A Practical Guide to Getting Tested for HIV

June 2018 — Health experts estimate that approximately 15% of Americans infected with HIV do not know their status — a figure that has profound public health implications. In fact, evidence suggests that most new infections stem from people who are unaware of their HIV status, according to the U.S. Centers for Disease Control and Prevention (CDC).

All sexually active people, particularly those who have had multiple sex partners (gay or straight) should get tested.

Even people in monogamous relationships should be tested and should know their partner’s status.

What is an HIV test?

When HIV enters the bloodstream, it begins to attack certain white blood cells known as CD4 cells. The immune system then produces antibodies to fight off infection. When you take an HIV test, doctors are actually looking for the presence of these antibodies, which confirm that HIV infection has occurred. Some HIV tests look for both antibodies and antigens, which are foreign substances that cause your immune system to activate and are produced even before antibodies develop. Antigen/antibody tests are recommended for testing done in labs and are now common in the United States. There is also a rapid antigen/antibody test available.

Why should I get tested?

Early diagnosis is crucial in preventing life-threatening health conditions and combating the spread of HIV. Knowing your status will allow you to take steps to protect your health and the health of others. If you know you are HIV-positive and pregnant, you can take medications and other precautions—such as refraining from breast-feeding— to significantly reduce the risk of infecting your child.

Am I at risk?

Anyone can become infected with HIV, but you are at greater risk if you:

Have ever shared injection drug needles and syringes or “works.”
Have ever had unprotected vaginal, anal, or oral sex with multiple sex partners, anonymous partners, or men who have sex with men.
Have ever been diagnosed with or treated for hepatitis, tuberculosis (TB) or a sexually transmitted disease such as syphilis.
Exchanged sex for drugs or money.
Received a blood transfusion or clotting factor between 1978 and 1985.
Have had unprotected sex with someone who would answer yes to any of the above questions.

If you are unsure of a sexual partner’s risk-taking behavior or if you or they have had many sex partners, you are at greater risk of infection.

The CDC recommends that all pregnant women be screened for HIV. In the U.S., mother-to-child HIV transmission is highly preventable if the mother begins treatment before or during childbirth.

Can’t I tell whether I’m infected without getting tested?

No. The only way to know for sure is to be tested. Within a few weeks after infection with HIV, some people may develop temporary flu-like symptoms or persistent swollen glands, but many people feel healthy for a decade, and some for even more. Unfortunately, HIV- infected people who look and feel perfectly healthy can still transmit the virus to others.

Photo by Derrick Coetzee

When and how can I get tested?

It can take up to 3 months after exposure to test positive for HIV. The time between when a person may have been exposed to HIV and when a test can tell for sure whether they have HIV is called the window period. The window period varies from person to person and depends on the type of test used to detect HIV.

You can ask your health care provider for an HIV test. Ask about the window period for the test you’re taking. Your health care provider or counselor may talk with you about your risk factors, answer questions about your general health, and discuss next steps with you, especially if your result is positive.

You can also buy a home testing kit at a pharmacy or online. If you’re using a home test, information about the test’s window period will be included in the package materials.

If you get an HIV test after a potential HIV exposure and the result is negative, get tested again after the window period for the test you’re taking to be sure. If your health care provider uses an antigen/antibody test performed by a laboratory on blood from a vein you should get tested again 45 days after your most recent exposure. For other tests, you should test again at least 90 days after your most recent exposure to tell for sure if you have HIV.

If you learned you were HIV-negative the last time you were tested, you can only be sure you’re still negative if you haven’t had a potential HIV exposure since your last test. If you’re sexually active, continue to take actions to prevent HIV, like using condoms the right way every time you have sex. If you’re at high risk, consider asking your healthcare provider about pre-exposure prophylaxis (PrEP) medicines to prevent HIV infection.

If your HIV test result is positive, you will need a follow-up test to confirm you have HIV.

No HIV test can detect HIV immediately after infection. If you think you’ve been exposed to HIV in the last 72 hours, talk to your health care provider about post-exposure prophylaxis (PEP), right away.

Many medical clinics, substance abuse programs, community health centers, and hospitals offer HIV testing also. You can also find a testing site near you by

calling 1-800-CDC-INFO (232-4636),

visiting gettested.cdc.gov, or

texting your ZIP code to KNOW IT (566948).

What types of HIV tests are available?

Several types of HIV tests are used today. The most common are blood and oral fluid tests. Unlike most testing methods, which can take several days to provide results, rapid HIV testing offers results in 20 minutes to an hour. Although these tests are very accurate, all positive HIV results must be confirmed with a follow-up test before a final diagnosis of infection can be made.

If I test HIV negative, does that mean that my partner is HIV negative also?

No. Your HIV test result only reveals your HIV status. Getting tested for HIV should not be seen as a method to find out if your partner is infected, and testing should never take the place of protecting yourself from HIV.

Does testing positive for HIV mean I have AIDS?

No. HIV tests simply reveal the presence of antibodies that the body produces in an effort to fight off infection with HIV. If someone has HIV antibodies, that means they have been infected with the virus. HIV can take many years to progress to AIDS, and HIV patients aren’t diagnosed with AIDS unless they have experienced one or more AIDS-related infections, or the number of CD4 immune cells has fallen below a certain level.

Photo by Kristopher Wilson

What if I test positive for HIV?

If you test positive for HIV, you can take immediate steps to protect your health. Early medical treatment and a healthy lifestyle can help you stay well. There are a number of important steps you can take immediately to protect your health:

See a doctor, even if you do not feel sick. Find a doctor who has experience treating HIV. There are now many drugs to treat HIV infection and help you maintain your health and avoid transmitting HIV to others.
Use condoms the correct way every time you have sex.
Get screened for sexually transmitted diseases (STDs). Undetected STDs can cause serious health problems. It is also important to practice safe sex behaviors to avoid contracting STDs.
Have a tuberculosis test done. Undetected TB can cause serious illnesses, but it can be successfully treated if caught early.
Also be tested for hepatitis C and hepatitis B. Hepatitis C is now curable with the correct medications. If you test negative for hepatitis B, get vaccinated to prevent infection.
Smoking cigarettes, drinking too much alcohol, or using illegal drugs can weaken your immune system. There are programs available that can help you reduce or stop using these substances.

How can I get more information?

The CDC’s National AIDS Hotline can answer questions about HIV and AIDS in a prompt and confidential manner. Staff can offer a wide variety of written materials and put you in touch with organizations in your area that deal with HIV and AIDS.

1-800-342-2437 (English)
1-800-344-7432 (Spanish)
1-800-243-7889 (TTY/deaf access)

Source: U.S. Centers for Disease Control and Prevention