Comprehensive Guide to HIV Testing

What is HIV Antibody Testing?
Why Should I Be Tested for HIV? - The Benefits of Knowing
How Is HIV Spread?
Who Should Be Tested for HIV?
When Should I Be Tested for HIV?
What About My Privacy? Confidential or Anonymous.
Where Can I Get Tested for HIV?
I've Taken the Test. What Happens Now?
What Do My HIV Test Results Mean?
Should I Take the HIV Test Again?

What is HIV Antibody Testing?

HIV testing determines whether or not you are infected with the Human Immunodeficiency Virus (HIV). This virus destroys the body's ability to fight off illness, and is the cause of AIDS (Acquired Immune Deficiency Syndrome).

HIV testing tells you if you are infected with the Human Immunodeficiency Virus (HIV) which causes AIDS. These tests look for "antibodies" to HIV. Antibodies are proteins produced by the immune system to fight a specific germ.

Other "HIV" tests are used when people already know that they are infected with HIV. These help measure how quickly the virus is multiplying (a viral load test) or the health of your immune system (a T-cell test). For more information, see Fact Sheet 124 (T-cell Tests), and Fact Sheet 125 (Viral Load Tests).

Why Should I Be Tested? - The Benefits of Knowing

• Immune system monitoring and early treatment can greatly improve your long term health.
• Knowing you are positive may help you change behaviors that would put yourself and others at risk.
• You will know whether or not you can infect others.
• Women and their partners considering pregnancy can take advantage of treatments that potentially prevent transmission of HIV to the baby.
• If you test negative, you may feel less anxious after testing.

courtesy of San Francisco AIDS Foundation

How Is HIV Spread?

• Anal, vaginal, or oral sex without a condom. If you have another sexually transmitted disease, your chances of contracting HIV during sex are much higher.
• Direct blood or mucous membrane contact with an infected person's blood.
• From an infected mother to her child, during pregnancy, birth, or breastfeeding.
• Sharing needles or equipment for drug use.

Who Should Be Tested?

Testing is recommended if:

• You think you may have been exposed to the HIV. If you're not sure, take this anonymous survey.
• You are sexually active (3 or more sexual partners in the last 12 months)
• You received a blood transfusion between 1977 and 1985, or a sexual partner received a transfusion and later tested positive for HIV.
• You are uncertain about your sexual partner's risk behaviors.
• You are a male who has had sex with another male at any time since 1977.
• Any of your male sexual partners has had sex with another male since 1977.
• You have used street drugs by injection since 1977, especially when sharing needles and/or other equipment.
• You have a sexually transmitted disease (STD), including pelvic inflammatory disease (PID).
• You are a health care worker with direct exposure to blood on the job.
• You are pregnant. There are now treatments that can greatly reduce the risk that a pregnant woman who has HIV will give the virus to her baby.
• You are a woman who wants to make sure you are not infected with HIV before getting pregnant.

Even if you have no risk factors for HIV infection, you may still want to get tested to ease your own mind. This also encourages everyone to be more responsible about HIV transmission.

When Should I Be Tested?

After a possible HIV exposure:

An HIV test will not detect the presence of the HIV virus immediately after exposure. Statistics show that 96% (perhaps higher) of all infected individuals will test positive within 2 to 12 weeks. In some cases, this may take up to six months.

Think about this: if you got a negative HIV test at six weeks, would you believe it? Would it make you less anxious? If so, go for it. But to be certain, you will need to be tested again for HIV at six months.

Periodic HIV Testing:

• Many people continue to engage in some degree of risky behavior, and choose to be tested for HIV periodically (every six months, every year, or every other year.)

  Since the window period for developing a positive test result can be as long as six months, it would rarely make sense to be tested more often than this.

  There are clear benefits to early medical attention for infection with the HIV virus. There is little agreement on how early this must be. But if you wait longer than two years, treatment of the disease may be less effective.

• If you are beyond the six month window period from a possible HIV transmission event and were reported HIV negative by an accurate HIV test (and you are not subsequently put at risk for HIV), you can consider yourself HIV negative. There is no need to retest. However if it eases your anxiety, you may wish to take the test again periodically.

What About My Privacy? Confidential or Anonymous.

Anonymous testing means that absolutely no one has access to your test results since your name is never recorded at the test site. Confidential testing sometimes means identifying yourself in some manner to the test site, with their assurance that this information will remain private.

Anonymous test sites are highly recommended because:

• The quality of the education and counseling that is provided is very good.
• The testing is usually free.
• The testing is reliable and automatically includes confirming tests.
• It protects you from risks of discrimination or adverse impact, especially in applications for insurance.
• Sometimes even taking an HIV test, regardless of the result, might cause an insurance application to be refused.

Anonymous HIV testing sites never give written results. Some sites who do anonymous testing also do confidential testing, which may also include written results. At least 11 states do not currently provide anonymous testing.

Where Can I Get Tested for HIV?

You can arrange for HIV testing at an established testing center, or at your doctor's office. Test results are usually available within one to two weeks. Home test kits allow you to mail in a sample, and receive your results sometime later via telephone.

HIV Testing Centers

Click here for NATIONAL HIV TESTING LOCATIONS

If you would like to talk to someone and have any questions, you can contact the

CDC National AIDS Hotline
at (800) 342-2437 (24 hrs/day, 365 days/year)

Home HIV Testing - Is It For Me?

Problems with Home Testing

• Getting test results over the phone can be very difficult, especially if the test is positive. A person can just hang up and never hear all the counseling and information they need to hear. Test counseling is best done face-to-face, and is most effective this way.
• If someone sees you purchase the test, finds the packaging in the garbage, or sees your test ID card, then your confidentiality may be compromised.
• Home testing is more expensive than going to the local health department. Testing through local health departments, and some private agencies, is free or low-cost. Home HIV test kits can cost up to $50.
• Another issue to be dealt with is confidentiality. If a person buys a home test kit in a store, everyone in the store will know that the person is taking an HIV test. Another option would be to purchase the kits by phone or through the Internet.
• When you order the tests (by phone or via the Internet), you must give your name and address. When you order by credit card, the charge for the test will appear on your credit card statement. Although your name is not linked to your test results, people who see your credit card statement may find out that you're being tested.
• When taking a test at home, after you're finished taking the test, all the packaging from the kit has to be well hidden in the garbage. If a garbage man empties your garbage and sees the test kit packaging, they'll know you took an HIV test. Also, if your garbage gets ripped open by animals, or if the garbage can gets blown open by the wind (and gets blown all over your neighborhood), your neighbors can also know you've been tested. So for people taking the home test, I say "hide your garbage!"
• In a home HIV test kit, a person has a test ID card that is used to identify the specimen by number. Anyone who has the number can get the test result over the phone. The person who is being tested has to make sure that nobody else sees the card. Otherwise, any person who sees the card or the number can get that other person's test results. So it's important that a person getting tested at home doesn't leave the ID number lying around the house, where other members of the household can see it. This differs dramatically from testing through the health department. To ensure confidentiality, health departments will usually not give test results over the phone or by mail. Test results through the health department are usually given in person.
• Getting test results over the phone can be hard to deal with, especially if the HIV test is positive. A person can just hang up and never hear all the counseling and information they need to hear. For this reason HIV test counseling is best done face-to-face and is most effective this way.
• Using HIV home testing, if a person is positive, there is no way to do partner notification (anonymously helping a person's sex/needle-sharing partners know they've been exposed). Partner notification is routinely done by local health departments around the country for HIV and other STDs. Home testing bypasses this important, and proven, preventive health measure.
• There are presently two home HIV testing companies that have received FDA approval for these types of tests, Home Access, and Confide, which is no longer on the market. Unfortunately I recently discovered at least three other companies that are selling home HIV tests that have not been approved by the FDA. The three companies I found were all advertising via the Internet. Beware of these unapproved kits and only use Home Access for now. (For more information, look at The Body.com section on HIV Testing.)

What Home HIV Test Should I Buy?

Be sure you get an FDA approved home HIV test kit, such as "Home Access." Other tests are available, and some have been shown to be inaccurate. These are available over-the-counter at most drug stores. more from Federal Trade Commission

The FTC recently tested HIV kits advertised and sold on the Internet for self diagnosis at home. In every case, the kits showed a negative result when used on a known HIV-positive sample - that is, when they should have shown a positive result. Using one of these kits could give a person who might be infected with HIV the false impression that he or she is not infected.

I've Taken the Test. What Happens Now?

• Depending on the test you take, you may have to wait a week or more obtain your results.
• If you can, take a friend with you to pick up your results - especially if this is your first test or if it has been a long time since you last tested. They may be a source of comfort for you if your results are positive. If not, the two of you can celebrate together.
• Some more recently developed tests can provide you with your results within an hour. Occasionally these tests can be inconclusive, and you must still wait one or two weeks for the final result.

What Do My HIV Test Results Mean?

A negative HIV test result means:

• If you have not engaged in any risky behaviors for the last 6 months, you are not currently infected with HIV. If you have had unprotected sex or shared needles or have other risk factors in the last 6 months, you should be tested again. You could still be HIV positive, and pass the HIV on to other people, even though your test is negative.
• A negative test does not mean that you are immune to HIV.
• Some people who have a negative test may be tempted to continue risk behaviors, believing "It can't happen to me." If you continue unsafe behaviors, you are still at risk.

A positive HIV test result means:

• You are infected with the HIV virus. This does not necessarily mean that you have AIDS.
• A person with HIV is infected for life. He or she can pass the virus to others by having unprotected sex, or by sharing drug use needles or equipment. To protect yourself and others, you need to avoid doing these things. A woman who has HIV can pass it on to her unborn or breast feeding baby. Those carrying the HIV virus should not donate blood, plasma, semen, body organs, or other tissue.
• You should choose a doctor to monitor the progression of HIV in your body, and advise you on when it is appropriate to begin treatment. There are differing opinions about how early to begin treatment, but it's clearly much better to begin treatment long before symptoms of AIDS develop. The only way you can tell when to begin treatment is by having a doctor interpret additional tests. You may wish to change to a doctor that specializes in HIV care.
• If your HIV test is positive, your sexual partners and anyone with whom you have shared drug injection equipment may also be infected. They should be told they have been exposed to HIV and advised to seek HIV counseling and antibody testing. You can tell them yourself, work with your doctor, or ask for help from the local health department. Health departments do not reveal your name to sexual or drug-use partners, only the fact that they have been exposed to HIV.

Should I Take the HIV Test Again?

Periodic testing has the following benefits:

• It takes up to 6 months for the HIV virus to be detected. If you have tested before this time has passed, you should test again to allow for this.
• Always knowing your HIV status may empower you to continue doing the right things.
• May give you an increased peace of mind in knowing you are negative.
• If you should become positive, you will know at the earlier possible moment and will have more treatment options available to you than if you learn about this later.

An Ounce of Prevention is Worth a Pound Of Cure.