HIV Testing

Overview

What is HIV?

HIV, short for human immunodeficiency virus, is a sexually transmitted disease (STD). This virus attacks a person’s immune system, which fights infections. After some time, the virus damages the immune system enough to make it very difficult to fight illnesses.

A person living with HIV can develop acquired immune deficiency syndrome (AIDS), often after many years. Not everyone with HIV will get AIDS.

How do you get HIV?

HIV is a sexually transmitted infection. The most common way for someone to get it is through a sexual activity where you exchange bodily fluids. This activity includes vaginal, oral and anal sex. However, you can contract the virus in other ways, including:

  • Sharing needles with an infected person to take drugs.
  • Passing between a mother and her unborn child.
  • Rarely, from a blood transfusion (all blood donations get tested for HIV).

A lot of misinformation exists about how you can get HIV. You cannot contract HIV from:

  • Air or water.
  • Drinking fountains.
  • Silverware, dishes or drinking glasses.
  • Toilets.
  • Touch, such as shaking hands, hugging or social, closed-mouth kissing.
  • Pets or insects, such as mosquitoes and ticks.

Who gets HIV?

Anyone can get HIV. You can get this indiscriminate virus if you participate in risky behaviors, such as unprotected sex or sharing needles for drug use.

The most common way people get HIV is through male-to-male sexual contact. But heterosexual sex causes about one in four HIV infections.

How do I find out if I have HIV?

The only way you can find out for sure if you have HIV is through a test.

Some people have flu-like symptoms two to four weeks after infection with HIV. This phase is called acute HIV infection.

Is there a cure for HIV?

Researchers have not found a cure. Once you have HIV, you have it for life. But you can successfully manage HIV with proper treatment from a healthcare professional.

Can HIV be prevented?

The only sure way to prevent HIV is to abstain from sex (not have sex) and never share needles. If you’re sexually active, using condoms can prevent transmission of HIV and other STDs.

Test Details

Who should get tested for HIV?

Roughly one in seven Americans who have HIV don’t know they do. The U.S. Centers for Disease Control (CDC) recommends that everyone between the ages of 13 and 65 get tested at least once. If you are in a higher risk group, you should consider more frequent testing.

Even if you tested negative, you should get tested if you can answer “yes” to any of these questions about your activity since that test. Have you:

  • Had sex with another man (if you are a man)?
  • Had anal or vaginal sex with someone who is HIV-positive?
  • Had more than one sex partner?
  • Injected drugs with a shared needle?
  • Received another STI diagnosis?
  • Had sex with someone who could answer yes to any of these questions?

If you believe you may have had HIV exposure within the last 72 hours, talk to your healthcare provider. You may be able to get post-exposure prophylaxis (PEP) -- ie, medication. A PEP can prevent HIV when administered correctly. The sooner you begin to take it, the better, although it isn’t 100% effective.

What types of tests diagnose HIV?

To diagnose HIV, healthcare providers can order any of three tests:

  • Nucleic acid (NAT) test: The NAT test looks for the virus in your blood. It is a thorough laboratory test but can be costly. The results can take several days to receive.
  • Antigen/antibody test: This test looks for antibodies and antigens to HIV in your blood. Your immune system forms antibodies when it comes in contact with viruses, such as HIV. Antigens, however, are foreign substances that activate your immune system. HIV has a particular antigen that this test can find. This rapid test uses a drop of blood from a finger prick and can give you results in roughly 30 minutes.
  • HIV antibody test: This test is similar to the antigen/antibody test, but it only looks for the antibody. Just like the antigen/antibody test, this test produces results in around 30 minutes. It uses either a drop of blood from a finger prick or a swab of saliva.

Some states allow for home testing. There are two types of home tests:

  • Rapid self-test: The only rapid self-test available in the United States uses a saliva sample to check for infection. After you receive your kit, you swab your gums and use the test kit to get results.
  • Mail-in self-test: This test uses a blood sample from a simple finger prick. All of the supplies are in the kit to help you take the sample, package it and send it to the lab. A healthcare provider will tell you the results.

If your results are negative, you can safely say you do not have HIV if you haven’t had exposure in the last three months. If your test is positive, contact your healthcare provider as soon as possible for a follow-up visit.

How soon after exposure to HIV can tests detect I have the virus?

The window of time between exposure to HIV and when a test will show you have the virus varies from person to person and by the type of test:

  • Nucleic acid test (NAT): The NAT test can detect HIV infection the earliest. It can tell if you have HIV infection 10 to 33 days after exposure.
  • Antigen/antibody test: The antigen/antibody test can detect infection 18 to 45 days after exposure when performed by a lab using blood from a vein. If the sample is from a finger prick, the window is 18 to 90 days after exposure.
  • Antibody test: Antibody tests (most home tests and rapid tests) can detect infection 23 to 90 days after exposure.

If your initial test is negative, get a second test after the window of time has passed. The second test can confirm your negative result in case you got tested before the infection was active in your body.

Remember, post-exposure prophylaxis (PEP) can help prevent infection, but you must start it within 72 hours of possible infection. Talk to your healthcare provider about how to start PEP.

Results and Follow-Up

How long does it take to get results?

The speed of results depends on the test type. The NAT test can take several days to get results. Rapid tests, such as antigen/antibody and antibody tests, can produce results in as little as 20 minutes.

What happens if the test is positive?

If you receive a positive result, you will want to work with your healthcare provider on a treatment plan. Your healthcare provider will determine how far HIV has progressed and recommend medicines to help you manage it.

You will also want to talk about your diagnosis with your sexual partner. If you and your partner have had unprotected sex, you could have transmitted the virus to them. They should get tested, too.

What should I do if my test is negative?

If your test result is negative, you’ll probably breathe a big sigh of relief. But don’t let down your guard. It’s important to protect yourself in the future. Talk to your healthcare provider about whether PrEP (pre-exposure prophylaxis) is right for you. The PrEP daily pill can reduce your risk of getting HIV from sexual contact by 99%. For IV drug users, it lowers the risk by 74%. PrEP is very important if you are HIV negative and in a stable monogamous relationship with HIV positive partner.

Even if you take PrEP, it’s still smart to practice safer sex. Always use a condom to reduce your risk of getting HIV and other STDs.

Additional Details

Is HIV testing confidential?

If you test positive for HIV, your status becomes part of your private medical record and is protected by federal privacy laws. Your state may require your healthcare provider to report the infection to your state health department. State departments send results to the CDC without your personal identifiable information.

Some states have laws that require you or your healthcare provider to notify your partner of your HIV-positive status. In some states, if you don’t report your status to your partner, you can be charged with a crime.

You can choose anonymous testing. Anonymous tests don’t link the results to your information. The state health department still collects the statistics, but the results aren’t part of your medical record.

Does insurance cover HIV tests?

The Affordable Care Act requires health insurance companies to cover HIV tests at no cost to you. If you do not have health insurance, you can find a free testing site.

What support is available?

If you receive an HIV diagnosis, you can find help. Your healthcare provider can recommend support groups and counselors.

If someone tells you they are HIV-positive, they are telling you because they trust you. The time right after diagnosis can be very tough. You can support them in many ways:

  • Be a friend. While they may not be ready to talk about their diagnosis right away, show them you care by treating them as you did before.
  • Listen. Your friend may just need someone to listen to their concerns and fears. Be there for them.
  • Learn about the disease. The reference section of this article has additional information to learn about the condition.
  • Encourage them to seek treatment. Your friend may not realize they have options available. They do, and they can get treatment. Help them find it and stick to it.
  • Get help for yourself. While it will be a challenging time for your friend, you may need some support too. Talk to others — a counselor, for example — about any concerns or anxieties you may have.

Should I get tested for HIV if I’m pregnant?

CDC recommends all pregnant women get tested for HIV as part of routine prenatal care. HIV can easily transmit from a mother to her unborn child. If tests detect HIV, you can begin antiviral medications to avoid spreading the virus to your baby.

What else do I need to know about HIV testing?

The world has come a long way from when the AIDS epidemic hit in the late 1980s. Researchers are working tirelessly to find treatments.

Unfortunately, many people still don’t understand much about HIV. Because of this, legislation exists to protect people living with HIV and AIDS. The Americans with Disabilities Act (ADA) protects people with HIV from discrimination. If you believe someone has discriminated against you because of your HIV status, you may wish to consult legal counsel.

A note from Cleveland Clinic

Research has made significant progress in terms of what we know about HIV. But there is still more to learn. Until researchers find a vaccine, HIV will continue to infect people. If you or someone you love may be HIV positive, please seek help. Current treatments can help HIV-positive people live happy, productive lives.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy