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How and Where to Get an HIV Test: The Process Explained

Blood in test tubes

Thinking about getting an HIV (human immunodeficiency virus) test might make you nervous, but various tests are widely available and affordable.

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).

The result is that many people are diagnosed at a late stage of HIV/AIDS and are unable to take advantage of the effective treatments that exist today.

If you believe there is a chance that you may have contracted HIV, it is imperative that you get tested as soon as possible.

Why have an HIV test?

Getting an HIV test is the only way to know for sure whether you have HIV. According to UCSF Health, having an HIV test early on is beneficial in several ways:

  • It allows you and your physician to start coming up with a treatment plan that may prevent infections and unnecessary complications, not to mention help you live healthily for many years.
  • Untreated HIV can lead to potentially fatal health problems.
  • An early diagnosis and education about your condition will make you aware of risky behaviors that can spread HIV to others
  • Getting tested can eliminate any anxiety associated with not knowing whether you have HIV.

Who should have an HIV test?

The CDC recommends that anyone age 13 to 64 be tested for HIV at least once. Those with certain risk factors are advised to get tested more often. This includes:

  • Men who have had sex with another man
  • People who have had anal or vaginal sex with an HIV-positive partner
  • People who have had more than one sex partner since their last HIV test
  • Drug users who have injected drugs and shared needles or drug-related equipment, like cotton or water, with other people
  • People who have exchanged sex for money or drugs
  • Those who have been diagnosed with a different sexually transmitted disease
  • People who have been diagnosed with or received treatment for tuberculosis or hepatitis
  • Those who have had sex with someone who has one or more of the risk factors noted above or someone whose sexual history is unclear

How do HIV/AIDS tests work?

It is difficult to detect HIV when the infection first develops. Therefore, early HIV testing typically entails assessing the body’s reaction to the virus, as opposed to simply looking for the virus itself.

There are several types of HIV tests used to measure the quantity of HIV in a person’s bloodstream, which is known as the viral load. Most involve a blood sample acquired through a blood draw or finger prick. Oral- and urine-based HIV tests exist as well, but blood tests are more accurate. The results can be ready in as few as 20 minutes or take up to a few days.

Most HIV tests are antibody tests. Your immune system produces antibodies when you are exposed to viruses such as HIV. HIV antibody tests search for antibodies to HIV in your blood or oral fluid. Generally speaking, blood-based antibody tests are able to locate HIV closer to the time of infection than tests conducted with oral fluid. Results of rapid antibody screening tests are available in a half-hour or sooner. They are generally preliminary tests that require follow-up confirmation for positive results.

There are also home-based antibody tests that are available online and at pharmacies. Only two such tests have been approved by the Food and Drug Administration: the Home Access HIV-1 Test System and the OraQuick In-Home HIV Test.

  • The Home Access HIV-1 Test System is an anonymous test that entails pricking a finger to get a blood sample, sending the sample to a lab and then calling to hear the results as soon as the next day. If the test comes back positive, a follow-up test is required to confirm the results. Confidential counseling and treatment referral are included.
  • The OraQuick In-Home HIV Test is a home-based test that involves swabbing the mouth for an oral sample and testing it with the materials provided. The results are available in 20 minutes. As with the Home Access HIV-1 Test, if the results come back positive, a follow-up test is required to confirm them, and confidential counseling and treatment referral are included.

A type of test called combination or fourth-generation testing is now recommended for U.S. labs and is becoming more common. This test searches for HIV antibodies as well as antigens, which activate the immune system.

Nucleic acid tests (NATs) search for HIV in the blood. These tests are quite expensive and typically are not used to screen people except in certain circumstances, such as an exposure to HIV paired with symptoms of HIV infection.

Talk with your doctor to find out which type of HIV test would be best for you. And once you have been tested, discuss the results with your doctor so that you can learn what type of treatment options are available (if the result was positive) or find out how to avoid getting HIV (if you are HIV-negative).

HIV testing costs and where to get tested

The Affordable Care Act requires insurance companies to cover HIV screening with no co-payment. Ask if your doctor can test you in his or her office. Be aware, however, that there may be a fee for the office visit.

If this is not an option, free testing is available at hospitals, health centers, and through substance abuse programs. Many of these facilities offer rapid HIV tests, with results available in about a half-hour.

If you would like to take an at-home HIV test, you might consider the FDA-approved OraQuick HIV test, which typically costs about $40.

Understanding the results

It is very important that you fully understand the results of your HIV test as it will help you to protect yourself and your partner.

Negative result

If you receive a negative result, that is great news — you probably don’t have HIV unless you have been exposed to the virus again extremely recently. However, there are still steps you need to take.

First, you will need to ask your doctor about a follow-up test. In some cases a negative test doesn’t mean you are completely out of the woods.

Keep in mind that following HIV exposure, it takes time for a detectable amount of the virus to grow. This is referred to as the window period. You will likely need to have a follow-up test to make sure that you were not in the window period when you had the first test

Positive result

A positive HIV test result means that you probably have HIV. The good news is that you can be treated for HIV, and today’s HIV treatments are highly effective.

HIV treatment reduces the quantity of HIV in the blood and helps to prevent AIDS and other HIV-related conditions. It also dramatically reduces your chances of transmitting HIV to others. If the quantity of HIV in your bloodstream becomes undetectable, this essentially means that you will not transmit HIV to sexual partners.

People who start treatment shortly after receiving a positive result can stay well for many years.

If you receive a positive test result, meet with your doctor, even if you feel fine. Your doctor will most likely advise you to have a follow-up test to make sure the first test was accurate. If the follow-up test is positive, this means that you have HIV.

But remember, a positive test does not mean that you have AIDS or that you will develop AIDS.

    Still have questions?

    If you have additional questions about HIV testing, refer to the following resources:

    • AIDSinfo, a service of the U.S. Department of Health and Human Services offering information in English and Spanish on the latest HIV treatment and prevention, clinical trials as well as other information for people affected by HIV/AIDS.

    • CDC Info hotline: 800-232-4636

    Article references

    1. Centers for Disease Control and Prevention, HIV in the United States and Dependent Areas https://www.cdc.gov/hiv/statistics/overview/ataglance.html
    2. Centers for Disease Control and Prevention, HIV Testing https://www.cdc.gov/hiv/testing/index.html 
    3. American Academy of HIV Medicine, HIV Testing https://aahivm.org/hiv-testing/
    4. Centers for Disease Control and Prevention, HIV Testing https://wwwn.cdc.gov/hivrisk/how_know/testing.html
    5. Centers for Disease Control and Prevention, Types of HIV Tests https://wwwn.cdc.gov/hivrisk/how_know/different_tests.html
    6. Centers for Disease Control and Prevention, Understanding Your HIV Test Results: What They Mean to You https://www.cdc.gov/stophivtogether/library/hiv-screening-standard-care/brochures/cdc-lsht-hssc-brochure-understanding-your-test-results.pdf
    7. UCSF Health, FAQ: HIV Testing https://www.ucsfhealth.org/education/faq-hiv-testing#1
    8. Louisiana Department of Health, HIV Antibody Test http://ldh.la.gov/index.cfm/page/1116
    9. Consumer Reports, 5 Reasons to Get an HIV Test Today https://www.consumerreports.org/hiv-aids/5-reasons-to-get-tested-for-hiv-today/
    10. Centers for Disease Control and Prevention, Hotlines and Referrals https://www.cdc.gov/hiv/library/hotlines.html
    11. The Affordable Care Act and HIV/AIDS https://www.hiv.gov/federal-response/policies-issues/the-affordable-care-act-and-hiv-aids