HIV Testing

Getting an HIV test is the only way to know if you have HIV. This section answers some of the most common questions related to HIV testing, including the types of tests available, where to get one, and what to expect when you go to get tested.

Should I get tested for HIV?

Current recommendations are that all men who have sex with other men have a HIV test at least once a year or every six months if you’ve had more than 10 sexual partners in less than 6 months.
One in 3 people in Australia who have HIV do not know they are infected.

Behaviors that put you at risk for HIV include having vaginal or anal sex without a condom or without being on medicines that prevent or treat HIV (PrEP), or sharing injection drug equipment with someone who has HIV. If you answer yes to any of the following questions, you should definitely get an HIV test:

If you continue having unsafe sex or sharing injection drug equipment, you should get tested at least once a year. Sexually active gay and bisexual men may benefit from more frequent testing (e.g., every 3 to 6 months).

You should also get tested if you have been sexually assaulted.

How can testing help me?

Getting tested can give you some important information and can help keep you—and others—safe. For example,

I don’t believe I am at high risk. Why should I get tested?

Some people who test positive for HIV were not aware of their risk. That’s why it’s recommended that providers in all health care settings make HIV testing a routine part of medical care for patients aged 13 to 64, unless the patient declines (opts out). This practice would get more people tested and help reduce the stigma around testing.

Even if you have been in a long-term relationship with one person, you should find out for sure whether you or your partner has HIV. If you are both HIV-negative and you both stay faithful (monogamous) and do not have other risks for HIV infection, then you probably won’t need another HIV test unless your situation changes.

When should I get tested?

The immune system usually takes 3 to 8 weeks to make antibodies against HIV, but tests differ in how early they are able to detect antibodies. Although most HIV tests look for these antibodies, some look for the virus itself. The period after infection but before the test becomes positive is called the window period.

Deciding when to get tested therefore depends on when you may have been exposed and which test is used. You can ask your health care provider about the window period for the HIV test you are taking. If you are using a home test, you can get that information from the materials included in the packaging of the test.

A few people will have a longer window period, so if you get a negative antibody test result in the first 3 months after possible exposure, you should get a repeat test after 3 months. Ninety-seven percent of people will develop antibodies in the first 3 months after they are infected. In very rare cases, it can take up to 6 months to develop antibodies to HIV.

Where can I get tested?

You can ask your health care provider, GP or local sexual health clinic for an HIV test. Many medical clinics, substance abuse programs, community health centers, and hospitals offer them, too.

What kinds of tests are available, and how do they work?

The most common HIV test is the antibody screening test (immunoassay), which tests for the antibodies that your body makes against HIV. The immunoassay may be conducted in a lab or as a rapid test at the testing site. It may be performed on blood or oral fluid (not saliva). Because the level of antibody in oral fluid is lower than it is in blood, blood tests tend to find infection sooner after exposure than do oral fluid tests. In addition, most blood-based lab tests find infection sooner after exposure than rapid HIV tests.

Several tests are being used more commonly that can detect both antibodies and antigen (part of the virus itself). These tests can find recent infection earlier than tests that detect only antibodies. These antigen/antibody combination tests can find HIV as soon as 3 weeks after exposure to the virus, but they are only available for testing blood, not oral fluid.

The rapid HIV test is an immunoassay used for screening, and it produces quick results, in 30 minutes or less. Rapid tests use blood or oral fluid to look for antibodies to HIV. If an immunoassay (lab test or rapid test) is conducted during the window period (i.e., the period after exposure but before the test can find antibodies), the test may not find antibodies and may give a false-negative result. All immunoassays that are positive need a follow-up test to confirm the result.

Follow-up diagnostic testing is performed if the first immunoassay result is positive. Follow-up tests include: an antibody differentiation test, which distinguishes HIV-1 from HIV-2; an HIV-1 nucleic acid test, which looks for virus directly, or the Western blot or indirect immunofluorescence assay, which detect antibodies.

Immunoassays are generally very accurate, but follow-up testing allows you and your health care provider to be sure the diagnosis is right. If your first test is a rapid test, and it is positive, you will be directed to a medical setting to get follow-up testing. If your first test is a lab test, and it is positive, the lab will conduct follow-up testing, usually on the same blood specimen as the first test.

RNA tests detect the virus directly (instead of the antibodies to HIV) and thus can detect HIV at about 10 days after infection—as soon as it appears in the bloodstream, before antibodies develop. These tests cost more than antibody tests and are generally not used as a screening test, although your doctor may order one as a follow-up test, after a positive antibody test, or as part of a clinical workup.

What should I expect when I go in for an HIV test?

When it’s time to take the test, a health care provider will take your sample (blood or oral fluid) and you may be able to wait for the results (if it’s a rapid HIV test). If the test comes back negative, and you haven’t had an exposure for 3 months,  you can be confident you’re not infected with HIV.

If your test comes back positive, you will need to get a follow-up test, which the testing site will arrange.

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.

See “Will other people know my test result? ” below.

What does a negative test result mean?

A negative result does not necessarily mean that you don’t have HIV. That’s because of the window period—the period after you may have been exposed to HIV but before a test can detect it. The window period depends on the kind of test that was used on your blood or oral fluid. For antibody tests, if you get a negative result within 3 months of your most recent possible exposure, you need to get tested again at the 3-month mark. For RNA tests or antibody/antigen tests, that timeframe may be shorter. Ask your health care provider if and when you need to be retested with a negative test result. And meanwhile, practice abstinence or mutual monogamy with a trusted partner, use condoms every time you have sex (and for every sex act—anal, oral, or vaginal), and don’t share needles and other drug equipment (works).

If I have a negative result, does that mean that my partner is HIV-negative also?

No. Your HIV test result reveals only your HIV status. HIV is not necessarily transmitted every time you have sex. Therefore, taking an HIV test is not a way to find out if your partner is infected. Ask your partner if he or she has been tested for HIV and about his or her risk behaviors, both now and in the past. Consider getting tested together, often referred to as couples testing.

What does a positive result mean?

If you had a rapid screening test, the testing site will arrange a follow-up test to make sure the screening test result was correct. If your blood was tested in a lab, the lab will conduct a follow-up test on the same sample. If the follow-up test is also positive, it means you are HIV-positive.

The sooner you take steps to protect your health, the better. Early treatment with antiretroviral drugs and a healthy lifestyle can help you stay well. Prompt medical care prevents the onset of AIDS and some life-threatening conditions.

Here are some important steps you can take right away to protect your health:

 To avoid giving HIV to anyone else,

If I test positive for HIV, does that mean I have AIDS?

No. Being HIV-positive does not mean you have AIDS. AIDS is the most advanced stage of HIV disease. Proper treatment can keep you from developing AIDS.

Will other people know my test result?

Your test results are protected by state and federal privacy laws. They can only be released with your permission. Whether anyone can know about your test results or your HIV status depends on what kind of test you take: confidential or anonymous. Some states only offer confidential testing.

With confidential testing, if you test positive for HIV or another STI, the test result and your name will be reported to the state or local health department to help public health officials get better estimates of the rates of HIV in the state. The state health department will then remove all personal information about you (name, address, etc.) and share the remaining non-identifying information with CDC. CDC does not share this information with anyone else, including insurance companies.

Should I share my positive test result with others?

Whether you share, or disclose, your status to others is your decision.

If you test positive for HIV, your sex or drug-using partners may also be infected. It’s important that they know they have been exposed so that they can be tested too.

You can tell them yourself—but if you’re nervous about disclosing your test result, or you have been threatened or injured by your partner, you can ask your doctor or the local health department to tell them that they might have been exposed to HIV. Health departments do not reveal your name to your partners. They will only tell your partners that they have been exposed to HIV and should get tested.

Most states have laws that require you to tell your sexual partners if you are HIV-positive before you have sex (anal, vaginal, or oral) or share drugs. You can be charged with a crime in some states if you don’t tell—even if your partner doesn’t become infected.

Family and friends
In most cases, your family and friends will not know your test results or HIV status unless you tell them yourself. While telling your family that you have HIV may seem hard, you should know that disclosure actually has many benefits—studies have shown that people who disclose their HIV status respond better to treatment than those who don’t.

In most cases, your employer will not know your HIV status unless you tell. But your employer does have a right to ask if you have any health conditions that would affect your ability to do your job or pose a serious risk to others. (An example might be a health care professional, like a surgeon, who does procedures where there is a risk of blood or other body fluids being exchanged.)

If you have health insurance through your employer, the insurance company cannot legally tell your employer that you have HIV. But it is possible that your employer could find out if the insurance company provides detailed information to your employer about the benefits it pays or the costs of insurance.

Who will pay for my HIV test?

In Australia standard HIV screening is covered by medicare. There may be a cost to booking an appointment to see the doctor.
Rapid HIV testing is not covered by medicare so there is an out of pocket fee for this service.