The only way to know for sure whether you have HIV is to get tested. CDC recommends that everyone between the ages of 13 and 64 get tested for HIV at least once as part of routine health care. Knowing your HIV status gives you powerful information to help you take steps to keep you and your partner healthy. 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 get tested.
CDC recommends that everyone between the ages of 13 and 64 get tested for HIV at least once as part of routine health care. About 1 in 7 people in the United States who have HIV don’t know they have it.
People at higher risk should get tested more often. If you were HIV-negative the last time you were tested, and that test was more than one year ago, and you answer yes to any of the following questions, you should get an HIV test as soon as possible because these things increase your chances of getting the virus:
• Are you a man who has had sex with another man?
• Have you had sex—anal or vaginal—with an HIV-positive partner?
• Have you had more than one sex partner since your last HIV test?
• Have you injected drugs and shared needles or works (for example, water or cotton) with others?
• Have you exchanged sex for drugs or money?
• Have you been diagnosed with or sought treatment for another sexually transmitted disease?
• Have you been diagnosed with or treated for hepatitis or tuberculosis (TB)?
• Have you had sex with someone who could answer yes to any of the above questions or someone whose sexual history you don’t know?
You should be tested at least once a year if you keep doing any of these things. Sexually active gay and bisexual men may benefit from more frequent testing (for example, every 3 to 6 months).
If you’re pregnant, talk to your health care provider about getting tested for HIV and other ways to protect you and your child from getting HIV.
Before having sex for the first time with a new partner, you and your partner should talk about your sexual and drug-use history, disclose your HIV status, and consider getting tested for HIV and learning the results.
Knowing your HIV status gives you powerful information to help you take steps to keep you and your partner healthy.
• If you test positive, you can take medicine to treat HIV. People with HIV who take HIV medicine as prescribed can stay healthy for many years. HIV medicine also helps prevent transmission to others.
• If you test negative, you have more prevention tools available today to prevent HIV than ever before.
• If you are pregnant, you should be tested for HIV so that you can begin treatment if you’re HIV-positive. If an HIV-positive woman is treated for HIV early in her pregnancy, the risk of transmitting HIV to her baby is very low.
CDC recommends that everyone between the ages of 13 and 64 get tested for HIV at least once as part of routine health care, and more often if you do things that might increase your risk for getting HIV.
Even if you are in a monogamous relationship (both you and your partner are having sex only with each other), you should find out for sure whether you or your partner has HIV.
All pregnant women should be tested for HIV so that they can begin treatment if they’re HIV-positive. If a woman is treated for HIV early in her pregnancy, the risk of transmitting HIV to her baby can be very low. Testing pregnant women for HIV infection and treating those women who have HIV have led to a big decline in the number of children infected with HIV from their mothers.
The treatment is most effective for preventing HIV transmission to babies when started as early as possible during pregnancy. However, there are still great health benefits to beginning preventive treatment even during labor or shortly after the baby is born.
There are three types of tests available: nucleic acid tests (NAT), antigen/antibody tests, and antibody tests. HIV tests are typically performed on blood or oral fluid. They may also be performed on urine.
– A NAT looks for the actual virus in the blood. The test can give either a positive/negative result or an amount of virus present in the blood (known as an HIV viral load test). This test is very expensive and not routinely used for screening individuals unless they recently had a high-risk exposure or a possible exposure and they have early symptoms of HIV infection. Nucleic acid testing is usually considered accurate during the early stages of infection. However, it is best to get an antibody or antigen/antibody test at the same time to help the health care provider understand what a negative NAT means. Taking pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP) may also reduce the accuracy of NAT if you have HIV.
– An antigen/antibody test looks for both HIV antibodies and antigens. Antibodies are produced by your immune system when you’re exposed to bacteria or viruses like HIV. Antigens are foreign substances that cause your immune system to activate. If you have HIV, an antigen called p24 is produced even before antibodies develop. Antigen/antibody tests are recommended for testing done in labs and are now common in the United States. There is also a rapid antigen/antibody test available.
– Most rapid tests and home tests are antibody tests. HIV antibody tests look for antibodies to HIV in your blood or oral fluid. In general, antibody tests that use blood from a vein can detect HIV sooner after infection than tests done with blood from a finger prick or with oral fluid.
– While most laboratories are now using antigen/antibody tests, laboratory-based antibody screening tests are still available. These tests require blood to be drawn from your vein into a tube and then that blood is sent to a laboratory for testing. The results may take several days to be available.
– With a rapid antibody screening test, results are ready in 30 minutes or less. These tests are used in clinical and nonclinical settings, usually with blood from a finger prick or with oral fluid.
– The oral fluid antibody self-test provides fast results. You have to swab your own mouth to collect an oral fluid sample and use a kit to test it. Results are available in 20 minutes. The manufacturer provides confidential counseling and referral to follow-up testing sites. These tests are available for purchase in stores and online. They may be used at home, or they may be used for testing in some community and clinic testing programs.
– The home collection kit involves pricking your finger to collect a blood sample, sending the sample by mail to a licensed laboratory, and then calling in for results as early as the next business day. This antibody test is anonymous. The manufacturer provides confidential counseling and referral to treatment.
– If you use any type of antibody test and have a positive result, you will need to take a follow-up test to confirm your results. If your first test is a rapid home test and it’s positive, you will be sent to a health care provider to get follow-up testing. If your first test is done in a testing lab and it’s positive, the lab will conduct the follow-up testing, usually on the same blood sample as the first test.
– After you get tested, it’s important for you to find out the result of your test so that you can talk to your health care provider about treatment options if you’re HIV-positive. If you’re HIV-negative, continue to take actions to prevent HIV, like using condoms the right way every time you have sex and taking medicines to prevent HIV if you’re at high risk.
No HIV test can detect HIV immediately after infection. 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), right away.
The time between when a person may have been exposed to HIV and when a test can tell for sure whether they have HIV is called the window period. The window period varies from person to person and depends on the type of test used to detect HIV.
• A nucleic acid test (NAT) can usually tell you if you have HIV infection 10 to 33 days after an exposure.
• An antigen/antibody test performed by a laboratory on blood from a vein can usually detect HIV infection 18 to 45 days after an exposure. Antigen/ antibody tests done with blood from a finger prick can take longer to detect HIV (18 to 90 days after an exposure). When the goal is to tell for sure that a person does not have HIV, an antigen/antibody test performed by a laboratory on blood from a vein is preferred.
• Antibody tests can usually take 23 to 90 days to reliably detect HIV infection. Most rapid tests and home tests are antibody tests. In general, antibody tests that use blood from a vein can detect HIV sooner after infection than tests done with blood from a finger prick or with oral fluid.
• Ask your health care provider about the window period for the test you’re taking. If you’re using a home 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 for the test you’re taking to be sure. If your health care provider uses an antigen/antibody test performed by a laboratory on blood from a vein you should get tested again 45 days after your most recent exposure. For other tests, you should test again at least 90 days after your most recent exposure to tell for sure if you have HIV.
• If you learned you were HIV-negative the last time you were tested, you can only be sure you’re still negative if you haven’t had a potential HIV exposure since your last test. If you’re sexually active, continue to take actions to prevent HIV, like using condoms the right way every time you have sex and taking medicines to prevent HIV if you’re at high risk.
If you take a test in a health care setting, 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 don’t have HIV.
If your HIV test result is positive, you may need to get a follow-up test to be sure you have HIV.
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.
A negative result doesn’t necessarily mean that you don’t have HIV. That’s because of the window period— the time between when a person may have been exposed to HIV and when a test can tell for sure whether they have HIV. The window period varies from person to person and is also different depending upon the type of HIV test.
Ask your health care provider about the window period for the test you’re taking. If you’re using a home 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 for the test you’re taking to be sure. For example, if your health care provider uses an antigen/antibody test performed by a laboratory with blood from a vein you should get tested again 45 days after your most recent exposure. For other tests, you should test again at least 90 days after your most recent exposure to tell for sure if you have HIV.
If you learned you were HIV-negative the last time you were tested, you can only be sure you’re still negative if you haven’t had a potential HIV exposure since your last test. If you’re sexually active, continue to take actions to prevent HIV, like using condoms the right way every time you have sex and taking medicines to prevent HIV if you’re at high risk.
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 has HIV.
It’s important to be open with your partners and ask them to tell you their HIV status. But keep in mind that your partners may not know or may be wrong about their status, and some may not tell you if they have HIV even if they are aware of their status. Consider getting tested together so you can both know your HIV status and take steps to keep yourselves healthy.
A follow-up test will be conducted. If the follow-up test is also positive, it means you are living with HIV (or HIV-positive).
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.
It is important that you start medical care and begin HIV treatment as soon as you are diagnosed with HIV. Antiretroviral therapy or ART (taking medicine to treat HIV infection) is recommended for all people with HIV, regardless of how long they’ve had the virus or how healthy they are. HIV medicine works by lowering the amount of virus in your body to very low levels. HIV medicine can make the viral load so low that a test can’t detect it (called an undetectable viral load). HIV medicine slows the progression of HIV and helps protect your immune system. If you take HIV medicine as prescribed and get and keep an undetectable viral load, you can stay healthy for many years, and you have effectively no risk of transmitting HIV to an HIV-negative partner through sex.
If you have health insurance, your insurer is required to cover some medicines used to treat HIV. If you don’t have health insurance, or you’re unable to afford your co-pay or co-insurance amount, you may be eligible for government programs that can help through Medicaid, Medicare, the Ryan White HIV/AIDS Program, and community health centers. Your health care provider or local public health department can tell you where to get HIV treatment.
To lower your risk of transmitting HIV:
• Take HIV medicine (antiretroviral therapy or ART) as prescribed. If you take HIV medicine as prescribed and get and keep an undetectable viral load, you have effectively no risk of transmitting HIV to an HIV-negative partner through sex.
• Use condoms the right way every time you have sex. Learn the right way to use a male condom and female condom.
• If your partner is HIV-negative, encourage them to talk to their health care provider to see if taking daily medicine to prevent HIV (called pre-exposure prophylaxis, or PrEP) is right for them.
• If you think your partner might have been recently exposed to HIV—for example, if the condom breaks during sex and you aren’t virally suppressed—they should talk to a health care provider as soon as possible within the next 3 days (72 hours) about taking medicines (called post-exposure prophylaxis, or PEP) to prevent getting HIV.
• Get tested and treated for STDs and encourage your partner to do the same.
• Receiving a diagnosis of HIV can be a life-changing event. People can feel many emotions—sadness, hopelessness, or anger. Allied health care providers and social service providers, often available at your health care provider’s office, will have the tools to help you work through the early stages of your diagnosis and begin to manage your HIV.
• Talking to others who have HIV may also be helpful. Find a local HIV support group. Learn about how other people living with HIV have handled their diagnosis.
No. Being HIV-positive does not mean you have AIDS. AIDS is the most advanced stage of HIV disease. HIV can lead to AIDS if a person does not get treatment or take care of their health.
If you take an anonymous test, no one but you will know the result. If you take a confidential test, your test result will be part of your medical record, but it is still protected by state and federal privacy laws.
Anonymous testing means that nothing ties your test results to you. When you take an anonymous HIV test, you get a unique identifier that allows you to get your test results.
Confidential testing means that your name and other identifying information will be attached to your test results. The results will go in your medical record and may be shared with your health care providers and your health insurance company. Otherwise, the results are protected by state and federal privacy laws, and they can be released only with your permission.
With confidential testing, if you test positive for HIV, 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.
It’s important to share your status with your sex partners. Whether you disclose your status to others is your decision.
Partners
It’s important to disclose your HIV status to your sex partners even if you’re uncomfortable doing it. Communicating with each other about your HIV status means you can take steps to keep both of you healthy. The more practice you have disclosing your HIV status, the easier it will become.
Many resources can help you learn ways to disclose your status to your partners. For tips on how to start the conversation with your partners, check out CDC’s Start Talking. Stop HIV. campaign.
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. This is called partner notification services. 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.
Many states have laws that require you to tell your sexual partners if you’re HIV-positive before you have sex (anal, vaginal, or oral) or tell your drug-using partners before you share drugs or needles to inject drugs. In some states, you can be charged with a crime if you don’t tell your partner your HIV status, even if your partner doesn’t get HIV.
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 has many benefits—studies have shown that people who disclose their HIV status respond better to treatment than those who don’t. And telling friends and family can provide an important source of support in managing your HIV.
If you are under 18, however, some states allow your health care provider to tell your parent(s) that you received services for HIV if they think doing so is in your best interest.
Employers
In most cases, your employer will not know your HIV status unless you tell them. 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.
All people with HIV are covered under the Americans with Disabilities Act. This means that your employer cannot discriminate against you because of your HIV status as long as you can do your job.
HIV screening is covered by health insurance without a co-pay, as required by the Affordable Care Act.
If you have health insurance, your insurer is required to cover some medicines used to treat HIV. If you don’t have health insurance, or you’re unable to afford your co-pay or co-insurance amount, you may be eligible for government programs that can help through Medicaid, Medicare, the Ryan White HIV/AIDS Program, and community health centers.
