HIV/AIDS

What You Need to Know About Getting Tested for HIV

Joseph Bennington-Castro
By Medically Reviewed by 
Reviewed:
Medically Reviewed
a blood test vial to test for HIV
HIV screening tests are very accurate, but follow-up blood tests are necessary to confirm a positive diagnosis.Getty Images
An estimated 1 in 8 HIV-positive people in the United States don’t know they’re infected with the virus because they haven’t been tested for it.

It’s important to get tested regularly for HIV (human immunodeficiency virus) if you have ongoing risk factors (or at least once in your life), because you can’t rely on HIV-related signs and symptoms as an accurate predictor of your HIV status. In fact, after contracting the virus, some people live for 10 years or more before experiencing any symptoms.

And if you do test positive for HIV, you can begin antiretroviral therapy. With proper treatment, you can manage the virus, live a healthy life, and reduce the risk of transmitting it to others.

Who Should Get Screened for HIV and When?

The CDC recommends that everyone between ages 13 and 64 get tested for HIV at least once.

For people in higher risk groups, more frequent testing is necessary. Unsafe sex practices and intravenous drug use put you at greater risk of contracting HIV.

The CDC recommends getting tested for HIV if you were last tested more than one year ago and can answer affirmatively to any of the following:

  • Had sex with an HIV-positive person or someone with an unknown HIV status
  • Shared needles, syringes, and other equipment for injecting drugs with other people
  • Had sex in exchange for drugs or money
  • Have been diagnosed with or treated for other sexually transmitted infections, which increase your risk of contracting HIV
  • Have been diagnosed or treated for hepatitis or tuberculosis
  • Have had more than one sexual partner since your last HIV test
  • Have had sex with someone for whom any of the above applies, or you had sex with someone whose sexual history you don’t know
You should also get tested if you’re pregnant or planning to become pregnant. If a pregnant woman is treated for HIV early in her pregnancy, it can greatly reduce the risk (to 1 percent or less) of transmitting the virus to the baby.

If you are the victim of sexual assault, it’s important to get tested.

If you’re having unsafe sex or sharing drug injection needles, you should get tested for HIV at least once a year.

Sexually active gay and bisexual men may want to get tested every three to six months, considering that this demographic accounted for almost two-thirds of the new HIV cases in the United States in 2020.

What Types of HIV Tests Are Available?

HIV tests look for either HIV antibodies (proteins your body makes to fight the virus), both antibodies and antigens (substances found on viruses that trigger the production of antibodies and are detectable in the blood before antibodies), or genetic material from the virus.

HIV tests are generally performed on blood or oral fluid samples; certain tests may also be performed on a urine sample.

Which test you take depends on how recently you think you may have been exposed to HIV, how long you want to wait for results, and where you take the test.

Nucleic Acid Test (NAT): 10 to 33 Days After an Exposure An NAT can detect HIV’s genetic material in the blood. This test must be taken in a clinic and is very expensive. It may be given to people with early, flu-like symptoms and a recent, high-risk exposure. Usually, healthcare providers use it to confirm other tests, rather than as an initial screening test.

Antibody/Antigen Test: 18 to 45 Days After an Exposure This test, commonly performed in a lab, checks for both antibodies and antigens. An antibody/antigen test can use blood drawn from a vein, with results in a few days. Or it can be a rapid test, using blood from a finger prick and delivering results in less than 30 minutes. The rapid test can take longer to detect HIV after exposure, from 18 to 90 days.

Antibody Test: 23 to 90 Days After an Exposure: An antibody-only test uses a fluid sample swabbed from inside your cheek or blood from a finger prick. These rapid tests and at-home tests can detect HIV antibodies three weeks after exposure at the earliest and deliver results in 20 to 30 minutes. They are also good at detecting chronic HIV.

There are antibody-only tests that use blood drawn from a vein rather than a finger prick. These tests can typically detect the infection sooner after exposure but take several days to deliver results, and are conducted at a lab.

All positive antibody tests should be followed up with an additional test to confirm the results.

There’s no HIV test that can detect the virus immediately after infection. If you think you’ve been exposed to HIV within the past 72 hours, contact your healthcare provider immediately or go to the emergency room. Post-exposure prophylaxis is a combination of HIV medicines that can prevent the virus from taking hold.

Those at high-risk for HIV exposure may want to talk to their doctor about pre-exposure prophylaxis (PrEP), a prescription medication that can reduce their risk when taken as prescribed.

Where Can You Get Tested for HIV?

Many places offer HIV testing, including your healthcare provider’s office, hospitals, community health centers or clinics, local health departments, and substance abuse clinics. Many pharmacies also offer testing.

Under the Affordable Care Act, HIV testing is covered by health insurance without a copay. If you’re uninsured, check the CDC’s HIV service locator or local health department to find free or low-cost testing options.

At-home tests are also available; you can purchase them at pharmacies or online. There are two kinds:

  • Rapid Self-Test This is done completely at home and can provide results within 20 minutes. The only rapid self-test currently approved by the Food and Drug Administration is OraQuick, an oral fluid test.

  • Mail-In Self-Test With this finger-stick test, you send your sample to a lab and test results are given to you by a healthcare provider.

Understanding Your Test Results

Most HIV tests are very accurate but not flawless. The time between when a person may have been exposed to HIV and when the virus can be detected is called the window period. This delay varies from person to person and depends on which test you took.

False negative results can happen when someone tests for HIV in the first weeks after infection — during the window period. After the window period, false negatives are extremely rare.

If your test is negative and you haven’t been exposed to HIV in the window period for the test you took, you can be confident that you do not have HIV.

It’s important to have a follow-up blood test to confirm a positive HIV diagnosis. If you tested negative but think you might have HIV, you should have another test to validate your results.

If you took any type of antibody test and had a positive result, you’ll need a follow-up test to confirm. If the follow-up test is also positive, it means you’re HIV-positive. Talk to your healthcare provider about starting HIV treatment as soon as possible.

Additional reporting by Deborah Shapiro.

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