No, a TB skin test is not always positive. The interpretation of a tuberculin skin test (TST), such as the Mantoux Test, depends on various factors, including the person's risk factors, clinical presentation, and local guidelines. A positive result indicates exposure to the tuberculosis (TB) bacteria and the development of a delayed-type hypersensitivity response, resulting in a significant induration at the test site. However, certain factors can affect the test's accuracy, leading to false-negative or false-positive results. Factors such as recent TB infection (too soon after exposure), certain medical conditions, weakened immune systems, or prior BCG vaccination can impact the test results. Therefore, a negative TB skin test does not always rule out TB infection, especially in individuals with high-risk factors or suspected exposure. It is important to interpret the test results in the context of an individual's clinical history and consult with healthcare professionals for accurate assessment and appropriate follow-up actions if necessary.