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How to get tested for HIV

At home, in the clinic, with a swab or a blood test, there are many ways you can find out your HIV status.

by Meera Shah, MD, MS, AAHIVS

Getting tested for HIV is a standard part of health care for U.S. adults. The Centers for Disease Control and Prevention (CDC) recommend that all people between ages 13 and 64 be tested at least once. Your health care provider may recommend testing more often depending on your personal risks. The good news is that there are lots of options for getting tested—including free tests, anonymous tests, and home test kits. Here are the details.

When to test for HIV

You can test for HIV any time, and the test you use will mostly depend on when you may have been exposed to HIV. Tests have different levels of accuracy because they look for different markers of HIV, and each marker becomes measurable at a different time. The most common HIV tests look for the body’s reaction to the virus, called an antibody. When the body first encounters the HIV virus, it may take up to 3 months to produce enough antibodies to measure with one of these tests. Other tests look for an antigen—a protein that’s part of the HIV virus—or for the virus itself. These tests can accurately determine your status within a few weeks of a possible exposure to HIV.

Ways to test for HIV

You can get tested at a clinic or use a home test. In both cases, there’s more than one option. All HIV tests are confidential, meaning that your results will not be shared with anyone other than you and your health care provider. Some tests go even further and are anonymous, meaning that your name and other identifying information are not linked to the test at all.

Testing at a clinic

Getting tested in a clinic can be quick, and some clinics offer free and/or anonymous testing. (Call ahead to find out.) There are also trained providers there to tell you the results and connect you with any other services you may need.

Rapid test

This test uses blood from a finger prick or a swab from the mouth to look for HIV antibodies. Results are usually available in about 20-30 minutes.

If the rapid test is negative…

… and it has been more than 3 months since your last possible exposure, you can be nearly certain that you are HIV-negative.

… and it has been less than 3 months since your last possible exposure, your health care provider may recommend screening again later or doing a different blood test.

If the rapid test is positive…

… your provider will likely confirm the test by sending a blood sample to a lab for a second test.

Antigen/antibody test

This test uses blood collected from a vein to look for both antibodies and antigens. The results are usually available within a few days. While it takes a bit longer than a rapid test, the benefit of this lab test is that it can detect HIV infection as little as 2-3 weeks after exposure.

If the antigen/antibody test is negative…

… and it has been more than 2-3 weeks since your last possible exposure, you can be nearly certain that you are HIV-negative.

… and it has been less than 2-3 weeks, your provider may recommend screening again later or doing a viral load test.

If the antigen/antibody test is positive…

… the lab may do a second test using the same blood sample to determine which type of HIV they detected. If this second test is positive, it’s considered a confirmation that you are HIV-positive.

Viral load test

Your provider may recommend using a viral load test if you have a high personal risk, your exposure was recent, or you have symptoms of a recent HIV infection (like fever, sore throat, or rash). This test is done in conjunction with the antigen/antibody test. It uses blood collected from a vein to look for the virus itself. The result is usually available within a few days to a week. The benefit of this test is that it can detect HIV 8 to 12 days after exposure.

If the viral load test is negative…

… and it has been more than 8-12 days since your last possible exposure, you can be nearly certain that you are HIV-negative.

If the viral load test is positive…

… and with a very low viral count, it may be a false positive and should be repeated.

… and with a high viral count (even if the antigen/antibody test is negative), this is considered a presumptive positive HIV test and the test should be repeated along with the antigen/antibody test for confirmation.

Testing at home

If privacy is a concern, or if it’s difficult for you to make it to a clinic, testing at home is an option. You may be able to buy these tests at your local drug store; you can definitely order them online. FYI, they are often more expensive than getting tested at a clinic.

Home Access HIV-1 test

This test uses blood from a finger prick to look for HIV antibodies. You put your sample in a postage-paid envelope and send it to a lab. You use a code number to call the lab and get your anonymous results within 7 business days.

If the Home Access HIV-1 test is positive…

… the company automatically does a second test to confirm this result using the same blood sample. When they send the result, they include information about the nearest health care provider who can counsel you and care for your health.

OraQuick in-Home HIV test

This test uses a mouth swab to look for HIV antibodies. You collect the swab yourself and get the results in your home, so it’s totally anonymous. Results are ready in about 20 minutes. Because antibodies are at lower levels in saliva, it may take longer than 3 months after exposure for this test to be accurate.

If the OraQuick test is positive…

… call OraQuick’s anonymous hotline to find a provider near you who can confirm with another test.

If the OraQuick or Home Access HIV-1 tests are negative…

… and it has been more than 3 months since your last possible exposure, you can be nearly certain that you are HIV-negative.

… and it has been less than 3 months, consider testing again after 3 months have passed, or talk to a health care provider about other testing options.

With so many options for HIV testing, it may help to discuss them with your provider. Whatever kind of test is best for you, it’s important to know your status in order to keep yourself and others healthy! Keep reading if you want to learn more about preventing HIV, living with HIV, or what we know about HIV and birth control.

Meera Shah, MD, MS, AAHIVS, is a family physician working at Callen-Lorde Community Health Center in New York City. She specializes in women’s health and HIV and transgender care. In her free time, she enjoys reading and traveling to new parts of the world.

read more about: how-to, stis, health, hiv, provider perspective

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