What should I know about HIV testing?
When thinking of getting tested for HIV, there are a few important things to consider:
How do HIV antibody tests work?
When a person is infected with a virus, the immune system creates antibodies to that virus. HIV antibody tests are looking for HIV specific antibodies. It can take some time for enough antibodies to show up on a test. For most people, 6 weeks is going to be enough time for their bodies to produce enough antibodies. For some people it may take longer than 6 weeks so the Center for Disease Control (CDC) recommends waiting at least 3 months for an accurate test.
What's the window period?
The window period refers to how long a person should wait to get tested for HIV after a possible exposure. For most people it takes 2-6 weeks for their bodies to produce enough antibodies to show up on a test. There is a chance that some people may take longer than 6 weeks. For a conclusive test result the CDC (Center for Disease Control) recommends waiting 3 months after the HIV risk activity occurred before getting tested. In some rare cases where a person has a highly compromised immune system, such as those in which a person has recently undergone chemotherapy or an organ transplant, it may take 3-6 months for their body to develop enough antibodies to show up on a test.
What's the difference between anonymous and confidential?
In many places you can get either an anonymous or confidential HIV test. Anonymous means that your name is not connected to the test but you still provide some basic demographic information (age, race, ethnicity, etc). You will most often find anonymous tests at community HIV testing sites. HIV is the only STD that you can be tested anonymously for. Confidential tests require you give a name and contact information when having the test done. Doctor's offices and other health clinics typically offer confidential testing. In most places, if you want a paper copy of your results when you leave, you will have to test using your name. In either case, your results are kept confidential. For more information on confidentiality laws click here.
Are my results reported?
When someone tests positive their result is reported to the State HIV Program for tracking purposes. The information is kept in a confidential database. For more information click here.
How much does it cost to get tested?
This will depend on where you go. If you have insurance it may cover the cost. Some clinics offer testing on a sliding scale meaning they'll charge you based on your income and what you're able to pay. There are also places to get free tests. Call the Oregon HIV/STD Hotline (800) 777-2437 or click here to find a testing place that meets your needs.
What are the different types of HIV antibody tests?
There are several screening tests used to detect HIV antibodies. These are the most common:
- ELISA: The ELISA (sometimes called EIA) is often used as the first screening tool as it is inexpensive and very sensitive in detecting HIV antibodies. A sample is collected through a blood draw (sometimes an oral swab or urine) and sent off to a lab for testing. They will then run the ELISA which is incredibly sensitive. If the test reacts then they will do a confirmatory test called the Western Blot. Results are usually given in 5-10 business days. **Reminder, the test is looking for antibodies and not virus. Oral mucosal/salvia/urine cannot transmit HIV**
- Western Blot: A Western Blot is a confirmatory test and is performed after a screening test (ELISA or Rapid) reacts. A Western Blot must be performed at a lab.
- OraSure: A swab is rubbed between the cheek and lower gum to collect an oral mucosal specimen, which is then sent out for testing. At the lab, an ELISA (and, if necessary, a Western Blot) is performed on the sample. Results are typically given in 5-10 business days. Reminder, the test is looking for antibodies and not virus. Oral mucosal cannot transmit HIV.
- Rapid Test: A rapid HIV antibody test provides results in 10-30 minutes depending on the brand of test used. The administrator will either prick the patient's finger and take a few drops of blood or swab the inside of their mouth to collect an oral mucosal specimen. The sample will then be placed into a solution to develop. If the test reacts this is called a preliminary positive and it means you may be infected with HIV. However, it is essential that you get a confirmatory test to confirm the results. . To confirm a reactive rapid test, blood is drawn or an Orasure test is administered and sent to a lab for the Western Blot test. Results for the confirmatory test are ready in 5-10 business days.
- Home Access: The only FDA approved home collection kit for HIV testing is called Home Access. The kit costs between $50-$70 and can be purchased over-the-counter at most pharmacies, online, or by phone. It involves pricking your finger and placing a couple drops of blood onto a card which is then mailed back for testing. Results can be received by calling a toll-free number 3-5 days later. The test is anonymous, but little to no counseling or support is involved, which is an aspect of testing that is offered at most community test centers. To find out more about Home Access, visit the manufacturer's website here.
To find a convenient testing site, to talk about testing options, or learn more about the testing process, call the Oregon HIV/STD Hotline at (800) 777-2437.
What is Pre and Post Test Counseling?
Most community test centers offer something called pre and post test counseling. Pre-test counseling is a time for you to speak with a HIV counselor about your possible HIV exposure, the testing process, the window period for HIV, future ways to protect yourself from HIV and/or other STDs, what the test results mean, and any other questions you have. Post-test counseling is the time after you receive your test results to ask questions about your test result, get support, and get linked to any services you need. If get a preliminary positive on a rapid test then they will do a second test to confirm the results (it takes about 5-7 business days to get the confirmatory test results back from the lab).
I just tested positive, what are my next steps?
Testing HIV positive can be an overwhelming experience. Whether you need help with insurance issues, securing medical care, finding a doctor, social support or other issues, there are people and places that can help. For more information on first steps and to get connected to services click here. If you want to talk to someone or need more information you can speak with a Hotline Counselor at the Oregon HIV/STD Hotline by calling 1-800-777-2437 or through online chat at www.oregonaidshotline.com