Table of ContentsView AllTable of ContentsPurpose of TestRisks/ContraindicationsBefore the TestDuring the TestAfter the TestInterpreting the ResultsFrequently Asked QuestionsNext in HIV/AIDS GuideHow HIV Is Treated
Table of ContentsView All
View All
Table of Contents
Purpose of Test
Risks/Contraindications
Before the Test
During the Test
After the Test
Interpreting the Results
Frequently Asked Questions
Next in HIV/AIDS Guide
This article is part ofHealth Divide: HIV, a destination in our Health Divide series.
An HIV test is used to determine if someone has been infected withhuman immunodeficiency virus (HIV). The test is commonly performed on a blood or saliva sample, but a urine-based test was approved for use in the United States in 2015.
Both point-of-care tests used in hospitals and clinics andat-home testsused at home are extremely accurate if used correctly. However, they can deliver an incorrect result if the test is performed too soon after an exposure.
Verywell / Emily Roberts
This article details what tests are available, how accurate the tests are, how the tests are performed, and what to expect if you test positive for HIV. It also looks at gaps in testing among people living with HIV. Gaps in testing among Black and Latinx people,men who have sex with men(MSM), transgender women, and the broader transgender community are discussed in this article.
There are an estimated 1.2 million people living with HIV in the United States, 13% of whom remain undiagnosed.In response, the U.S. Preventive Services Task Force issued updated guidance recommending that everyone between the ages of 15 and 65 undergo HIV testing as part of a routine doctor’s visit.
Testing every three to six months is advised for people who belong to groups more likely to be diagnosed with HIV, including:
Verywell / Julie Bang
Testing Types
There are a few testing options, which vary in their speed, accuracy, and ease of use and include:
Any positive result—called the preliminary positive—would require a second confirmatory test to ensure the diagnosis is correct. The only exception is the NAT, which does require confirmation.
Stigma and HIV Testing Among Black People
Test Accuracy
HIV tests are highly accurate if used correctly. However, some testing methods aremore reliable than others. Improper use or storage can also undermine the accuracy of a test.
By and large, point-of-care tests are more accurate than home-based tests due in part to user error. Similarly, blood tests tend to be more accurate than saliva or urine tests because there are higher concentrations of HIV in blood.
Clinics in the United States report a 98.5% accuracy rate when using an antibody test and a 99.9% accuracy rate when an antibody test is combined with a confirmatory test. This translates to onefalse-positiveresult for every 250,000 tests.
Certain conditions can also trigger a false-positive test result, meaning that the test shows positive for HIV while the person is not actually HIV-positive. Conditions that can trigger a false positive include syphilis, lupus, and Lyme disease. Confirmatory testing will almost always weed out these incorrect findings.
According to the Food and Drug Administration (FDA), at-home rapid HIV tests have an 8% false-negative rate. This means that 1 of every 12 negative results is incorrect and the person tested actually has the virus. This is not only due to user error but also to the fact that the saliva-based test is less sensitive.
Risks and Contraindications
There are no contraindications for HIV testing, meaning there is nothing that makes getting tested inadvisable. Also, there are few risks. If a blood draw is required, you may experience soreness, swelling, and bruising at the injection site. Light-headedness and testing HIV positive are also possible.
If you are afraid of needles or are squeamish about blood, let the nurse orphlebotomist(healthcare professional who draws blood) know in advance. Other testing options may be available. Additionally, if you have hemophilia (a blood disorder that interferes with blood clotting) or if you are taking blood thinners, a child-sizedbutterfly needlemay be used to reduce the risk of bleeding.
The HIV test requires no preparation other than your readiness to take the test. That said, HIV remains highly stigmatized, and people often avoid HIV testing out of fear of disclosure.
If you are concerned about your privacy, find a clinic that offers either confidential testing (in which your name is shared only with your healthcare provider, your insurance company, and a government reporting agency) or anonymous testing (in which your name is shared with no one).
Confidentiality and HIV Testing
Timing
Timing is an important part of HIV testing. If you have been exposed to HIV, there will be a period of time, called the window period, when the test cannot deliver an accurate result.
Because HIV tests generally detect antibodies and/or antigens, you need to wait until your body has produced enough of these to get an accurate result. If you test too early, you will get a false-negative reading. Even with the nucleic acid test, you need to wait until the virus has replicated to detectable levels.
The procedure itself involves three steps: pre-test counseling, the HIV test, and post-test counseling. Depending on the test being performed, the process can take 30–45 minutes. Walk-in centers may take far longer.
Ask an Expert: When Should I Get Tested for HIV and How Do I Find a Free Testing Site?
Location
HIV tests are available at many medical and public health facilities. These include hospitals, clinics, retail pharmacies, community-based HIV organizations, antenatal and family planning clinics, youth drop-in centers, mobile testing sites, and drug and alcohol treatment centers.
Confidentiality and HIV Testing in Black PeopleBlack people in the United States often have limited options for healthcare. Many within the community will avoid getting tested because it forces them to go to a local clinic where others may see them. Even buying an at-home HIV test at a local drugstore poses risks.
Confidentiality and HIV Testing in Black People
Black people in the United States often have limited options for healthcare. Many within the community will avoid getting tested because it forces them to go to a local clinic where others may see them. Even buying an at-home HIV test at a local drugstore poses risks.
Food and Drink
There are no food or drink restrictions for an HIV test. However, if you are using an at-home oral test, avoid brushing your teeth or using mouthwash 30 minutes beforehand as this may affect the results.
What to Bring
Even if you are undergoing anonymous testing, the facility may require government-issued ID to confirm your residency. Call in advance for details. You should also check to see if the site accepts your insurance, if you have a plan. If so, bring your insurance card.
You may also want to consider bringing someone with you if you are unsure how you might react to a positive HIV diagnosis. Having support can be very important.
Cost and Health Insurance
Most insurance plans, including Medicare and Medicaid, will cover the cost in full as part of the Affordable Care Act’s essential health benefits.
HIV and Health Insurance Among Black People
Despite increased access to healthcare under theAffordable Care Act, 1 of every 9 Black people is without insurance.Black trans people, especially Black trans women, often experience hostility in health settings. Black transmasculine people are often excluded from HIV discourse despite testing positive at higher rates in comparison to the general population.
HIV Disclosure Laws
Despite whether your HIV test is anonymous or confidential, any positive test result will be reported to your local health department who will, in turn, disclose the information—without your name—to the CDC in Atlanta. The information is not shared with any other government agency.
A positive result may also be shared with your insurance company and the doctor who referred you for testing. It cannot be shared with any other doctor or agency without your expressed written consent under theHealth Insurance Portability Accountability Act (HIPAA)of 1996.
Many states and some cities havepartner-notification laws, meaning that your healthcare provider may be legally obligated to tell your sex partner or needle-sharing partner if someone they have been with has tested positive for HIV. Your name or personal information is not shared in the disclosure.
HIV and Medical Mistrust in Black MenHigh rates of distrust of public health services have seeded doubts aboutmedical confidentialityin many Black communities.This, in turn, has led to lower HIV testing rates, particularly among Black men.
HIV and Medical Mistrust in Black Men
High rates of distrust of public health services have seeded doubts aboutmedical confidentialityin many Black communities.This, in turn, has led to lower HIV testing rates, particularly among Black men.
Other Considerations
HIV Post-Exposure Prophylaxis
Many sites will also ask you to fill out a questionnaire to get some background information on you, including your ethnicity, sexual orientation, sexual activity, and substance use, and whether you have had an HIV test before. Some of the information will be used for confidential reporting purposes; some to assist with counseling.
Pre-Test
Pre-test counseling is performed in a private room with a qualified health professional. During the counseling, you may be asked about your recent exposure, if any, as well as your sexual or recreational drug practices. The questions are not meant to judge or embarrass you. Rather, they help the counselor gain a better understanding of your personal risk of transmission.
The counselor will then explainwhat HIV and AIDS are, how the test is performed, what a window period is, and what a positive and negative result means. If it is determined that you are testing too soon, the counselor may request that you come back when the test is more likely to be accurate.
Feel free to ask any questions you need. There is no such thing as a bad question.
Throughout the Test
The testing procedure in a clinic can vary based on whether you are taking a rapid HIV blood or oral test, or an HIV antibody blood or saliva test. (The urine test, while approved, is rarely used in a clinical setting. This is, in part, because it is less accurate than any of the other tests.)
A rapid HIV blood testis performed as follows:
A rapid HIV oral testis performed as follows:
Note that if you used a home kit, the toll-free support helpline listed on the test’s instructions will advise your further.
An HIV antibody blood testis performed as follows:
An HIV ELISA saliva testis performed as follows:
Some people will tell you that the hardest part of an HIV test is not taking the test but waiting for the results. This is especially true if you have a preliminary positive result and have to wait several days or more for the final results.
The wait can often be agonizing; so much so, in fact, that as many as 1 in 15 people will not return for their results, according to astudypublished in theInternational Journal of STDs and AIDS.
There are several measures you can take to remain composed during the wait, including:
If you are unable to cope and don’t have someone to talk to, call the 24-hour, toll-freeHIV hotlinein your state for a referral to a qualified counselor in your area.
Black men are 24% less likely to return for HIV test results than other groups.The fear of stigmatization paired with an underlying conspiracy belief (such as HIV being created in a government lab) account, in part, for this disparity.
Test results are interpreted as follows:
Post-test counseling is always performed, no matter your test results. The aim of counseling is twofold: to help you understand what the results mean and to provide you with information on next steps to stay safe and healthy.
A positive HIV test result may be shared with the CDC, your insurance company, or your doctor, or certain individuals in accordance with the rules you agreed to before your test. If your confidentiality is breached, you canfile a complaintwith HHS and seek legal damages as laid out in the laws of your state.
Upon receiving an HIV-positive diagnosis, you will be advised that there are treatment options and support systems to link you to medical care. You may also be referred to a care navigator, who can assist you with referrals and anyfinancial, emotional, family, legal, or drug treatment services you need.
If you feel overwhelmed, you can request to discuss your options on another day or use the time to ask as many questions as you need. Coming to terms with an HIV diagnosis is a process. Don’t feel rushed.
HIV Doctor Discussion GuideGet our printable guide for your next doctor’s appointment to help you ask the right questions.Download PDFEmail AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
Download PDF
Email AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
Sign Up
Thank you, {{form.email}}, for signing up.
There was an error. Please try again.
However, if you are ready to proceed and the test was performed in a clinic or hospital, you may be asked to undergo additional tests called aCD4 countandHIV viral load. The CD4 count measures the number of immune cells (calledCD4 T-cells) in your blood and helps establish how strong your immune system is. The viral load uses a similar technology to the NAT and counts how many viruses there are in a microliter (µL) of blood.
Both of these tests help establish your baseline status before treatment and will be routinely repeated to assess your response to therapy.
HIV treatmentshould ideally be started at the time of diagnosis. Genetic tests may be used to identify which drugs work best for you. The drug therapy itself typically involves a once-daily dose and, if taken as prescribed, can ensure a normal quality of life and anear-normal life expectancy.
A positive HIV diagnosis does not mean the same thing that it used to. Advances in HIV therapy are such that you can now live a long and healthy life and may never be faced with the prospect of a serious HIV-related illness or AIDS.
Accessing HIV Care in Black CommunitiesAccording to the CDC, only 63% of Black people in the United States receive some medical care after an HIV diagnosis, while only 48% remain in care. Many of the factors that discourage people from getting tested discourage them from staying with their treatment.
Accessing HIV Care in Black Communities
According to the CDC, only 63% of Black people in the United States receive some medical care after an HIV diagnosis, while only 48% remain in care. Many of the factors that discourage people from getting tested discourage them from staying with their treatment.
A Word From Verywell
Receiving an HIV diagnosis can be a life-altering event, and there is often no way to know how you will react to the news. Whatever your response, accept that it is normal. Some people might even feel a sense of relief from no longer having to wonder about their status. By knowing your HIV status, you can make an informed choice on how to protect yourself from testing positive forother strains of HIVand others.
This is not to suggest that living with HIV is without its challenges. If you are having trouble coping, consider joining a support group or seeking one-on-one counseling from a qualified therapist.
On the other hand, if you are experiencingextreme depression or anxiety, ask for a referral to a psychiatrist who may be able to offer medications and therapy to help you better cope.
Frequently Asked QuestionsWhile it’s unusual to get a false-positive result on an HIV test, it can sometimes happen if you’ve participated in an HIV vaccine study or have certain medical conditions, such as an autoimmune disease. It can also happen for technical reasons in the lab, such as improper handling or misinterpreting a result.A follow-up test can help verify if your first test result was accurate.Yes, an infant born to an HIV-positive birthing parent can have HIV antibodies but not HIV. For these babies, the birthing parent’s HIV antibodies are transferred across the placenta and stay in their system for 18 months. To get an accurate result, children up to 18 months need viral diagnostic testing. After that age, an antibody test should be accurate for detecting HIV.You can get an HIV test in a healthcare setting (doctor’s office or lab), a community-based organization, a mobile testing van, or at home.Some of these involve different methods of testing for HIV. For example, a rapid home test kit can use saliva or blood to deliver results quickly but may be less accurate than a rapid point-of-care test done in a doctor’s office. In the rapid point-of-care test, HIV can be tested using a drop of blood, urine sample, or oral swab for more accurate results.
While it’s unusual to get a false-positive result on an HIV test, it can sometimes happen if you’ve participated in an HIV vaccine study or have certain medical conditions, such as an autoimmune disease. It can also happen for technical reasons in the lab, such as improper handling or misinterpreting a result.A follow-up test can help verify if your first test result was accurate.
Yes, an infant born to an HIV-positive birthing parent can have HIV antibodies but not HIV. For these babies, the birthing parent’s HIV antibodies are transferred across the placenta and stay in their system for 18 months. To get an accurate result, children up to 18 months need viral diagnostic testing. After that age, an antibody test should be accurate for detecting HIV.
You can get an HIV test in a healthcare setting (doctor’s office or lab), a community-based organization, a mobile testing van, or at home.Some of these involve different methods of testing for HIV. For example, a rapid home test kit can use saliva or blood to deliver results quickly but may be less accurate than a rapid point-of-care test done in a doctor’s office. In the rapid point-of-care test, HIV can be tested using a drop of blood, urine sample, or oral swab for more accurate results.
How HIV/AIDS Is Treated
19 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
HIV.gov.U.S. statistics.
U.S. Preventative Services Task Force.Human immunodeficiency virus (HIV) screening.
National institutes for Health.HIV testing overview.
Arora DR, Maheshwari M, Arora B.Rapid point-of-care testing for detection of HIV and clinical monitoring.ISRN AIDS. 2013;2013:287269. doi:10.1155/2013/287269
Food and Drug Administration.OraQuick In-Home HIV Test.
Mathews A, Farley S, Conserve DF, et al.“Meet people where they are”: a qualitative study of community barriers and facilitators to HIV testing and HIV self-testing among African Americans in urban and rural areas in North Carolina.BMC Public Health.2020;20:494. doi:10.1186/s12889-020-08582-z
Pant Pai N, Balram B, Shivkumar S, et al.Head-to-head comparison of accuracy of a rapid point-of-care HIV test with oral versus whole-blood specimens: a systematic review and meta-analysis.Lancet Infect Dis.2012;12(5):373-80. doi: 10.1016/S1473-3099(11)70368-1
Centers for Disease Control and Prevention.False-positive HIV test results.
Food and Drug Administration.Information regarding the OraQuick In-Home HIV Test.
Pharr JR, Lough NL, Ezaonolue EE.Barriers to HIV testing among young men who have sex with men (MSM): experiences from Clark County, Nevada.Glob J Health Sci.2015 Nov 3;8(7):9-17. doi:10.5539/gjhs.v8n7p9
Lacombe-Duncan A.An intersectional perspective on access to HIV-related healthcare for transgender women.Transgender Health.2016;1(1):137-141. doi:10.1089/trgh.2016.0018
Dorell CG, Sutton MY, Oster AM, et al.Missed opportunities for HIV testing in health care settings among young African American men who have sex with men: implications for the HIV epidemic.AIDS Patient Care STDS. 2011 Nov;25(11):657-64. doi:10.1089/apc.2011.0203
Doshi RK, Malebranche D, Bowleg L, Sangaramoorthy T.Health care and HIV testing experiences among Black men in the South: implications for “Seek, Test, Treat, and Retain” HIV prevention strategies.AIDS Patient Care STDS.2013 Feb;27(2):123-33. doi:10.1089/apc.2012.0269
HIV.gov.Post-exposure prophylaxis.
Centers for Disease Control and Prevention.Estimated HIV incidence and prevalence.
Stanford Children’s Health.AIDS/HIV in children.
HIV.gov.HIV testing overview.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
