HIV testing is integral to HIV prevention, treatment, and care efforts. Knowledge of one’s HIV status is important for preventing the spread of disease. Early knowledge of HIV status is also important for linking those with HIV to medical care and services that can reduce morbidity and mortality and improve quality of life. The U.S. Centers for Disease Control and Prevention (CDC) released revised recommendations for HIV testing in health-care settings in 2006, recommending routine HIV screening for all adults, aged 13–64, and repeat screening at least annually for those at high risk. CDC recommends HIV testing for those who have engaged in the following behaviors that increase risk of HIV transmission:
- injected drugs or steroids or shared equipment (such as needles, syringes, works) with others
- had unprotected vaginal, anal, or oral sex with men who have sex with men, multiple partners, or anonymous partners
- exchanged sex for drugs or money
- been diagnosed with or treated for hepatitis, tuberculosis, or a sexually transmitted disease (STD), like syphilis
- had unprotected sex with anyone who falls into an above category, or with someone whose history is unknown.
HIV testing is offered in public and private settings throughout the country, including free-standing HIV counseling and testing centers, health departments, hospitals, private doctors’ offices, and STD clinics. See below for testing sites in Tucson.
An HIV test is either confidential or anonymous. With confidential testing, a person’s name is recorded with their test result. With anonymous testing, no name is used. All states offer confidential testing but not all offer anonymous testing. As of May 2007, 11 states offered only confidential testing.
Testing Techniques
Tests used for HIV screening look for the presence of antibodies produced by the body to fight HIV infection. Detectable antibodies usually develop within 3 months after infection, but may take longer.
There are several kinds of HIV tests available in the U.S. They differ based on the type of specimen tested (e.g., whole blood, serum, or plasma; oral fluid; urine); how the specimen is collected (e.g., blood draw/venipuncture; finger prick; oral swab); where the test is done (e.g., laboratory, point-of-care site); and how quickly results are available (conventional or rapid).
The main types of tests are:
- Conventional blood test: Blood sample drawn by health-care provider; tested at lab. Results: a few days to two weeks.
- Conventional oral fluid test: Oral fluid sample collected by healthcare provider, who swabs inside of mouth; tested at lab. Results: a few days to two weeks. OraSure is the only FDA-approved HIV oral fluid test.
- Rapid tests: Sample collected by health-care provider at lab or care site, depending on complexity of rapid test. Results: available in as little as 20 minutes. If test is negative, no further testing is needed. If positive, test must be confirmed with a more specific test through conventional method. There are six FDA-approved rapid tests: OraQuick Advance Rapid HIV-1/2 Antibody Test (whole blood finger prick or venipuncture; plasma; oral fluid); Reveal Rapid HIV-1 Antibody Test (serum; plasma); Uni-Gold Recombigen HIV Test (whole blood finger prick or venipuncture; serum; plasma); Multispot HIV-1/HIV-2 Rapid Test (serum; plasma); and two Clearview tests—Clearview HIV 1/2 Stat Pak, Clearview Complete HIV ½ (whole blood; serum; plasma). Some rapid tests have been granted CLIA waivers which allow them to be performed by persons without formal laboratory training and outside traditional laboratories. The makers of OraQuick and Uni-Gold are pursuing over-the-counter (home use) indications for rapid testing with the FDA.
- Home Tests: Individual performs the test by pricking their finger with special device, placing drops of blood on treated card, and mailing to lab for testing. Identification number on card is used when phoning for results; counseling and referral available by phone. Results: in as little as three days. HomeAccess HIV-1 Test System, the only home HIV test currently approved by the FDA, may be purchased from many drug stores and online.
- Urine Test: Urine sample collected by health-care provider; tested at lab. Calypte is the only FDA-approved HIV urine test. Results: a few days to two weeks.
Information provided by The Henry J. Kaiser Family Foundation, HIV/AIDS Policy Fact Sheet, June 2007.
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