Human immunodeficiency virus (HIV) is a virus that strikes the immune system, making it difficult for the body to fight infections and diseases. It is what causes acquired immunodeficiency syndrome (AIDS).
About 1.1 million Americans have HIV, according to HIV.gov, and globally, HIV is among the most daunting of public health problems. UNAIDS reported in 2019 that about 37.9 million people had HIV worldwide at the end of 2018.
HIV awareness continues to be a problem. In the United States, about 15 percent of people infected with HIV are unaware of their condition. Of the nearly 38,000 people diagnosed with the disease in the U.S. and six of its territories in 2018, about 40 percent of these cases were spread by people who did not know they had the virus, according to the Centers for Disease Control and Prevention (CDC). Globally, about 79 percent of those with HIV were aware of their condition in 2018.
Much of this unawareness comes down to a lack of access to information and testing. In many parts of the world and some areas of the United States, there is little if any access to HIV testing services. The result is that many people receive diagnoses at late stages of HIV/AIDS and are not able to benefit from the extraordinary advances in treatment that have occurred over the past few decades.
However, the lack of awareness and dearth of access to treatment in some communities is unfortunate and unnecessary because quick, convenient HIV tests are now widely available. If you have reason to believe that you could have HIV or AIDS, read on to learn more about rapid HIV/AIDS tests.
Who should be tested for HIV?
Gay and bisexual men, along with other men who have sex with men, are at disproportionate risk of contracting HIV. Some 26,000 men in this group are infected with HIV each year, HIV.gov says.
But contrary to popular opinion, this group is not the only one at high risk of contracting HIV. In fact, everyone between the ages of 13 and 64 should be tested for HIV one or more times, according to HIV.gov.
If you answer yes to any of the following questions you should be tested more often:
- Have you had sex with another man?
- Have you had vaginal or anal sex with someone who is HIV positive?
- Have you had more than one sex partner since your previous HIV test?
- Have you ever shared needles or works (water, cotton) with someone else when injecting drugs?
- Have you accepted money or drugs in exchange for sex?
- Have you ever been diagnosed with a sexually transmitted disease (STD) other than HIV/AIDS?
- Have you been diagnosed with tuberculosis (TB) or hepatitis?
- Have you ever had sex with someone who might answer yes to any of the questions above?
- Have you ever had sex with someone whose sexual history is unknown to you?
The testing process
A few different types of rapid-HIV tests exist to measure what's called the “viral load” — how much HIV virus is present in a person’s bloodstream. Most of these involve drawing a blood sample or obtaining a blood sample by pricking the finger. Oral and urine tests are also available, but are not as accurate as HIV blood tests.
Rapid HIV tests measure antibodies against HIV. These can take as little as 20 minute but results are generally available the same day. The Home Access HIV-1 Test is an anonymous test sold over the counter that you can give yourself by pricking a finger to obtain a blood sample, the CDC explains. The sample is then sent to a lab. You get the results by calling the lab the next day. Should the test come back positive, a second test is needed to confirm the initial results. Counseling and treatment referrals — both confidential — come with the Home Access HIV-1 Test.
The OraQuick In-home HIV Test is a test you conduct at home by taking a mouth swab to obtain an oral sample. Materials needed for the swab are included, and it takes just 20 minutes for the results. Like the Home Access HIV-1 Test, positive results from the OraQuick In-home HIV Test must be confirmed through a follow-up test. Also like the Home Access HIV-1 Test, counseling and treatment referrals are included.
Another type of rapid HIV test, called combination or fourth-generation testing, is now available as well. This test looks for HIV antibodies and antigens, the latter of which are toxins that trigger an immune response in the body, such as the production of antibodies.
Privacy and confidentiality
If you choose to have an HIV test at your doctor’s office or a medical clinic, the test and its results will become part of your medical record. However, by law, your test results must be kept confidential. Your health care provider will give you the results but will not release them to any other entity unless you give written permission.
There are also places where you can have a confidential, anonymous test. Clinics that offer these tests do not record your name, phone number, address or any other identifying information. Instead, the clinic uses a code on your record.
However, if you opt for anonymous testing and receive a positive result, it is important that you notify your doctor immediately to discuss follow-up testing and treatment. Once you notify your doctor, the HIV care will be a part of your medical record, and your HIV status must be reported to the health department.
Depending on where you live, anonymous testing may be available through public health departments, community agencies (such as Planned Parenthood) or other organizations. To learn about anonymous HIV testing options, contact your local health department. You can also contact AIDSInfo or the CDC (see contact information below)
Knowledge is power, so knowing whether you have HIV is essential to being able to protect your health and the health of any sex partners you have. Luckily, the results of rapid HIV tests are often available in 30 minutes or less.
What comes next depends on whether you receive a negative or preliminary positive (also known as reactive) result.
If your results come back negative, it is unlikely you have HIV. The exception would be if you contracted the virus very recently. That being said, you should definitely ask your doctor if you need to have a follow-up test. The reason for this is that, following exposure to HIV, it takes a certain amount of time for the HIV to grow enough for testing to detect it. This time period is known as the window period. Without a second test, people who have contracted HIV during the window period would never know they had the disease.
If you received a negative HIV test result but feel ill or have any of the following symptoms, contact your doctor immediately:
- Swelling in the neck, underarms or groin, which could indicate swollen lymph nodes
- Mouth sores
- Symptoms resembling the flu
- Extreme fatigue
Preliminary positive (reactive) result
If you receive a preliminary positive result, you need to have another test to confirm the results. If your first test was a rapid home test, you should see your doctor or another health care provider for follow-up testing. If your first test was conducted at a doctor’s office or lab, the lab will do the follow-up test, typically using the same blood sample used in the initial test.
A preliminary positive result most likely means that you have HIV. It’s not what anyone tested is hoping for, but there is some good news: These days, those treated for HIV soon after diagnosis are usually able to live healthy, normal lives for many years to come.
Modern HIV treatments can accomplish all of the following:
- Lower the amount of HIV in the bloodstream
- Contribute to preventing AIDS and other ailments related to HIV
- Dramatically lower the risk of spreading HIV to others
In fact, if HIV treatment succeeds in lowering your viral load to undetectable levels, there is very little risk that you will spread the disease to sex partners.
If you received a preliminary positive HIV test result, regardless of whether you feel sick, schedule an appointment with your doctor as soon as possible. And remember that a preliminary positive does not necessarily mean that you have HIV or will develop AIDS, and almost certainly doesn’t mean that your disease is terminal.
If you still have more questions about HIV testing, contact AIDSinfo, a service of the U.S. Department of Health and Human Services (HHS) that offers information (in English and Spanish) on HIV treatment and prevention clinical trials as well as general information for people affected by HIV/AIDS:
- By phone: 1-800-HIV-0440 (448-0440)
- By email: firstname.lastname@example.org
You can also obtain additional information about HIV/AIDS from the CDC through its hotline: (800) 232-4636
- Centers for Disease Control and Prevention, HIV in the United States and Dependent Areas https://www.cdc.gov/hiv/statistics/overview/ataglance.html
- Centers for Disease Control and Prevention, HIV Testing https://www.cdc.gov/hiv/testing/index.html
- American Academy of HIV Medicine, HIV Testing https://aahivm.org/hiv-testing/
- HIV.gov, Who Should Get Tested? https://www.hiv.gov/hiv-basics/hiv-testing/learn-about-hiv-testing/who-should-get-tested
- Centers for Disease Control, Types of HIV Tests https://wwwn.cdc.gov/hivrisk/how_know/different_tests.html
- Centers for Disease Control, Hotlines and Referrals https://www.cdc.gov/hiv/library/hotlines.html
- Referrals New York State Department of Health, AIDS Institute, Information on Non-reactive (Negative) HIV Test Results https://www.health.ny.gov/diseases/aids/providers/testing/docs/information_on_negative_hiv_test_results.pdf
- UW Health, HIV Testing: Should I Get Tested for Human Immunodeficiency Virus? https://www.uwhealth.org/health/topic/decisionpoint/hiv-testing-should-i-get-tested-for-human-immunodeficiency-virus/abl4059.html
- HIV.gov, HIV Basics: Data & Trends https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics
- UNAIDS, Global HIV & AIDS statistics — 2019 fact sheet https://www.unaids.org/en/resources/fact-sheet
- The Aurum Institute, How Do I Know If I Have HIV? https://www.auruminstitute.org/hiv-aids/understanding-hiv-aids/symptoms-of-hiv
- HIV.gov, Understanding HIV Test Results https://www.hiv.gov/hiv-basics/hiv-testing/learn-about-hiv-testing/understanding-hiv-test-results
- HIV.gov, Living with HIV https://www.hiv.gov/hiv-basics/hiv-testing/just-diagnosed-whats-next/living-with-hiv
- Terrence Higgins Trust, How HIV treatment works https://www.tht.org.uk/hiv-and-sexual-health/living-well-hiv/hiv-treatment/how-hiv-treatment-works
- Cleveland Clinic, HIV Testing https://my.clevelandclinic.org/health/diagnostics/4849-hiv-testing/test-details?view=print
- Kaiser Permanente, HIV testing is routine preventive care https://wa.kaiserpermanente.org/healthAndWellness/index.jhtml?item=%2Fcommon%2FhealthAndWellness%2Fconditions%2Fstd%2FhivTests.html