HIV Testing

 

Taking the Test

For some, considering an HIV test can be a scary process. However, taking the HIV test is one of the best ways to fight HIV/AIDS. If you find out that you have HIV, it can be an important step toward taking care of your health and planning for the future. Learning that you are HIV negative, too, can help you figure out how to stay that way. It is best to take the test in a situation where the test is voluntary and where counseling is offered before and after the test.

• How does the HIV test work?

• Choosing a Test Site

• Types of Tests

• What about treatment?

How does the HIV test work?
When HIV enters the blood, the body reacts by making cells called antibodies. Most HIV tests look for these antibodies and not the virus itself. It can take the body up to three months to make enough antibodies to be detectable on the test, but most people will create enough antibodies in just 4 weeks after infection. We call this 4 week to 3 month time frame the window period.

During the window period, the HIV test may not be able to detect infection. There is a test, called a PCR, that detects HIV itself (it looks for the virus and not the antibodies) within 3-7 days after exposure, but this test is not currently approved as a way to diagnose HIV infection. It can also be very expensive and is not offered at most testing facilities.

Choosing a Test Site
There are many places to choose from when considering taking the test. In many states, there are public and private clinics that offer free, completely anonymous tests. There are also many more clinics that offer confidential testing options. The basic difference between the two is that anonymous testing sites will not ask you for a name, and confidential sites will usually ask for some kind of identifying information or ask you for a name without asking you for identification. Confidential also means that they will not and cannot release your name to anyone except another health care provider or your health insurance company, but only if you use your health insurance to cover the cost of the test. (In some states, including New York, doctors and clinics are required to forward the names of people who test HIV positive to their local health departments for demographic purposes. These names are kept confidential and are not released to any other agencies.)

There are also "home tests" available over the counter in some states. These tests ask you to take blood from your finger with a lancet that they provide. You are then asked to send your blood sample into a lab. They don't use your name, and only offer counseling over the phone. BEWARE — the only home test that has been approved for use in the United States is called Home Access. For more information you can visit their website at www.homeaccess.com or call the GMHC HIV/AIDS Hotline at 800.243.7692.

Types of Tests
Today, there are several types of HIV tests. The three tests listed below are the most commonly used antibody tests and are all considered better than 99% effective at detecting the antibodies to HIV. There are other types of tests not listed that use blood or urine to detect antibodies to HIV. There is also the "home test" option" noted above.

Rapid HIV Test (OraQuick® Advance™)
The name OraQuick® Advance™ might be confusing, since this can be used as a blood test or an oral test. This test uses oral fluid (officially, oral mucosal transudate or "OMT") or a small amount of blood (1 drop) collected from a finger stick or "venipuncture" (a blood draw, usually from the arm). You can get your results in anywhere from 20 minutes to 1 hour. If a person tests HIV-positive with this test, it is considered a Preliminary Positive result. Although the test is extremely accurate, this type of test requires additional testing for confirmation. A standard blood draw is generally encouraged as the test of choice for confirmatory testing. The turnaround time for confirmatory results can take anywhere from 3 days to 2 weeks.

Standard HIV Blood Draw
This type of test requires that a tube of blood be drawn from the person getting tested for HIV. Results can take anywhere from 3 days (at some private clinics) to 2 weeks. Each testing site is different, so you might want to ask what their turnaround time is for results with this test.

Oral HIV Test (Orasure®)
This type of test requires that oral fluid be collected with a swab from inside the cheek. Results can take anywhere from 2 days to 2 weeks. Again, each testing site is different so you might want to ask what their turnaround time is for results with this test.

Some tips in preparing to take the HIV test:

• Try to identify people — family, friends, a teacher you trust, a health care professional, a member of your spiritual community — that you can talk to openly before you take the test. They might even be willing to go with you to the test site for support.

• Think about what you will do if you test negative, as well as what you will do if you test positive. Do you feel ready for either result? If you find out you are negative, how can you stay that way? If you test positive, how will you use that information to take care of your health and that of your partners?

What about treatment?
People with HIV or AIDS can do a number of things to stay healthy — but only if they know they are infected. The most important thing to know is that treatments are now available, often at low cost, which can prevent AIDS-related illnesses. There are also several treatments that help fight the virus itself. And there is a test, called a "viral load" test that can tell you how much virus is in your blood. Knowing this can help you and your doctor decide what kind of treatment to try. Many treatments are covered by health insurance. If you can't afford health insurance and are HIV positive, there is a program called the AIDS Drug Assistance Program (ADAP) to help you get medications for free, although what ADAP covers varies from state to state.