HIV Testing Overview

What Can You Expect When You Get an HIV Test?

There are many ways to get tested for HIV. Your HIV testing experience might differ depending on where you get tested and the types of tests offered at a particular location.

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HIV Testing in a Health Care Setting or Lab

If you take a test in a health care setting or a lab, a health care provider or lab technician will take a sample of your blood or oral fluid. If it&#;s a rapid test done by taking oral fluid or by pricking your finger for a few drops of blood, you may be able to wait for the results. If it&#;s a blood sample that goes to a lab, it can take several days for your results to be available. Your health care provider or counselor may talk with you about your HIV risk factors, answer any questions, and discuss the next steps with you, especially if your rapid test result is positive.

• If your test comes back negative, and you haven&#;t had an exposure during the window period for the test you took, you can be confident you don&#;t have HIV. You can take actions to prevent HIV, such as using pre-exposure prophylaxis.
• If your oral swab or finger prick test is positive, it will need to be followed up with a blood sample to confirm the results.
• If that confirmatory blood sample test result is positive, the lab will conduct follow-up tests. If you receive a positive test result, you can take medicine to treat HIV (called antiretroviral therapy or ART), which protects your health and prevents transmission to others. You may be able to start treatment the same day you get your test result.

HIV Testing in a Community-Based Setting

If you get an HIV test outside of a health care setting or lab&#;such as at a community-based organization, mobile testing van, or elsewhere&#;you will likely receive a rapid HIV test.

• If your test result is negative, and you haven&#;t had a possible exposure during the previous three months, you can be confident you don&#;t have HIV.
• If your test result is positive, you should go to a health care provider or clinic for follow-up testing. Counselors providing the initial test should be able to answer your questions and provide referrals for follow-up testing. You can use the HIV.gov locator to find a health center near you.

Learn about the different places where you can get an HIV test.

Is HIV Self-Testing an Option?

Yes. HIV self-testing allows people to take an HIV test and find out their result in their home or other private location. There are two kinds:

• A Rapid Self-Test is done entirely at home or in a private location, and results are ready in as little as 20 minutes. You can buy a rapid self-test kit at a pharmacy or online. Or you can order a free HIV self-test through CDC&#;s

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• A Mail-In Self-Test includes a specimen collection kit that contains supplies to collect dried blood from a fingerstick at home. The sample is then sent to a lab for testing, and a health care provider provides the results. You can order a mail-in self-test online. Some health care providers can also order a mail-in self-test for you.

Check to see if your local health department or an HIV service organization near you provides rapid self-tests for a reduced cost or for free. HIV self-tests and mail-in HIV tests may be covered by insurance. Be sure to check with your insurance provider and your health care provider about reimbursement for tests you purchase.

Note: State laws regarding self-testing vary and may limit availability. Check with your provider for additional testing options.

Learn more about HIV self-testing and which one might be right for you.

Can an HIV Test Detect the Virus Immediately After Exposure?

No HIV test can detect HIV immediately after exposure, including a blood test. This is because of the window period&#;the time between when a person gets HIV and when an HIV test can accurately detect it. The window period varies from person to person and also depends on the type of HIV test performed. Some tests can detect HIV sooner than others. (See image below.)

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), immediately.

Types of HIV Tests and Their Window Periods

There are three types of HIV tests: nucleic acid tests (NAT), antigen/antibody tests, and antibody tests, and they all have different window periods:

• Nucleic Acid Test (NAT)&#;A NAT can usually tell if you have HIV infection 10 to 33 days after exposure. It is performed by a lab on blood from your vein.
• Antigen/Antibody Test&#;An antigen/antibody test performed by a laboratory on blood from your vein can usually detect HIV infection 18 to 45 days after exposure. An antigen/antibody test done with blood from a finger prick takes longer to detect HIV (18 to 90 days after an exposure).
• Antibody Test&#;An antibody test can usually detect HIV infection 23 to 90 days after an exposure. Most rapid tests and self-tests are antibody tests. In general, antibody tests that use blood from a vein detect HIV sooner after infection than tests done with blood from a finger prick or with oral fluid.

Ask your health care provider or HIV testing counselor about the window period for your test and whether you will need a follow-up test to confirm the results. If you&#;re using a self-test, you can get that information from the materials included in the test&#;s package.

If you get an HIV test after a potential HIV exposure and the result is negative, get tested again after the window period. Remember, you can only be sure you are HIV-negative if:

• Your most recent test is after the window period.
• You haven&#;t had a potential HIV exposure during the window period. If you have had a new potential exposure, then you will need to be retested.

What If You Can&#;t Pay for Your HIV Test?

As required by the Affordable Care Act, HIV screening is covered by health insurance without a co-pay. If you don&#;t have health insurance, some testing sites, health centers, or local health departments may offer free tests. Use CDC&#;s Get Tested to search for free testing resources.

These days, thanks to advances in technology, there are more ways than ever to get tested for HIV.

Here is all you need to know about the different types of HIV tests available and some considerations you should consider.

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5 Facts About Testing

1. It takes time for HIV to be detected in the body
   Most people who&#;ve been exposed to HIV will test positive within one month after exposure, but a small number of people take up to three months.
2. You&#;re highly infectious during the &#;window period&#;
   That&#;s the time between HIV infection and the production of antibodies. A lot of HIV transmission occurs because guys don&#;t know that they have HIV developing in the window period.
3. Testing negative after three months is a good sign
   A negative test three months after an initial test will almost always mean a person does not have HIV, given there&#;s been no risk of HIV transmission in the meantime.
4. Your HIV test results are confidential
   If you&#;re worried about the confidentiality of your results, you should know that all testing in private GPs and public clinics is governed by Privacy Law. Talk with your GP or clinic about this when testing. At some clinics, you don&#;t need a Medicare card, and in some cases, you don&#;t even have to give your real name if you don&#;t want to.
5. HIV and STI testing is available free of charge at many sexual health clinics
   In many cases, HIV testing is free, and you don&#;t need a Medicare card. You can find your nearest testing site in NSW here.

What HIV Tests Are Available?

Rapid HIV Test

A rapid HIV test involves drawing a small amount of blood, generally via a finger prick, with a result usually available within 30 minutes.

There are three possible results: negative, reactive, and invalid. These results are only preliminary, and blood will still need to be collected from your arm and sent to a laboratory to confirm them.

• Negative &#; HIV antibodies were not detected in the sample. It&#;s important to note that people within the HIV window period might also receive a negative result.
• Reactive &#; HIV antibodies were detected in the sample, but this result needs to be confirmed with laboratory-based blood testing.
• Invalid &#; In the unlikely case that the test shows an invalid response, it simply means something went wrong with the test itself. This result is not an indication of the person&#;s HIV status, and they would be offered a repeat rapid HIV test.

Rapid HIV testing is available at many locations in NSW, or if you are in Sydney, you can also visit a[TEST].

HIV Antibody Test

The HIV antibody test is the most common test gay men will have during a sexual health check.

If you have contracted HIV, your immune system will start producing antibodies reacting to the virus within 2-12 weeks following exposure. This test detects these antibodies, and if you test positive, a follow-up test will be done to confirm the result.

Antigen Test

An antigen test will detect HIV infection at an earlier stage than an HIV antibody test. It tests for quantities of a protein known as the p24 antigen, which is part of the HIV virus and produced in high amounts early on after contracting HIV. Most labs in Australia currently test for HIV antibodies and the p24 antigen.

Dried Blood Spot (DBS) Test

A DBS test is a free, accurate and convenient way to test for HIV in the comfort and privacy of your home.

It involves collecting a few drops of blood from your finger and allowing the blood to dry on a test card. You then send the card away to get tested and wait around a week to get the result back. DBS is no longer a preferred method of testing in NSW thanks to advances in self-testing kits.

HIV Self-Test (HST)

An HIV self-test is a finger-prick blood test that you can perform on yourself, at home or elsewhere, and receive results in 15 minutes. The testing kit comes as an easy-to-use device with directions. Australia only has one test approved for sale, which you can find online or in-store at pharmacies.

You can now order up to a year&#;s supply (one every three months) of HIV self-tests for free through hivtest.au so long as you live in Australia and are over the age of 18.

For more detailed information on approved HIV self-testing in Australia, visit the AFAO website.

HIV self-testing devices work by detecting HIV antibodies, which the immune system produces anywhere between two weeks to three months after exposure to the virus. Because of this window period, HIV self-testing devices may not provide a conclusive result until up to three months after a risk of exposure.

As these devices are screening tests, the possible results are &#;reactive&#;, &#;negative&#; (non-reactive), or &#;invalid&#;. Any reactive result needs to be confirmed by a blood test conducted by a healthcare professional.

Window Period

It takes time for HIV to be detected in the body. Most people who&#;ve been exposed to HIV will test positive within one month after exposure, but some may take up to three months. This period is known as &#;the window period&#;.

The window period is the time between HIV infection and the production of antibodies; a lot of HIV transmission occurs because guys don&#;t know that they have HIV developing in the window period. So, if you test negative three months after your potential exposure to HIV, it will almost always mean you do not have HIV, so long as there has been no other risk of transmission in the meantime.

Read more about the HIV window period here.

Pre-test discussion checklist

If you are testing at a GP or a sexual health clinic (i.e. getting a rapid HIV test, antibody test or antigen test), you&#;ll have a few minutes to chat with your healthcare provider about the following:

• What the test means and the implications of a positive or negative result
• Your sexual activity since your last test to gauge how likely it is that you may have been exposed to HIV
• Your understanding of HIV, how it is transmitted and how to protect yourself
• The support available to you after your result
• The window period of the test you are taking and if you need to be retested

Some clinics provide an express service where you enter some of this information directly on a computer before seeing the nurse, which cuts down on the length of the discussion, meaning you get out of there quicker!

Need to talk?

If you&#;ve had a recent risk event, you can take PEP to prevent infection, but only if it&#;s taken within 72 hours after exposure to HIV. Call the PEP Hotline at 737 669.

If you want to talk to someone about a positive or reactive result, call:

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