Tessa Quinn
HIV tests are available at hospitals, medical clinics, substance abuse programs, and community health centers. These tests are often covered by health insurance and can be conducted anonymously or confidentially. Most HIV tests involve a healthcare professional drawing blood and sending it to a lab for analysis, but there are also at-home self-testing kits available. The CDC recommends a sequence of three tests for HIV diagnosis, including antigen/antibody tests, antibody tests, and NAT tests. These tests can detect HIV antigens, antibodies, and the virus itself. While most tests check for HIV in blood samples, some also use saliva, urine, or oral fluid. After starting HIV treatment, additional lab tests may be conducted to monitor the effectiveness of the medications and check for complications or side effects.
| Characteristics | Values |
|---|---|
| Who can perform the test? | A healthcare professional or the patient themselves (self-test) |
| Where can the test be performed? | Hospitals, medical clinics, substance abuse programs, community health centres, at home (self-test) |
| What sample is required? | Blood, saliva, urine |
| Types of tests | Antibody test, antigen/antibody test, NAT test, rapid test, self-test, lab test |
| Time taken for results | 5 minutes to several days |
| Accuracy | Depends on the type of test, time since exposure, and method of sample collection |
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What You'll Learn
Antibody tests
The CDC recommends that everyone aged 13 to 64 be tested for HIV as part of a routine health care exam. Testing is important because it helps catch the virus early, allowing for early treatment and preventing transmission. HIV testing can be performed by a healthcare provider, or through self-testing kits, which are available for purchase online or at a pharmacy.
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Antigen/antibody tests
Antigens will show up in your blood sooner than antibodies after HIV exposure. An antigen called p24 is produced even before antibodies develop. Antigen/antibody tests are recommended for testing done in labs and are common in the United States. They can be performed in two ways: a rapid test using a finger stick, and a lab test using blood drawn from a vein. The rapid antigen/antibody test takes 30 minutes or less, while the lab test may take several days to provide results.
The window period, or the time between HIV exposure and when a test can detect HIV in your body, depends on the type of test used. Antigen/antibody lab tests using blood from a vein can usually detect HIV 18 to 45 days after exposure. In contrast, rapid antigen/antibody tests using blood from a finger stick can detect HIV 18 to 90 days after exposure.
If you test positive on an antigen/antibody test, your provider will perform additional testing to confirm the results. The CDC recommends that the second test be an antibody test to check for antibodies associated with HIV-1 and HIV-2. If this test is also positive, your HIV-positive status is confirmed. If the results are inconclusive, a NAT test will be performed to check for the presence and quantity of HIV in your blood. This combination of testing is nearly 100% effective at diagnosing HIV.
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NAT tests
NAT (Nucleic Acid Test) tests are one of the three main types of HIV tests, alongside antibody tests and antigen/antibody tests. NAT tests look for the HIV virus in the blood, rather than signs of the virus, such as antigens and antibodies. This makes them more expensive than other tests, and they are therefore rarely used for routine screening. Instead, NAT tests are primarily used to monitor HIV treatment.
If you think you may have been exposed to HIV, it is important to talk to a healthcare professional, who will be able to advise on the best course of action and the most appropriate type of HIV test.
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Rapid tests
Rapid HIV tests are a quick and convenient way to check for HIV antibodies in the blood or oral fluid. These tests can be self-administered in the privacy of one's home or conducted by a healthcare professional in a clinical setting. Rapid tests are typically antibody tests, which look for the presence of HIV antibodies in the blood or oral fluid. Antibodies are produced by the immune system to fight off the HIV virus.
There are two main types of rapid HIV tests: the oral fluid test and the finger-stick blood test. The oral fluid test involves swabbing the upper and lower gums to collect a sample of oral fluid, which is then analysed to detect the presence of HIV antibodies. This type of test is non-invasive and can provide results within 20 to 40 minutes. The only FDA-approved at-home oral fluid rapid test is the OraQuick® In-Home HIV test.
The finger-stick blood test, on the other hand, involves a small prick on the finger to collect a blood sample. This type of rapid test can provide results in as little as five minutes, although it is important to note that these are preliminary results. If the initial result is positive, additional testing is necessary to confirm the HIV status. Rapid finger-stick blood tests can be self-tests or administered by a healthcare provider.
Rapid HIV tests are generally recommended for preliminary screening, and they offer a quick and accessible way to check for potential HIV infection. However, it is important to remember that rapid tests may not detect HIV immediately after infection due to the "window period". This period refers to the time between HIV exposure and when the test can detect the virus in the body, which can vary depending on the type of test used. For antibody tests, this window period is typically 23 to 90 days after exposure, while rapid antigen/antibody tests can usually detect HIV 18 to 90 days after exposure.
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Self-tests
HIV self-tests are a convenient way to learn your HIV status in your own time and space. They are also a great way to confirm your status if you have previously tested positive for HIV. Self-tests are available as rapid self-tests or mail-in self-tests, but state laws may limit their availability in some locations.
The U.S. Food and Drug Administration (FDA) has approved one rapid HIV self-test called the OraQuick In-Home HIV test. This test is an oral swab (not a blood test) and can be purchased over the counter or online. It is shipped within the continental United States and to Alaska and Hawaii via UPS, FedEx, and/or USPS. The product is typically processed within 1 business day and delivered within 5-10 days, or 2 days via expedited shipping.
To use the OraQuick test, you swab your gums to collect a sample of oral fluid, which is then tested in a vial. The test will show a positive or negative result within 20 to 40 minutes. If the result is positive, you will need to take additional tests to confirm. Other self-tests may provide results in as little as 5 minutes, but these are preliminary, and a follow-up test is required.
It is important to read the instructions included in the test kit before taking a self-test. If you do not follow the directions as described, the test may not work. Additionally, a negative result does not necessarily mean that you do not have HIV due to the window period, which is the time between HIV exposure and when a test can detect the virus in your body. If the self-test is invalid, you will need to use another self-test or seek testing at a health care provider or testing center.
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Frequently asked questions
HIV tests can be conducted in a hospital or lab by a healthcare professional, or at home. The former involves drawing blood from a vein or a finger prick, while the latter can be done using a mouth swab or urine test. The most common type of HIV test is the antigen/antibody test, which looks for HIV antibodies and antigens in the blood. Other types of tests include NAT tests, antibody tests, and rapid tests.
You can get an HIV test from your healthcare provider, or at hospitals, medical clinics, substance abuse programs, and community health centres. The CDC also has a locator to find HIV testing services in your area.
Rapid tests can provide results in as little as five minutes, but these are preliminary. With a lab test, it may take several days to receive your results.
