prep pre-treatment test kit

This test can be used by anyone who is intending to take PrEP (Pre- Exposure Prophylaxis). PrEP is used by HIV negative people to prevent them from becoming HIV positive.

It is very important to have an HIV test before you start PrEP as it can only be used if you are HIV negative. If you take PrEP without being tested and find out later that you are HIV positive then you could develop resistance to the drugs that you will need for successful treatment.

The HIV test is 99.8% accurate 45 days after potential exposure.

It’s also important to check your kidney function before you start talking PrEP and every 12 months thereafter.

It’s important to know if you have Hepatitis B before you start PrEP as, although you can still take PrEP, it needs to be used more carefully and medical advice and monitoring is needed especially if you decide to stop taking it.

You will need to produce a small blood sample using a sterile lancet that is enclosed within the test kit. The lancet pricks the side of your little finger and you massage a small blood sample into the collection tube. Full instructions are supplied with the kit. There is a pre-paid addressed envelope for your sample that can be posted in any post box.

We will send your test kit in discreet packaging with no mention of the contents or who it’s from. Your parcel will be delivered, by our carrier DPD, in a very convenient 1 hour delivery slot or you can divert it to 1 of 2,500 pickup shops.
If you order before 4pm we will send out your test kit the same day for free tracked delivery the next working day. If you order after 4pm it will be processed the next working day.

If you order on a Friday before 4pm you can upgrade your delivery, for a small premium of only £4, to a Saturday or Sunday tracked delivery.

The HIV test that we use is a 5th Generation test. This is the first commercial screening assay to be able to distinguish between HIV-1 antibodies, HIV-2 antibodies and HIV-1 p24 antigen.

In addition to the early detection offered by 4th generation assays, this 5th generation assay provides more information by specifically identifying HIV-1 or HIV-2 and allows results of antigen and antibody detection to be reported individually. Because antigens and antibodies are detectable at different stages of the infection, reporting of both helps to differentiate between acute and established HIV infection.

HIV lives in the blood and some body fluids. To get HIV, one of those fluids from someone with HIV has to get into your blood. The body fluids that contain enough HIV to infect someone are:-

• blood, including menstrual blood
• semen
• vaginal fluids
• breast milk
• lining inside the anus

Other body fluids, like saliva, sweat or urine don’t contain enough of the virus to infect another person.

Most people diagnosed with HIV in the UK acquire the virus through unprotected vaginal and anal sex. It’s also possible to catch HIV through unprotected oral sex but the risk is much lower and so it’s very rare.

Other ways of getting HIV include sharing needles, syringes and other injecting equipment. Also, sharing sex toys with someone infected with HIV.  It can be passed from mother to baby before or during birth or by breastfeeding but thanks to antenatal screening programmes, most pregnant women find out about their HIV status.  If necessary they can receive HIV medication and so now, hardly any babies are born with HIV in the UK.

If you think that you may have contracted HIV in the last 72 hours then please visit your local sexual health clinic or A&E department of a hospital immediately. This is very important as you can be offered post exposure prophylaxis (PEP). PEP is a treatment that can prevent HIV infection after the virus has entered a person's body.

To help you work out if PEP is appropriate for you or someone you’ve had sex with you can call THT(Terrence Higgins Trust) Direct on 0808 802 1221

The liver is a large organ on the right hand side of your body. It has many important functions including turning food into energy and filtering toxins- including alcohol and medicines.

Hepatitis means ‘inflammation of the liver’ - this can happen because of a viral infection or because of exposure to alcohol. Hepatitis B is caused by a virus that infects the liver.

Hepatitis B, sometimes called hep B or HBV, is a virus carried in the blood and body fluids which infects and damages the liver and is the most widespread form of hepatitis worldwide.

Even a tiny amount of blood from someone who has the virus can pass on the infection if it gets into your bloodstream, through an open wound, a cut or scratch, or from a contaminated needle. Hepatitis B is very infectious, 50 – 100 times more infectious than HIV. The virus is able to survive outside the body for at least a week which means objects and surfaces contaminated with dried blood also can pose a risk.

It often doesn't cause any obvious symptoms in adults and typically passes in a few months without treatment and therefore many may be unaware that they are infected.

A simple blood test can detect if you are infected with the hepatitis B virus.

This test detects a protein on the surface of the virus called hepatitis B surface antigen (HbsAg). If you are found to be infected (if you are HBsAg-positive) then other tests can be done, by your GP, to check on the severity of infection, liver inflammation and damage to the liver.

Patients who have hepatitis B are often unaware of the infection as, in many cases, they don’t have any symptoms. If the infection persists for more than six months it is considered chronic. Chronic hepatitis B can cause complications such as liver damage.

Some people may only have a mild illness and feel they are not ill enough to see a doctor. There are many general symptoms, some of which may be confused with flu.

A few people develop a serious illness and need to be looked after in hospital. More severe symptoms may include:
• diarrhoea
• pale bowel motions
• dark urine
• jaundice (yellowing of the skin and eyes)

Hepatitis B is less common in the UK than other parts of the world, but certain groups are at an increased risk.
This includes people originally from high-risk countries*, people who inject drugs and share needles and other drug equipment, such as spoons and filters. It can be spread by people who have oral, vaginal or anal sex with an infected person without using a condom  or rimming. The virus can be passed on by having a tattoo, body piercing, medical or dental treatment in an unhygienic environment with unsterilized equipment . You are also at risk if you share razors, toothbrushes, nail scissors, hair clippers and tweezers because traces of blood on them can pass on hepatitis B.

*Hepatitis B is found throughout the world, but is particularly common in:
Sub-Saharan Africa
East and southeast Asia
the Pacific Islands
parts of South America
Southern parts of Eastern and Central Europe
the Middle East
the Indian subcontinent

Most new cases of Hepatitis B in the UK occur in people who caught the infection in one of these areas before moving to the UK.

Post-exposure prevention

If you are not immunised and have been exposed to the virus you should see a doctor or visit your local sexual health clinic or A&E department of a hospital immediately. (For example, if you are a healthcare worker and you have a "needlestick" injury.) You can be given an injection of antibodies called immunoglobulin as well as starting a course of immunisation. This may prevent the infection from developing.

Creatinine is a waste product that is produced continuously during normal muscle breakdown. The kidneys filter creatinine from the blood into the urine, and reabsorb almost none of it.

The level of creatinine in the blood is an indicator of kidney function. If the kidneys become impaired for any reason, the creatinine level in the blood will rise due to poor clearance of creatinine by the kidneys. Doctors use creatinine levels to check renal function (kidney function).

Women usually have a lower creatinine level than men. This is because women usually have less muscle mass than men. Creatinine level varies based on a person's size and muscle mass.

You will receive a serum creatinine in umol/l  from  The Doctors Lab, where your blood sample is sent to, from which we will work out your eGFR (estimated Glomerlular Filtration rate).

Normal eGFR is a value greater than 60mL/min/1.73m2

An increase in blood creatinine can be due to increased ingestion of cooked meat (which contains creatinine converted from creatine by the heat from cooking) and so you should avoid eating high amounts of meat (eight ounces) within 24 hours of testing.

Intense exercise can increase creatinine by increasing muscle breakdown and so you should avoid doing strenuous exercise two days before testing.

Also, excessive intake of protein and creatinine supplements, taken to enhance athletic performance, can increase blood creatinine levels as can certain medications.

Your parcel will be delivered in plain packaging with no mention of the contents or who it’s from.

Your test result will be completely confidential and we will not inform anyone, including your GP, that you have used our service unless you ask us to.

Although HIV can be detected 45 days after potential exposure to the virus it can take, on average,  up to 12 weeks for Hepatitis B to be detected in a sexual health screen.

If you do this test before 12 weeks have passed since you had contact with an infected person, you should confirm any negative results at a later date by repeating the test.

Your test result usually arrives within 2-3 days of the lab receiving your blood sample. You will receive a message via your chosen method, text or an email, from us asking you to log into your secure account to access your result.

1) For HIV the test will give you 1 of 2 results :-
i) “Undetected” means that there is no HIV detected in your blood sample. You do not need to take any further action unless you have been exposed to HIV since taking the sample. 
ii) “Reactive” means that there is a possibility that you have HIV. It doesn’t mean that you are definitely positive for HIV as the test has a small margin of error as it can react with cold or flu viruses within your body. You will need a confirmation venous blood test to determine if you are HIV positive. This test can be done at a sexual health clinic. We can signpost you to your nearest sexual health clinic and our doctors will be available with help and advice so that you can find specialist care in your area and local support groups.

2) For Hep B :- the test will indicate whether you are “positive” or “negative” for Hepatitis B.

3) For kidney function :-  you will receive a serum creatinine in umol/l  from which we will work out your eGFR (estimated Glomerular Filtration Rate) which is an indication of your kidney function.
Normal kidney function has a value for eGFR greater than 60mL/min/1.73m2

There are two other tests that you should be doing if you are taking PrEP.

1)HIV Test Kit
Once you have started to take PrEP you should have an HIV test and a urine protein dipstick test every 3-4 months.

This will check if you are still HIV negative and if the PrEP is having an adverse effect on your kidney function. If the dipstick test detects any protein in your urine then it’s a sign that your kidneys might be affected by taking PrEP and you should make an appointment with your GP or other healthcare provider or attend a local sexual health clinic. They will perform further tests that are able to determine your kidney function more accurately.
You can buy a urine protein dipstick test kit at your local pharmacy.

2) PrEP Annual Test Kit
Every 12 months you should have an HIV and kidney function test.
This will check that you are still HIV negative and is more accurate at determining your kidney function than a urine protein dipstick test.

Counselling and emotional support from THT:-http://www.tht.org.uk/sexual-health/Clinics-and-Services/Browse-For-Services/Counselling-services/Counselling-and-emotional-support