Testing for HIV

HIV is a sexually transmitted disease that, if left untreated, can lead to acquired immunodeficiency syndrome (AIDS).

HIV patients may not exhibit any signs or symptoms. Only testing can determine whether or not you have a sexually transmitted infection.

If you are sexually active and have unprotected intercourse, it is critical to test for sexually transmitted diseases so that you are aware of your sexual health.

What's measured by an HIV test?

HIV testing detects and measures HIV antibodies (HIV-1 and HIV-2), antigens, or the presence of the HIV virus itself. There are different testing types available---a healthcare provider can help you determine which test type is most appropriate for your situation.

When should I get a HIV test?

Everyone between the ages of 13 and 64 should get tested for HIV at least once in their lifetime, suggests the CDC. People who meet risk factors for HIV should be tested more frequently, or at least once per year.

According to the CDC, HIV risk factors are:

• being a male who has had sex with another male
• having had vaginal or anal sex with someone who has HIV
• having had more than one sex partner since you were last tested for HIV
• having shared drug injection equipment with others, such as needles or syringes
• having had sex with someone in exchange for drugs or money
• being diagnosed with or treated for another sexually transmitted infection
• being diagnosed with or treated for hepatitis or tuberculosis
• having had sex with someone who has practiced any of the behaviors listed above
• having had sex with someone whose sexual history isn't familiar to you

Talk to your healthcare provider if unsure whether you can benefit from an HIV test. Your provider can discuss HIV risk factors in greater detail and make a sound recommendation.

Types of HIV tests

Antibody testing

Antibody testing uses blood or saliva to determine the presence of antibodies in the body.

These tests use either a finger stick, an oral swab, or a blood sample drawn from a venipuncture. This type of test is available in a home test kit (which commonly uses a fingerstick blood sample).

Antibody testing is used commonly as a screening tool, and a positive antibody test will warrant further testing to confirm a diagnosis.

Antigen/Antibody Combo tests

Antigen/antibody combo tests are the most common in the United States according to the CDC.

They require blood sourced from a fingerstick or venipuncture. These tests are usually analyzed in a laboratory, and can yield an accurate result between 11 and 30 days after being infected, according to the NIH.

A positive antigen/antibody test will warrant a NAT test to confirm a diagnosis.

Nucleic Acid Test (NAT)

A nucleic acid test (NAT) will detect the presence of the HIV virus in the blood, as well as the viral load (how much virus) is present.

According to the CDC, this test is recommended for people who have been exposed, possibly exposed, or are experiencing symptoms of HIV. This test requires a blood sample sourced by venipuncture and must be analyzed in a laboratory.

This test is also used as a "confirmatory test" for those who had a positive result with an antibody or antigen test.

What to expect with a HIV test

There are three ways to get an HIV test: a blood test, an oral swab test, or a urine test. The most common tests are a blood test or oral swab.

Blood tests involve either a fingerstick or a venipuncture to source a blood sample, while the oral swab involves swabbing the inside of your cheek to gather a saliva sample.

Urine tests are less accurate according to the NIH. For this reason, they are not usually recommended.

Before the test

Patients generally do not need to prepare for HIV testing.

Patients should inform their doctor about any prescription or over-the-counter medications they are taking, just as they would for any other blood test, although it is uncommon to have to modify medications prior to taking an HIV test.

During the test

HIV testing involves having a sample of your blood or saliva checked for the presence of HIV. Your HIV test provider can explain in greater detail how your test will work and what to expect.

If you use an at-home HIV test, the test kit will provide you with explicit instructions on how to take the test.

An HIV test that requires a blood sample may be performed using either a needle or a small lancet, reports the National Library of Medicine (NLM). A needle is used to draw blood from a vein in your arm, while a lancet is used to prick your finger for a small sample of blood. If you are having a blood test, you may experience slight bruising or soreness at the site where the needle or lancet went in.

For an HIV test that requires a saliva sample, your healthcare provider will wipe a swab across your gums to collect a sample, adds the NLM.

Most at-home HIV test kits come with a small lancet for a finger prick or a special swab that collects saliva.

If you get an HIV test in a healthcare setting, the provider will send your blood or saliva sample to the lab where it is analyzed and checked for the presence of HIV. If you take an at-home saliva test, your results may be ready within minutes.

The NLM notes that if you take an at-home blood test, you will be required to send your sample to the lab address specified in the test packaging where lab technicians can check it for HIV.

After the test

After an HIV test, like any other blood test, you will likely have a bandage placed over the draw site, but there are no restrictions on normal activities after a blood sample is collected.

It is recommended to abstain from further sexual activity until after the test results are received. If your test results indicate an active HIV infection, you should consult your healthcare provider regarding next steps and ensure you avoid spreading the infection to others.

HIV Test Results

If your HIV test results come back positive, it means that signs of an HIV infection were found in your blood or saliva sample, says the NLM. You will need a follow-up test to confirm that your results are positive; if your HIV follow-up test comes back positive, it means you have HIV.

If you took your HIV test at a lab or healthcare center and the results are positive, your provider will do a follow-up test using the same blood sample that was initially used, reports the CDC.

If you did an at-home test or tested in a community program, the CDC recommends visiting a healthcare center to do a follow-up test.

When you test positive for HIV, you will need to start antiretroviral therapy (ART) right away, even if you are still healthy, says the NLM. The NLM also notes that ART may lower the amount of HIV in your blood to help you stay healthy and protect others.

The CDC adds that ART is recommended for all people with HIV, regardless of how healthy they are or how long they've had the virus.

Continued testing is also recommended, to monitor the level of virus present in your blood.

Contact your healthcare provider right away if you test positive for HIV. Your provider can help you find the right type of ART and work with you to manage your condition.

Finding a HIV test

The process of finding and getting tested for HIV is rather easy.

If you have a primary care physician, they are likely to be able to perform the test. The examination might take place at a medical laboratory, hospital, doctor's office, or community health center.

If you are not under the care of a physician, a HIV test can be ordered for yourself through Solv.

Once you've ordered the test online, you will be sent to a Clinical Laboratory Improvement Amendments (CLIA)-approved lab for your test with a physician consultation made available to you following a positive test result.

Can I get a HIV test at home?

Yes, at home HIV tests are available for patients to purchase, however, the CDC does not recommend home tests for anyone who has active symptoms or who has had sexual contact with someone who has tested positive for HIV.

This is because home tests will need to be sent to a laboratory, and results can take several days.

If you are at high risk for HIV, the CDC recommends that you be tested by a doctor near you so that you can begin treatment as soon as possible.

Cost of an HIV test

The national average for HIV testing varies between free and $485, however, the cost of an HIV test will vary depending on your location and insurance coverage.

The cost of testing may be separate from office visit fees and laboratory fees in some cases. Home testing kits range from $15 to $169. Some community health centers offer free HIV testing. You can order an HIV test through Solv for $89.

Combining HIV testing with other STI testing may also increase the cost.