Is there a test for HIV infection?
Yes. There are a number of tests that detect either antibodies to HIV or HIV itself.
Your body produces antibodies to fight germs. People who are infected with HIV have HIV antibodies in their body fluids. There are two kinds of HIV antibody tests available in New York State: a blood test and an oral test.
For adults and children age 18 months or older, both types of HIV antibody test are more than 99% accurate in determining whether a person is infected.
HIV antibody tests do not measure the amount of virus in the bloodstream. The tests also cannot tell if a person has AIDS, which is a late stage of HIV disease.
Other tests measure HIV directly rather than measuring antibodies to the virus. These tests are usually used to measure the amount of HIV in the bloodstream of someone who has already had a positive HIV antibody test. In some special situations (for example, to test newborn babies of HIV-infected women), tests that measure HIV directly are used to detect HIV infection. However, the HIV antibody test is by far the most common test for HIV infection.
Who should get tested for HIV?
Your health care provider is required to offer HIV testing to all persons between the ages of 13 and 64, regardless of apparent risk. You are strongly encouraged to accept testing; it may provide you with important information about your health and staying healthy. These are important points to know about HIV testing:
- HIV is the virus that causes AIDS. It can be spread through unprotected sex (vaginal, anal, or oral sex) with someone who has HIV; contact with HIV-infected blood by sharing needles (piercing, tattooing, drug equipment, including needles); by HIV-infected pregnant women to their infants during pregnancy or delivery, or by breastfeeding.
- There are treatments for HIV/AIDS that can help a person stay healthy.
- People with HIV/AIDS can use safe practices to protect others from becoming infected. Safe practices also protect people with HIV/AIDS from being infected with different strains of HIV.
- Testing is voluntary and can be done without giving your name at a public testing center (anonymous testing).
- By law, HIV test results and other related information are kept confidential (private).
- Discrimination based on a person's HIV status is illegal. People who are discriminated against can get help.
- Consent for HIV-related testing remains in effect until it is withdrawn verbally or in writing. If the consent was given for a specific period of time, the consent applies to that time period only. Persons may withdraw their consent at any time.
How do I get tested for HIV?
There are several different HIV testing options. Anonymous HIV testing is provided free by the New York State Department of Health, by the New York City Department of Health and Mental Hygiene, and by some county health departments. Confidential HIV antibody testing is offered by many local health department clinics, community health centers, hospitals, family planning clinics, and private doctors.
HIV testing is voluntary. When you go for an HIV test at a clinic or other testing site, or if you are offered a test by a doctor's office, you will receive information about the HIV test. This will include information about available testing options and the meaning of test results.
For a standard HIV test, a blood or oral fluid sample is taken and sent to a laboratory; you will need to call or come back in about a week after the test to get your test result. At some clinics and doctor's offices, you can get a rapid HIV test, which can give you the results that day. The test takes about 20 minutes to get results. If your rapid HIV test is positive, it will need to be confirmed by a second test, which is sent to a laboratory. This is called a confirmatory test. The results of this test are not ready right away. When you get your test result, you will receive information about what the result means. . If you test positive for HIV, you will receive post-test counseling on how to reduce the risk of passing the virus to others, referrals for medical care, and other social services.
A home HIV test kit is sold over-the-counter at pharmacies and other stores. With the home test kit, you take a finger-stick blood sample and send it to a laboratory. Later, you call to get the test result over the phone, using an anonymous code number. You can receive a referral for re-testing if you test positive for HIV and a referral for medical treatment.
To find out more about getting tested, call your doctor, local hotline number, or the State Department of Health.
What is the difference between anonymous and confidential testing?
If you have a confidential HIV test, you will give your name and other identifying information (age, gender) to the test counselor, doctor, or other health care provider, and the test result will be put in your medical record. The names of people who test positive for HIV are given to the New York State Department of Health to help the department better respond to the HIV/AIDS epidemic in New York State. Information about your HIV status is given only to the New York State Department of Health and is kept confidential. The confidentiality of all HIV-related information is protected by New York State Public Health Law.
If you have an anonymous HIV test, you do not have to give your name or any other identifying information. Instead, you are given a code number, which you use to get your test results when you return to the testing site. An anonymous test result is not recorded in your medical record and is not sent to your doctor or to other health care providers. If you test positive for HIV at a site that provides anonymous testing, you can choose to give your name and change the test result to confidential - which allows you to get HIV-related medical care and support services (like housing assistance) without waiting for a second HIV test to confirm the result.
The New York State and New York City HIV/AIDS Hotline numbers listed in the Resources section can help you find anonymous HIV counseling and testing clinics in your area.
What is meant by "informed consent" and "capacity to consent" for an HIV test?
HIV testing is voluntary. Informed consent means that you have been provided information about HIV testing and you have agreed to be tested. You may provide informed consent verbally for a rapid HIV test or in writing for a standard HIV test. Written consent may be part of a general consent for treatment or a separate form specific to HIV testing, depending on the testing site. The New York State Department of Corrections requires written consent for HIV testing.
Capacity to consent means that a person is able to understand what it means to be tested. The overall goal of "informed consent" is to assure that the person being tested fully understands the information about the HIV test.
Should I wait for symptoms to appear before getting tested?
No. If you think that you may have been exposed to HIV, you should get tested as soon as possible. You may have HIV and have no symptoms for many years. The sooner that HIV is detected, the sooner medical care can begin, which helps people with HIV stay healthier and live longer. In most cases, the immune system will stay healthier for a longer period of time if treatment starts before a person has symptoms.
How soon after exposure can HIV infection be detected?
Most people who are infected with HIV will test positive within one month of being infected. The period of time after infection, before the HIV test turns positive is called the window period.
When a person becomes infected with HIV, the body makes antibodies to fight HIV. When enough antibodies are developed, the HIV antibody test will be positive. Each person's body responds to HIV infection a little differently, so the window period varies slightly from person to person. Most people infected with HIV will develop enough antibodies to be detected by HIV antibody tests four weeks after the exposure (transmission). Virtually all cases of HIV infection can be detected by three months.
During the window period, a person with HIV infection can pass it to others, even if his or her HIV antibody test is negative. In fact, during this period, the person may have very high levels of the virus and be most likely to infect others.
If the HIV antibody test is negative, a person can be sure that he or she does not have HIV only if he or she did not engage in any HIV risk behaviors (having unprotected sex or sharing needles) during the past three months.
A PCR (Polymerase Chain Reaction) test looks for HIV directly instead of detecting antibodies. This test can find HIV infection soon after the person is infected. Doctors may suggest an HIV PCR test if a person has symptoms suggestive of HIV infection (fever, rash, swollen lymph nodes, etc) and reports high risk behaviors in the past few weeks. It is used to find HIV infection in newborn of mothers known to be infected with HIV. Sometimes doctors use a PCR test to measure viral load. The viral load shows the amount of HIV in the blood of someone who is already known to be infected.
Is HIV testing ever mandatory?
In New York State, HIV testing is generally voluntary and cannot be done without the informed consent of the person being tested. However, testing is mandatory in New York State under certain circumstances:
- As of February 1997, all newborns in New York State are tested for HIV antibodies. A newborn's test result also provides information about the mother's HIV status.
- Blood and organ donations are tested for HIV
- HIV testing can be required in order to participate in some federal programs, such as the Job Corps and the Armed Forces.
- Under certain conditions, inmates in federal prisons (but no in state or local correction facilities) are tested for HIV without their consent.
- HIV testing can be required for certain types of insurance, like disability or life insurance. However, insurance companies must tell applicants they will be tested for HIV, must provide them with general information, and must have the applicant sign a consent form. In New York State, people cannot be denied health insurance because they have HIV or AIDS.
Why is it recommended that all pregnant women have an HIV test?
HIV can be passed from mother to child during pregnancy, labor and delivery, and breastfeeding. However, there are medicines that can reduce this risk. The sooner a pregnant woman knows she has HIV, the sooner she can begin treatment to lower the risk of passing the virus to her baby and for her own health. Because it is so important for pregnant women to know their HIV status, doctors are required to provide HIV counseling to all pregnant women in New York State and to recommend testing. Ideally, women should know their HIV status before considering pregnancy. HIV testing should occur as early as possible in pregnancy and should be repeated in the third trimester.
Why are all newborns in New York State tested for HIV?
It is very important that infants born to HIV-infected women get special medical care. Ideally, women with HIV should take HIV medicines during pregnancy and labor and delivery, and their babies should be given medicines right after birth to reduce the risk of HIV being passed to the baby. However, some women do not know that they have HIV when they are pregnant. If a woman does not take HIV medications before the baby's birth, medications can still be given to the infant right after birth to lower the chances that the baby will become infected.
Newborn screening is a safety net program for infants whose mothers were not tested for HIV during pregnancy. In New York State, all babies are tested for HIV antibodies. Since all newborns carry their mother's antibodies, the baby of a woman with HIV will test positive for the first 6 to 18 months, even if the baby is not actually infected. A baby with HIV antibodies will be given medicines to lower the risk of HIV infection. If a baby's HIV antibody test is positive at birth, the baby's blood will be tested a few times using a special test called PCR (which looks for HIV directly). The first test (to find out if the infant is actually infected with HIV) should be done soon after birth, preferably during the first week of life. The baby's doctor will recommend the best time(s) for the next PCR test(s). Generally, by age 4 months, a PCR test can show whether or not an infant has HIV.