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?
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:
- If you don't have health insurance, you may want talk to
an HIV counselor before taking the test. You can also call an anonymous
hotline, such as the GMHC HIV/AIDS Hotline 800.243.7692 to find out what
your insurance options are.
- 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.
© 2006 Gay Men's Health Crisis
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