There are more ways to prevent and test for HIV today than ever. For people at a higher risk of contracting HIV, there’s medication available (PrEP) that reduces their risk, and research is ongoing into new and potentially more efficient ways to reduce HIV transmission.
Promising results of a study published in the New England Journal of Medicine on Wednesday found that an injection that’s given just twice a year significantly lowered the rate of HIV incidence among girls and women in South Africa and Uganda compared to background HIV incidence. None of the 2,134 study participants who took the studied drug (lenacapavir) acquired HIV.
Beyond advancements in preventive medicine, testing to know your HIV status is key to taking control of your health. Getting diagnosed today with HIV does not mean the same thing as it did years ago. By simply sticking to their medication plan, most people can get the virus to an undetectable level, meaning there’s no longer an infection risk. Current treatments mean that someone who tests positive for HIV can live a lengthy life and may keep the virus so undetectable that they won’t pass it on to a sexual partner.
If you’ve been through a typical sex ed class, you’ve probably heard that checking your HIV status is a good idea at least once, regardless of individual factors that influence your risk of contracting it. But has any information changed since you were last in school? Here’s what we know now about HIV tests, and where you can get one.
Who needs an HIV test? How often should I get one?
The US Centers for Disease Control and Prevention recommends that all people get at least one HIV test during their lifetime. However, many people are recommended to test more often. How often you might benefit from a test is personal and depends on several factors, including your recent sexual history, your partners, what drugs you use and more. Here are some more specific recommendations:
If you’re a man who has sex with men and you’re not in a monogamous relationship where the two of you already know your status: You should get an HIV test at least once a year. Some sexually active gay or bisexual men might benefit from testing more often, like once every three or six months.
Like many viruses, HIV has a disproportionate effect on certain populations. Gay, bisexual and other men who have sex with men have the highest risk of contracting HIV in the US, making up about 68% of new diagnoses in 2020. Black and Hispanic men are at higher risk.
If you’ve had more than one sexual partner since your last HIV test, the CDC recommends getting another one. You can get it at the same time as your test for other sexually transmitted infections, like chlamydia. Similarly, though kind of in reverse, if you’ve been diagnosed with another STI, you should also get a test for HIV.
If you’ve exchanged drug equipment with another person, such as needles, syringes or cookers, you should get an HIV test. If you share drug equipment regularly, you should test for HIV at least once a year.
If you’ve exchanged sex for things like money, you should get an HIV test. If you do so regularly, you should get tested at least once a year (possibly every three months, for example).
If you’ve had sex with a person who’s been recommended a test based on the above criteria, or you don’t know their sexual history, you should get an HIV test.
If you’re pregnant, your doctor will also probably recommend an HIV test early in your pregnancy. If someone who is HIV-positive follows the guidelines given to them for their medication regimen during pregnancy and birth, they have a 99% chance of not passing HIV onto their baby, according to the American College of Obstetricians and Gynecologists.
You can get an HIV test a few different ways, and they’re all pretty quick.
Where to get an HIV test
HIV tests can be antibody, antigen/antibody tests or NAT (lab-based) tests. Most rapid HIV tests are antibody tests, which means they work by detecting antibodies your body produces if you have HIV, either through blood or a swab of the cheek.
Health clinics like Planned Parenthood offer HIV testing. You can also check in with your local health department, as smaller clinics often offer discounted or even free testing if you’re worried you can’t afford one. If you have a regular primary care physician you see, they’ll also be able to run an HIV test for you.
If you’d rather test at home, you also have options. OraQuick In-Home HIV Test is an HIV testing kit that requires a swab of your cheek — no blood involved. In 20 minutes, you’ll get your results. You can get one or two OraQuick home HIV tests for free if you order through Together TakeMeHome, an initiative by the CDC to get more HIV tests out. And according to the Together TakeMeHome website, people in the US and Puerto Rico can order every three months.
You can also buy OraQuick online for $39. If you’re testing within three months after potentially being exposed to HIV, OraQuick recommends testing again after the three-month mark, as there’s a window of time when false negatives are more likely. (Read more about when to test in the section below.)
There are other testing options, including mail-in HIV tests where you administer the test at home but mail in your sample to a lab for processing. Pharmacies such as CVS sell HIV tests, sometimes in kits that test for other STIs as well.
The LetsGetChecked Standard 5 test, for example, screens for HIV but also common STIs including chlamydia, gonorrhea, syphilis and trichomoniasis. You’ll need to do a finger prick and provide a urine sample that you’ll ship out for testing, and you should receive results within two to five days, according to the company.
HIV tests are generally accurate if you follow the test instructions, but if you get a positive result, follow up with your doctor to confirm the result and get next steps for treatment. If you test positive at your doctor’s office or in a clinic, your health care provider might run a second test to confirm.
When to take a test if you think you were exposed to HIV
If you’ve been exposed to HIV and do end up developing it, how soon a test will turn positive depends on the type of test you’re taking and also varies a bit person to person. But it may take up to three months for a rapid test to detect HIV, as the body needs to build up enough antibodies to turn a test positive.
If you’re looking for an accurate result in the fastest amount of time, you can ask your doctor for a nucleic acid test (NAT), which may detect it as early as 10 days after an exposure, though it may take longer.
If you have an exposure and take a negative test, get tested again as soon as the “window period” of whatever test you’re using is over. For antibody tests, this means testing again after 90 days have gone by. For NAT tests, this means waiting 33 days. See the CDC’s window period for different HIV tests here. If you think you were exposed to HIV, you can also talk with your doctor or another health care provider so they can advise you on the best timing to test, or direct you to testing.
If you test positive for HIV: Know you are not alone, and that the medications available today mean you’ll most likely be able to bring the virus down to a level that’s undetectable, which means your body is on top of it and you have effectively no chance of spreading it to a sex partner.
According to the CDC, most people can get an undetectable viral load within six months of starting medication, as long as they take it as prescribed.
Find a list of a few support groups for others with a positive HIV diagnosis here.