HIV Testing

The only way to know for certain whether or not you have been infected with HIV is to be tested. Experts recommend that everyone aged between 13 and 64 should be tested at least once for HIV as part of a standard health care routine. Being aware of your HIV status is powerful knowledge that can enable you to take the necessary steps to ensure that both you and your partner remain healthy.

The need for HIV testing

There is a need for more frequent HIV testing for certain people with particular risk factors that increase the likelihood of being infected. Even if you have previously tested negative for HIV, it is a good idea to get tested again at least twice a year if you:

• Are a gay man who has had sexual relations with other men

• Have had multiple sex partners since your previous test

• Have had sex in return for money or drugs

• Have been treated for or diagnosed with tuberculosis (TB) or hepatitis

• Have had vaginal or anal sex with a partner who is HIV positive

• Have shared needles or works (such as cotton or water) with other people, or injected drugs

• Have sought treatment for, or been diagnosed with another sexually transmitted infection

Pregnant women concerned about HIV should talk to their doctor about testing and the ways in which they and their child can be protected from infection. Sexual assault victims should also be tested as soon as possible following the assault. In such circumstances post-exposure prophylaxis should also be considered. This involves taking antiretroviral medicines to prevent HIV infection after potential exposure.

Prior to the commencement of sexual activity with a new partner, it is a good idea for both of you to discuss your previous drug use and sexual history, including your HIV status if you are aware of it, and to consider HIV testing if you are not.

How HIV testing can help

HIV testing can help to maintain your health. In the event that you discover that you are HIV positive, you can then take the appropriate HIV medication in order to make sure that you are able to remain healthy for many years to come, and to cut down the chances of infecting your sexual partner with the virus. If you are negative, testing can still be helpful, both to put your mind at ease and to learn about more prevention tools to ensure you stay that way. Pregnant women who learn they are HIV positive could also begin immediate treatment, which, providing they are still early on in their pregnancy, could greatly reduce the chances of the virus being transmitted to their child.

The Tests

There are three broad kinds of HIV test available at present, those being fourth generation or combination tests, nucleic acid tests, and antibody tests. Blood, urine or oral fluid can be used for HIV testing.

Antibody tests

The great majority of HIV tests, including most home and rapid tests, are antibody tests. Bacteria or viruses such as HIV cause the immune system to create antibodies to fight them, which can be detected by antibody tests. There is a window period of between three to twelve weeks in which enough antibodies will have been made by the body against HIV to be detectable, which is why it is recommended that a follow-up test is taken three months after an initial negative test.

Results can be ready in half an hour or less if a rapid antibody screening test is used. Home testing involves collecting a blood sample at home by pricking the finger and sending it to a licensed laboratory by mail. These tests are anonymous and the results can be ready as early as the next morning, and accessed by telephone.

Nucleic acid tests

Nucleic acid tests check the blood for the actual HIV virus rather than for antibodies. It is not used routinely except for individuals at high risk of exposure, as it is very expensive.

Fourth-generation (combination) tests

Combination tests look for antibodies as well for antigens, foreign substances that activate the immune system. P24 antigens activate prior to antibodies in someone infected with HIV, and rapid combination tests are becoming increasingly common.