    September 8, 2014 at 4:45 pm

    Doc Craig , oh bad ga, those lips, are you single doc, can you be my Mcsteamy………
    It’s hurt everywhere oh Doc Craig

  9. rs

    September 8, 2014 at 4:50 pm

    The FIRST thing to do at the start of any relationship(sexual relationship) is for the two people involve to exchange medical records. Allow your medical record to your partner and demand for his or her record. Do not limit the record to STI history alone because you need to know everything about the person you are planning on spending the rest of your life with. I would not date a girl without seeing her CURRENT AND PAST medical/STI record.

    • Pat

      September 8, 2014 at 8:05 pm

      @ rs good point but at the same time, getting medical record from a partner before having sexual relationship with a person does not totally guarantee anything. Like in the case of HIV/AIDS as Dr Craig said in this article one could have HIV and the virus could be undetectable because the person has been on meds. and test negative. In addition, the person can still transmit HIV even when the virus is undetectable in the blood, HIV still exists in the semen, vagina and rectal fluids, breast milk and other parts of the body.

  10. Annie

    September 8, 2014 at 4:58 pm

    Just a look at the fine doc’s lovely face/eyes and headache is gone…..praise the Lord somebody……

  11. sum1special

    September 8, 2014 at 5:08 pm

    Very educating and very cute doctor.lol

  12. Dimma

    September 8, 2014 at 5:35 pm

    Only God can cure diseases.
    But one thing is really needed
    Ur strong faith

  13. like

    September 8, 2014 at 5:54 pm

    Dear BN, we are now familiar with Dr Craig, so the big introduction can go…

    Dear Ladies, try as much as possible to focus on the content of the post and avoid falling head heels over Dr. Craig… the post can save you

  14. Tbaby

    September 8, 2014 at 6:11 pm

    I pity anyone who comes on this platform n take that fellow who calls himself Bruno, seriously.

    • Anon

      September 8, 2014 at 7:27 pm

      Take a bow Tbaby.

  15. Asgrl

    September 8, 2014 at 6:23 pm

    If you are worried and not sure, maybe you should trust your instinct?..

  16. dinga

    September 8, 2014 at 7:01 pm

    Very educative!

  17. ATL's finest

    September 8, 2014 at 7:22 pm

    Whoa!!! I’m in UBA for a research program and who knows, I may find him at University of Brimighmam 🙂

    • Colour Purple

      September 8, 2014 at 10:04 pm

      Ermmmm, I think you meant UAB, University of Alabama, Birmingham.

  18. lilian

    September 8, 2014 at 7:54 pm

    Welldone Doc.

  19. Pat

    September 8, 2014 at 8:07 pm

    Dr. Craig you are spot on, on your description

  20. kin

    September 8, 2014 at 8:16 pm

    BN should start putting a disclaimer on “Ask Dr Craig”… that this dude is very much engaged and about to tie the knot pretty soon

    • Nneka

      September 8, 2014 at 9:00 pm

      And what has that got to do with the content of his articles or goal of his BN presence??

      HIV is still very prevalent so please have that talk about your sexual health beforehand. Same with other STDs.

  21. Pat

    September 8, 2014 at 8:37 pm

    @rs I get your point though, its always better to take precaution.

  22. baboushka

    September 8, 2014 at 10:14 pm

    See thirst! Dr.Craig abeg please provide an “unfine” photo or don’t use photo at all because from the look of things your fineness is distracting to the message you intend to pass across.

  23. asgrl

    September 8, 2014 at 11:05 pm

    Dear God. Whether he’s engaged or not, he’s attractive and people have eyes. Its not like his contact information is posted on here. Its really just harmless ogling in my mind. I would hope his fiancee would know better than to get annoyed or jealous of faceless women on the net.

  24. benny

    September 9, 2014 at 1:23 am

    Dr Craig is fine. We have read the article. We understand. There is nothing Dr Craig wrote that I will like to counter. Dr Craig is a fine fine fine looking man; nothing wrong in expressing it please. Why chastise women for appreciating this fine specimen?
    Im hooked and I think he is handsome. Oga just saw the pic and agreed with me. Allow girls to thirst abeg
    OAN;; ever since the issue of that port Harcourt doc came to light ( sneaking to treat an ebola patient and coming home to wifey without saying a word). Iv morphed into a bag of paranoia; always double checking Mr Man’s movt and all that. We all react differently to situations and while im making conscious efforts to go back to the blissfully ignorant lover I used to be, I still suggest that people in relationships “married, fiancé, fiancée, friends with benefits, semi taken etc, discuss health issues and encourage regular checkups .

  25. ijebu boy

    September 9, 2014 at 2:50 am

    i would like to know more about cross-infection. cos i have always been like, “if you both have it, then all bets are off. just dey fire dey go (with each other only of course)…

  26. wunmi

    September 9, 2014 at 9:51 am

    “Wider grin” @ Dd. @Isthatwhywearehere – you cant blame a girl for trying. @ Babi *Laughing uncontrollably* walahi it hurts EVERYWHERE. @like – we’ll try but mehn……….. d doc does things to a woman that…..(sealed lips). Chai! see stalking @ ATL’s finest. @colour purple- don’t blame ATL’s finest; the doc can do that to a person. the babe just dey see UBA Bank sha. @ asgrl- faceless women you say” my dear you’d be amazed to know how far some babes can go to get a dude esp. one this “fiiiiinnnneeee”.

  27. Modella

    September 9, 2014 at 3:33 pm

    The quest to get hook is real…Thirsty girls!!!

  28. dd

    September 10, 2014 at 1:43 am

    Oh zip it darling. Dont come here acting lil miss perfect. Its ur kind dat hav inderiority complex

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