HIV Tests

For whatever reason, you have decided to get an HIV test.  Your friend coaxed you, you’ve been feeling tired lately, you had sex with Bob after just the second date (he's now long gone), or (horrors) you have received notification from the health department that a recent sexual partner has tested positive for a sexually transmitted disease and named you on his sexual contact list.  Perhaps you have had a nagging feeling for a long time that you may be HIV positive but just didn’t want to face it. 

Maybe you were offered a test at your recent annual physical exam.  In 2006, the Center for Disease Control (CDC) recommended routine testing for all adults age 13 to 64.  This is a far cry from the olden days when it was necessary to be counseled both before and after testing and to sign an informed consent.  Now you may be told that an HIV test will be done, unless you decline the test.  Note, some states have been slow in following this CDC recommendation.  

I believe that everyone who is having sexual relations--oral, vaginal, or anal,  should be tested every year or so--everyone.  That includes married people.  I can’t tell you how many times I have met with patients and friends who thought they were in a faithful relationship with their sex partner only to find out their partner was not being loyal to them.

You may have taken your HIV test at home.  I am unsure how often these tests are used as I have yet to see a patient that used one of these tests to find out if they have HIV.  Be aware: the home tests are not approved by the Food and Drug administration and the results may not be accurate.  Many clinics are now using rapid HIV tests--by rapid, I mean that the results are available the same day.  The HIV test may involve a test of these substances: saliva, urine, finger-stick blood, or blood through puncturing a vein.  

Nearly all HIV tests measure special HIV "antibodies" that the body makes upon encountering HIV.  It usually takes the human body 2-8 weeks to develop antibodies against the new HIV in one's body--the average is around 25 days.  Some people (3 out of every 100) can take longer than three months, and up to 6 months, to test positive.  The time between getting the HIV infection and the HIV antibodies showing up in the blood is called the "window period." 

All these rapid tests must be backed up by an ELISA test. The ELISA test is 99% reliable in detecting HIV antibodies.  If the ELISA test is positive, your blood will be sent for a confirmatory test called the Western Blot.  In other words if Elisa says you are positive, she asks “Western Blot,” just to be sure.  

A more expensive test, called the HIV RNA test (or HIV viral load test) may be done.  This test measures the amount of actual virus in the blood.  Still, it takes 9-11 days after the infection for this test to turn positive.  There is no way to determine infection earlier than this.  

Nearly all pregnant women are tested upon first getting OB care, then again further along in the pregnancy.  This is so that the woman may begin treatment immediately if she is HIV positive.  She will continue HIV drugs through her entire pregnancy and during delivery.  Chances are, with treatment, her baby will be born without HIV.  

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