Counselling and testing

Should I be tested for HIV?

Yes. In a world with HIV, it is important to get tested, as this is the only way to know your status. If you test positive for HIV, you can take the necessary measures to adapt your lifestyle while your doctor monitors your health so that you begin therapy when it will be most effective. If you test negative, the result might help to reduce anxiety and provide an opportunity to personalize your own HIV-prevention plan with a trained counsellor. Remember that HIV prevention is a life-long undertaking and that you should be tested regularly for HIV if there is any possibility you may have been exposed.

The UN system does not require you to be tested for HIV, although the UN Medical Services encourage all staff members to know their HIV status. It is highly recommended that all family members who are sexually active or who may have been exposed to HIV in other ways get tested as well. As UN system personnel, you are not required to disclose your HIV status to a supervisor or any other co-worker.

The online UN Cares Services Directory on HIV provides a list of reliable sources of HIV counselling and testing at your duty station; you might also ask the UN Medical Services or any UN designated physician at your duty station. Going to one of these recommended testing facilities will ensure that you receive the appropriate counselling and information. Self-testing is not recommended.

I really don't think I'm at risk of being infected with HIV. If I'm not at risk, why should I be tested?

Only you can assess your risk of infection. Studies among people living with HIV, however, consistently show that a large share of people living with HIV were unaware of their risk prior to their diagnosis. Knowing your HIV status is an important way of protecting and maintaining your health.

I'm afraid to be tested for HIV. I know that if I test positive, I'll be upset.

Getting tested for HIV can be scary. Whenever possible, choose a testing facility where a trained counsellor is available to provide you with support and to answer any questions before the test and when you receive your results.

We should all know our HIV status. Being tested can help reduce anxiety and allows us to create a personal HIV-prevention plan with a trained counsellor.

We have learned a lot from UN colleagues who have found out they are living with HIV. When they were tested they say they were scared, and were upset upon learning that they have HIV. However, they also tell us that they have learned to live with the results and are able to thrive, because now they have the information they need to protect their families and to care for themselves. It is often useful for couples to go to HIV counselling and testing together.

Depending on the level of your anxiety about receiving your test results, you might consider having a friend or loved one on standby to talk to. While your post-test counsellor will be available to calm your fears and offer you relevant information, it also helps to have a support network to help you work through your emotions.

How long after possible exposure should I wait to be tested for HIV?

It is recommended that you get tested for HIV immediately after potential exposure. This first test will serve as a baseline. If you knew you were negative before the possible exposure, a positive result will be an indication that you already have been exposed since your last test. If the test is negative, it does not mean that you have not been exposed. You will need to wait three months for a second test for HIV.

Although HIV antibody tests are very sensitive, there is a 'window period' of 3 to 12 weeks, which is the period between infection with HIV and the appearance of detectable antibodies to the virus. In the case of the most sensitive HIV tests currently recommended, the window period is about three weeks. This period may be longer if less-sensitive tests are used.

During the window period, people infected with HIV have no antibodies in their blood that can be detected by an HIV test. However, the person does have very high levels of HIV in body fluids such as blood, semen, vaginal fluids and breast milk. HIV can be passed on to another person much more readily during the window period even though an HIV test may not show that you are infected with HIV.

I'm afraid that if I test HIV-positive, I'll be alone. Is that true?

No. None of us need to be alone if we test HIV-positive. Millions of people throughout the world are living with HIV. HIV infection does, though, present some important challenges. If you test HIV-positive you should think about contacting a local AIDS service organization or the UN HIV focal point in your country to obtain information about a support group to join. You may also consider referring to the UN Cares Services Directory on HIV for more information. An increasing number of workplaces have their own support groups. By sharing our experiences with other people living with the virus, we can reduce our anxieties, learn new strategies for coping with HIV infection, and build new friendships with people who are facing similar challenges. Information about UN Plus, the UN System HIV-Positive Staff Group, can be found online at www.unplus.org.

If you would like to speak confidentially to a UN HIV counsellor outside your duty station, you may contact the UN staff counsellor's office in New York at +1-212-963-4782 or send an email with your phone number to HIVadvice@uncares.org and a counsellor can call you back.

If I test positive for HIV, what should I do?

First of all, try to listen carefully to what the counsellor from the testing centre is telling you. He or she will provide you with important information about the next steps, where to get medical care and where to seek support. If you forget something or are simply overwhelmed, call and ask to talk to the counsellor again. Many people find it difficult to retain the information the first time around because they cannot concentrate.

See a medical doctor who specializes in HIV to obtain a second HIV test in order to confirm the result of the first and, if the result is confirmed positive, start your medical care plan. If you are worried that you may have exposed someone to HIV through unprotected sex, your counsellor or doctor can help you with approaches you may take to encourage them to get tested for HIV. You should always practise safer sex. If you familiarize yourself with various issues around HIV you will become a more competent partner to your medical doctor with regards to maintaining your health.

If I test HIV-positive, do I have to tell anyone at work? I'm afraid I might be discriminated against or mistreated. Whom do I tell and how?

No one living with HIV is required to disclose his or her status. For those of us living with HIV, it can be difficult to decide if, or when, to tell another person, especially a colleague or supervisor. It is natural to worry about being rejected by family, friends, neighbours or colleagues. Discrimination against people living with HIV remains all too common, so those of us who are HIV-positive should think about who we can trust with this information.

Although as personnel of the UN system we will never be made to disclose our HIV status, there may be advantages in sharing this information with a trusted supervisor or other colleagues, such as human resource professionals or the UN system physicians. There are also things that you should keep in mind as a UN employee, such as the fact that your contract and terms of employment should be the same as they would be if you were not living with HIV, and that you ought to have the same opportunities for advancement and mobility. Disclosing your status may make it easier to be open and honest about why you may need to take time off for medical care, or why you may need to work on a flexible schedule. Should you decide to disclose your status to your managers and/or colleagues, they will be better able to address the matter if it comes up. Some people find that in the long run keeping their HIV status a secret can cause stress and anxiety. In the end, though, whether or not you disclose your status is your decision.

Will the UN continue to allow me to work if I test HIV-positive?

Yes. UN staff members cannot be fired, demoted, or denied a promotion or assignment solely on the basis of HIV infection. Most people living with HIV are fully capable of continuing to work-whether within or outside the UN system. In the UN system, fitness to perform the required duties is the sole medical requirement for employment.

When you are placed in a new position in the UN or sent on mission, the UN Medical Services conduct a medical exam to determine your physical fitness for the assignment. Keep in mind that the UN Medical Services do not automatically test for HIV, either for medical clearance or for periodic medical check-ups. Depending on the nature of the assignment, its location, and the state of your own health, the UN Medical Services might decline to certify you as being fit for a particular job. In all such cases, qualified medical staff will make this determination only after an individualized assessment of your health situation; no blanket exclusion of people with HIV is allowed for jobs in the UN. It may be in your own interest to reveal your status to the medical services if you are being transferred to a duty station which may not have good medical services or a good supply of the medicines for treating HIV. If a medical clearance is withheld for a new assignment, the UN Medical Services will not disclose to your supervisor or your colleagues the nature of any health condition revealed or detected during a medical examination, or reveal why you are not being cleared for a specific duty station or assignment. Should you decide to disclose your HIV status to them, the UN Medical Services will closely guard the confidentiality of this information, as it does all personal medical information, including your HIV status.

If, at any time, you have difficulties in performing your job as a result of HIV infection, the UN system will work with you to adjust your work situation so that you can continue to be employed by the UN system as long as your health situation allows you to actively contribute to the organization's mandate.

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