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Getting Tested

The HIV test may be offered by:

  • AIDS service organizations
  • Public health departments
  • Public health clinics
  • Some drug and alcohol treatment programs
  • Some hospitals and private doctors
  • Private laboratories (usually very expensive)

Generally, these are the steps involved in taking a test for HIV:

1. Decide if the test should be confidential or anonymous.

Some testing centers offer both options, but some only offer one or the other. A confidential test means that test results are treated like any other part of your medical record. Results are kept in a file with your name on it, but no one is allowed to see the file or know the results without your permission. The following can be notified of test results: health care provider including emergency care; agent or employee of health care provider; funeral director; coroner/medical examiner; sheriff or jailer; and others by court order.

An anonymous test means that your name is not known to anyone, including the test center. No records indicating your name are kept. An assigned number or code name is given to you that only you know. The only way results can be obtained is for you to give that number or code name to the testing center and this is usually done in person.

2. Receive pre-test counseling and give a blood sample or oral mucous sample.

Testing centers usually have pre-test counseling available that is given by a health worker, nurse, or specially trained outreach worker. It generally includes information about the HIV test and how long it will take to get the results. Pre-test counselors often discuss personal risks for HIV, plans to reduce risk, and generally allow you to ask any questions you may have.

Two types of HIV tests are given. The traditional method involves taking a blood sample. This procedure involves drawing blood from the arm with a needle, but in some cases, a finger-stick method is used to get the sample. The sample is then labeled with your identification number and sent to a laboratory.

A newer testing method is now being used in many centers, called OraSure. In this process, a device that looks like a toothbrush is inserted into the mouth. It contains a specially treated pad that is placed between your lower cheek and gum for 2 minutes. It collects a mucous sample, not saliva. The pad is then placed in a vial, with your identification number, and sent to a laboratory to be tested the same way blood is tested. Ora-Sure is a highly accurate and easier alternative to blood testing.

3. Laboratory conducts the HIV test.

The standard HIV test is called ELISA. This test shows whether or not there are antibodies to HIV in the blood or mucous sample. If the result is negative, it means that antibodies were not found. No other tests are performed if your results are negative.

If the ELISA results are positive, this means that a presence of HIV antibodies have been found in the blood or mucous. In this case, a second, highly sensitive test is run called Western Blot.

The ELISA test is highly sensitive but less specific - i.e., there is a risk of false positives in a population with a low rate of HIV infection. The Western Blot is highly specific, but less sensitive - i.e., a relatively high degree of false negatives, especially if inappropriately used as the initial screening test. In parallel, the two tests increase specificity without sacrificing sensitivity, which means it would be rare to miss a true positive or mistake a true negative for a false positive.

If the Western Blot is negative, then your HIV test is considered negative, meaning that there is no evidence of HIV.

If the Western Blot is positive, then your test is considered positive, meaning that antibodies have been found and you are carrying HIV.

4. Receive test results and post-test counseling.

Test results are generally available within 2-3 weeks. In most cases, you must return in person to get the results. Very few centers give test result information over the phone.

If the results are negative, there is no indication of HIV. However, once exposed to the virus, it may take 3 months or longer for a person to develop HIV antibodies. If you test negative, but engage in high-risk behavior, it's a good idea to be tested again in 6 months and not engage in risky behavior during that time.

If the results are positive, this means that HIV is present. However, it does not mean that you have AIDS. It means that you are infected with the virus and can infect others through sex or blood contact. Being HIV positive means that you should seek medical care in order to develop a program of care so that you can stay healthy as long as possible.

If you test positive, you should also avoid risky behavior so you don't become re-exposed to HIV. If you become re-infected through another exposure to the virus from unprotected sex or sharing needles, it could worsen the condition and make it easier to develop AIDS faster.

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