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Diagnostics & Testing

HIV Testing

What is HIV?

HIV is the abbreviation for human immunodeficiency virus, the virus that causes acquired immune deficiency syndrome (AIDS). The virus weakens a person's ability to fight infections and cancers. A person can get HIV by coming into contact with an infected person's body fluids (blood, semen, vaginal fluids, breast milk). HIV can be spread through:

  • Vaginal, oral, or anal sex
  • Sharing unclean needles to take drugs
  • Pregnancy (from mother to baby)
  • Blood transfusions (Since 1985, blood donations have been routinely tested for HIV, so infection from blood transfusions is now rare.)

You cannot get HIV from:

  • Touching or hugging someone who has HIV or AIDS
  • Public bathrooms or swimming pools
  • Sharing cups, utensils, telephones or other personal items
  • Bug bites

How do I get an HIV test?

Your doctor can order a simple blood test to see if you have been infected with HIV. The test looks for HIV antibodies in your blood as well as the presence of the virus itself. These antibodies are substances that the body makes in response to the HIV infection.

A small sample of your blood is drawn and sent to the laboratory for testing. If the first test (preliminary test) shows signs of HIV, the sample will be tested again (confirmatory test). HIV infection is only confirmed after the sample of blood has been tested at least two times.

What is the difference between the various HIV tests?

There are a few different types of HIV tests. In the past, screening for HIV was done through detection of antibodies only (called third-generation assays). Newer tests look for both antibodies and the virus itself (called combination or fourth generation assays). The newer tests are better able to find infection earlier, when antibodies may not yet be seen.

Antibody-only tests still have the advantage of being widely available and can often be done more rapidly in an office or a community lab.

Home-based testing is available. The sample can be obtained via oral secretions (saliva), or a blood sample from a finger-stick test strip that is then mailed to a laboratory for screening. These tests tend to be very accurate. However, positive results must be confirmed by your doctor before a diagnosis of HIV infection can be established.

Do I have to take the test?

No. HIV testing is voluntary. Anyone is free to decline testing. Your decision whether to get tested, or the test result itself, will not prevent you from getting health care. Multiple national guidelines recommend routine voluntary HIV screening of all patients aged 18 to 75 years of age as a normal part of medical care. There are no longer any requirements for signed consent or additional counseling prior to obtaining the test. The reason for these recommendations is that nearly one out of five people infected with HIV are not aware that they have the infection.

However, there are many good reasons to get tested:

  • If you are pregnant and are HIV positive, it is critical that you take medications to help protect your unborn baby from becoming infected.
  • If HIV infection is found, your health care provider can provide more appropriate care. You can also learn ways to stay healthy longer.
  • HIV testing helps prevent the spread of HIV.

What does the test result mean?

Positive test result: A confirmed, positive test result means you have been infected with HIV. Being infected with HIV does not necessarily mean that you have AIDS. It can take many years for people with HIV to develop AIDS.

Negative rest result: A negative test result means that no signs of HIV infection were found in your blood. A negative test does not always mean that you do not have HIV. Signs of HIV may not show up in the blood for several months after infection. For this reason, you should be tested again if you have been exposed to HIV or are at risk for HIV infection.

What happens to my test results?

Your test results become part of your medical record. Therefore, the results could be disclosed to third-party payers (such as medical insurance companies) and other authorized parties. A positive test result will also be reported to the appropriate health department.

Can my test results be kept confidential?

Yes. Though HIV tests performed become part of the patient's medical record, there are places you can go that provide confidential HIV testing. These places will perform HIV tests without even taking your name (anonymous testing). An anonymous HIV test does not become part of your medical record. For more information on anonymous testing, call the Ohio AIDS hotline at 1.800.332.AIDS.

If you discover that you have HIV, inform your medical provider so that you can receive proper care.


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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 4/14/2015...#4849.