Answer: Many places provide HIV testing. Common testing locations include offices of private doctors, hospitals, Health Maintenance Organizations (HMOs) and sites specifically set up to provide HIV antibody testing.

Do all clinics and private physicians offer pre and post-test counseling?

Answer: Although it is not mandatory, ethical practice demands the provision of appropriate counseling both before and after clients take the HIV test. Individuals may want to check with the clinic or physician before taking the tests. It is, however, important to seek testing at a place that provides counseling about HIV and AIDS.

Counselors can answer any questions about risky behavior and protection of self and others. In addition, they can help individuals understand the meaning of the test results and refer them to available AIDS-related resources in their locality.

What is informed consent?

Answer: Informed consent, in the context of HIV antibody testing, is legally defined to require practitioners to disclose to clients both the risks and the benefits of the HIV test, and the alternatives to the test. It is also to ensure that clients demonstrate the mental capacity to understand this information and freely agree, without coercion, to have the test performed.

Can I be tested for HIV without my consent?

Answer: Nobody should be tested for HIV without consent, except with some exceptions.

What is an anonymous test?

Answer: An anonymous test means that absolutely no one has access to your test result since your name is never associated with the test or the test results. In anonymous settings, the client is expected to give informed consent, but to protect anonymity, the consent is not written. Anonymous sites never give written results.

Anonymous test sites are highly recommended because:

The quality of the education and counseling is very good.
The testing is usually free.

It protects you from risks of discrimination or adverse impact, especially in applications for insurance. Sometimes even taking an HIV test, regardless of the result, might cause an insurance application to be rejected.

What is confidential testing?

Answer: Confidential antibody testing means that you and the health care provider know your result and that it may also be recorded in your medical record.

In addition, you pay directly or use insurance to pay for an HIV test, the result (and even the fact that the test was ordered) will be available to insurance companies through computer networks. However, some physicians may agree to omit the test results from the medical record. In confidential settings, the client must give written informed consent.

What are rapid HIV tests?

Answer: A rapid test for detecting antibodies for HIV is a screening test that produces very quick results, usually in 5 to 30 minutes. In comparison, results from the commonly used HIV antibody screening test, the EIA (enzyme immunoassay), are not available for 1-2 weeks.

Although rapid HIV test is considered to be just as accurate as EIA, the Food and Drug Administration (FDA) has licensed only one such procedure for use in the United States. Also, the availability of rapid HIV test may differ from one place to another.

What is OraSure HIV test?

Answer: OraSure is a test for antibodies found in mucosal transudate, which can be found in saliva. However, it is not a saliva test. OraSure uses a technology that draws mucosal transudate, containing antibodies and not virus, from the blood stream through cheek and gum tissues and then onto a specially treated collection pad.

(Note: the saliva and oral mucus contain antibodies to HIV itself, so HIV is not transmitted through these fluids.)

The cotton collection pad is placed between the cheek and lower gum for two minutes. The sample is sent to a lab, where it undergoes an ELISA procedure. All positive ELISA samples undergo a Western Blot confirmatory test. The combined accuracy of OraSure ELISA and Western Blot procedures is comparable to traditional blood testing.

What is the difference between OraSure and the blood test?

Answer: OraSure is for use in persons 13 years and older, and testing is done by placing cotton pads in the mouth to collect test specimens. On the other hand, blood testing can be done on persons of any age, and requires that a needle is inserted into a vein to collect blood into a tube for testing.

While both tests require special training, more people will be able to administer OraSure test than the blood test. With OraSure there are no sharp needles to use or dispose of. It is also not necessary to puncture a vein when using OraSure. Overall, OraSure appears safer to use.

What does a negative HIV test mean?

Answer: A negative HIV test means that HIV antibodies have not been found in your blood at this time; you are probably not infected or you are in the window period.

However, a negative test result does not mean:

You are not infected with HIV (you may still be in the "window period").
You are immune to AIDS.
You have a resistance to infection.
You will never gets AIDS.

What is the window period?

Answer: The window period is the time it takes for a person who has been infected with HIV to develop antibodies. The CDC definition of three to six month window period has been commonly used for a number of years and is most often used. For most individuals, antibodies will develop after three months; however, this is not true for everyone.

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

Answer: No. Your HIV test result reveals only your HIV status. Your negative test result does not tell you whether your partner has HIV. HIV is not necessarily transmitted every time there is an exposure. Therefore, your taking an HIV test should not be seen as a method to find out if your partner is infected. Testing should never take the place of protecting yourself from HIV infection.

What does a positive HIV test mean?

Answer: A positive test result means that you have HIV antibodies and you may have been infected with the virus at some point in time.

People with a positive result should assume that they have the virus and could infect others, or become re-infected. They should not donate blood, organs, tissue, and must stop breastfeeding. They must practice safer behaviors and inform sex and/or needle sharing partners about their status.

A positive test result does not mean:

You have AIDS.
You will necessarily get AIDS.
You are immune to AIDS, even though you have antibodies.

What is an indeterminate result?

Answer: Indeterminate result (which is rare) means the Western Blot is neither negative nor positive. This may be due to a number of factors, which have nothing to do with HIV infection, or it can occur early in the infection when there are not enough of the HIV antibodies present to give a positive test result. If this happens, it is recommended to re-test following 3-6 months.

Why should I test for HIV?

Answer: Benefits of testing for HIV include:

If you know you are HIV-positive, you can take advantage of immune system monitoring and early treatment and intervention.
By taking the test, you can find out whether or not you can infect others.
Regardless of the result, testing often increases your commitment to overall good health habits.
If you test negative, you may feel less anxious after testing.
Women and their partners considering pregnancy can take advantage of treatments that potentially prevent transmission of HIV to the baby.
Counseling can provide a critical opportunity to assist you in identifying your risk of acquiring or transmitting HIV.
Counseling also provides an opportunity to negotiate and reinforce a plan to reduce or eliminate the risk.

What are the risks of testing for HIV?

Answer: Risk of testing for HIV includes the following:

Taking the HIV antibody test is a stressful event, regardless of the results.
Disclosures of an antibody test result, or sometimes the disclosure that a person even took the test, may lead to discrimination, denial of health coverage, stigmatization and violence.

If I am HIV positive, where can I get information about treatments?

Answer: It is recommended that you be in the care of a doctor or medical service, ideally one with experience treating people living with HIV. Your doctor can provide information and guidance.

Getting tested

While some routine medical visits may include a sexual health interview and examination, testing for HIV and most STDs requires specific tests and cannot be done without your consent or cooperation. Most tests involve collecting samples from the urethra, cervix, anus or throat with a swab, or testing a urine or blood sample. Many STDs occur without any signs or symptoms. If you are sexually active, see a health care provider regularly and ask to be tested for HIV and STDs.

How do HIV tests work?

Once HIV enters the body, the immune system starts to produce antibodies - (chemicals that are part of the immune system that recognize invaders like bacteria and viruses and mobilize the body's attempt to fight infection). In the case of HIV, these antibodies cannot fight off the infection, but their presence is used to tell whether a person has HIV in his or her body. In other words, most HIV tests look for the HIV antibodies rather than looking for HIV itself. There are tests that look for HIV's genetic material directly, but these are not in widespread use.

The most common HIV tests use blood to detect HIV infection. Tests using saliva or urine are also available. Some tests take a few days for results, but rapid HIV tests can give results in about 20 minutes. All positive HIV tests must be followed up by another test to confirm the positive result. Results of this confirmatory test can take a few days to a few weeks.

What are the different HIV screening tests available in the United States?

In most cases the EIA (enzyme immunoassay), used on blood drawn from a vein, is the most common screening test used to look for antibodies to HIV. A positive (reactive) EIA must be used with a follow-up (confirmatory) test such as the Western blot to make a positive diagnosis. There are EIA tests that use other body fluids to look for antibodies to HIV. These include

Oral Fluid Tests - use oral fluid (not saliva) that is collected from the mouth using a special collection device. This is an EIA antibody test similar to the standard blood EIA test. A follow-up confirmatory Western blot uses the same oral fluid sample.
Urine Tests - use urine instead of blood. The sensitivity and specificity (accuracy) are somewhat less than that of the blood and oral fluid tests. This is also an EIA antibody test similar to blood EIA tests and requires a follow-up confirmatory Western blot using the same urine sample.

Rapid Tests

A rapid test is a screening test that produces very quick results, in approximately 20 minutes. Rapid tests use blood from a vein or from a finger stick, or oral fluid, to look for the presence of antibodies to HIV. As is true for all screening tests, a reactive rapid HIV test result must be confirmed with a follow-up confirmatory test before a final diagnosis of infection can be made. These tests have similar accuracy rates as traditional EIA screening tests.

Home Testing Kits

Consumer-controlled test kits (popularly known as "home testing kits") were first licensed in 1997. Although home HIV tests are sometimes advertised through the Internet, currently only the Home Access HIV-1 Test System is approved by the Food and Drug Administration. (The accuracy of other home test kits cannot be verified.) The Home Access HIV-1 Test System can be found at most local drug stores. It is not a true home test, but a home collection kit. The testing procedure involves pricking a finger with a special device, placing drops of blood on a specially treated card, and then mailing the card in to be tested at a licensed laboratory. Customers are given an identification number to use when phoning in for the results. Callers may speak to a counselor before taking the test, while waiting for the test result, and when the results are given. All individuals receiving a positive test result are provided referrals for a follow-up confirmatory test, as well as information and resources on treatment and support services.

RNA Tests

RNA tests look for genetic material of the virus and can be used in screening the blood supply and for detection of rare very early infection cases when antibody tests are unable to detect antibodies to HIV.

For a list of HIV tests that are FDA-approved, visit the Food and Drug Administration (FDA) Center for Biologics Evaluation and Research.

HIV testing can be quite scary for any individuals but remember that not all infected individuals exhibit symptoms so it is very important that you make yourself undergo testing especially if you think that you’ve been exposed. Early detection will allow your doctor to know the progress of the disease and when the treatment should start.

HIV is determined when the body’s antibodies are detected in the blood. The two major blood tests that are used to detect the presence of HIV antibodies are the following:

ELISA test or the enzyme linked immunosorbent assay
Western blot assay, this test is done after the ELISA test. HIV is determined only after two or more positive results of ELISA tests are done and another one positive result of Western blot assay.

Generally, it takes from two weeks up to six months from the time an individual become infected before the antibodies are detected in the blood. This is period is known as the window period.

During this period, the individual is highly contagious and can transmit the disease to anyone. So it is important that if you’re results for the HIV is negative, it is advisable that you should undergo another round of test after six months.

Early detection of HIV is very important as it will help to control the spreading of the disease and for the infected person, he or she will know how and when the treatment to slow down the progress will start.

HIV testing can be frightening for any individual but this procedure is highly recommended because the presence of HIV may not really give symptoms so it is important that you submit yourself for HIV testing especially if you think that you had possible exposure with HIV transmission.

The HIV testing is made through blood testing. The 2-major blood test that is done to determine the presence of HIV is:

1. ELISA test (Enzyme Linked Immunosorbent assay)

2. Western blot assay

The Western blot assay is done after the results of ELISA test are made.

You are an HIV infected if the results show that you have two or more affirmative results of ELISA testing and one affirmative result from Western blot assay.

It is known that the HIV has a window period to which an individual can be infected but the antibodies will only be detected in the blood from 2 weeks up to 6 months from the time he got the infection.

That is why it is very important that you repeat again your HIV testing after six months even after you got negative the result and it is also highly recommended that you avoid activities that may transmit the disease to others.

Understanding HIV Testing Recommended Resources:

National HIV/AIDS Clinicians' Consultation Center

University of California