HIV test:

HIV test


The only means through which a person can be sure if he/she has HIV is testing for HIV. Most infected individuals do not experience the symptoms and may live for several years in ignorance of the fact that they have the virus. The process of testing is confidential, painless, quick and free in most of the cases. The Center for Disease Control suggests that every person between the age of 13 and 64 should get himself/herself tested for HIV at least one time as part of the regular healthcare check-up. The present paper ripostes some of the most fundamental questions pertaining to HIV testing, entailing the types of tests, HIV test kit, and what to do when tested positive and negative.

HIV test

What HIV test types are there? Many of the available types of HIV tests analyze blood or other body fluids to check if the person is infected. Most of the tests cannot detect the infection right away because the body takes time to develop antibodies. Four types of HIV test are available, namely: HIV antibody test, combination or fourth generation test, rapid tests and nucleic acid tests (NAT)

How do they work?

HIV antibody tests – When a person becomes HIV infected, his/her body starts producing specific antibodies. An HIV antibody test detects such antibodies in the blood, urine or saliva. If the antibodies are detected, it implies that the person is HIV infected. However, this test is accurate only at least three months after the infection, because the body takes up to 90 days to produce sufficient antibodies for them to become recognizable in the test. Generally, a healthcare specialist would take small blood specimen and send it to the laboratory for testing in the course of an antibody test.

Fourth Generation tests – This test can spot both HIV antigens and HIV antibodies in a person’s blood. In fact, a fourth-generation system can test HIV infection sooner than the HIV antibody test. In most cases the body takes two to six weeks to produce sufficient antibodies and antigens for the test to recognize HIV infection.

Rapid tests – It is now possible to obtain the results of the HIV test at any healthcare establishment, without the samples being sent to the lab. There are various rapid tests available and the majority of these test for HIV antibodies. While such tests are steadfast, follow-up lab testing might be recommended in some cases, because rapid tests have a somewhat higher probability of producing a ‘false positive’ result.

Nucleic Acid test – This test looks for HIV infection in the blood. It can identify HIV infection in 7 to 28 days after a person has been infected with the virus. However, these tests are very costly and not used routinely for HIV screening unless the person has had a high-risk vulnerability.

HIV test kit

What does a typical HIV test kit for home use comprise?

The American Food and Drug Administration has approved two HIV diagnostic tests for home use, namely Home Access HIV-1 Test System and OraQuick In-Home HIV Test. Both these tests are HIV antibody tests.

The Home Access HIV-1 Test Kit – This is a home collection kit which requires pricking a finger for a sample of blood, sending that sample to an authorized lab to get tested and then following up on the lab for results the very next day. If the test result is positive then the laboratory will conduct a second test on the same sample of blood for confirming the first test result. The kit consists of several components like materials for collection of specimen, information manual, testing directions, and prepaid materials for sending the sample to a lab for testing.

The OraQuick In-Home HIV Test Kit – This consists of a tube and a test stick with a testing solution. The test stick is used by the person to swab his/her mouth in order to get a sample of the saliva. The test stick then needs to be inserted into the test tube for obtaining results. The results are ready within twenty minutes of the test.

Where can I buy one?

The two tests mentioned above are easily available for purchase over the counters at pharmacies, vending machines convenience stores and also on the Internet. At least, these are the sources you can go to when looking for a test kit in the United States.

How much do they cost?

The price of both tests ranges from $40 to $60 depending on where you’re purchasing them from.

Oral HIV test accuracy

An oral HIV test has accuracy corresponding to that of the regular blood antibody test for people with longstanding or chronic HIV infection. However, like all HIV antibody tests, the oral HIV test is also not 100% reliable during the “window period” (lasting for up to 3 months following the infection) between the time an individual is infected and the time when sufficient antibodies have been made by the body for a test to detect them. An oral HIV test has a longer window period as compared to HIV blood tests, implying that for a person with new or acute HIV infection, some blood tests can identify the antibodies sooner than the oral test. It is also likely to get a false positive outcome (the oral HIV test result could be positive but in reality, the patient may not actually be infected with the virus). This is why if a person gets a positive result through the oral HIV test, he/she should undergo a confirmatory blood test prior to making a diagnosis.

The oral HIV test’s accuracy is described in terms of sensitivity and specificity. The former refers to the proportion of outcomes that will be positive due to the presence of HIV, while the latter refers to the proportion of results that will be negative due to HIV not being present in the patient’s body. The OraQuick which is an oral HIV test available in the market has 92% sensitivity and a specificity of 99.8%. This implies that nearly 10% individuals who are HIV negative might be identified incorrectly as HIV positive using this test. Due to its position in the US market, the effectiveness of OraQuick has been examined more widely compared to some other rapid test kits. Certain issues like false positive results and restricted sensitivity in individuals with recent infection have been recognized. More issues have taken place when the test is used with saliva instead of when used with plasma, venipuncture blood, serum or finger prick blood.

HIV tests for use at home: pros and cons

Pros of In-Home HIV Tests:

  • For people who are apprehensive of going to a clinic to be tested due to the fear of being seen there or any other privacy issue, a home HIV test is a great option. Through this, the individual can collect his own sample and send it to the laboratory to be tested confidentially. In case of oral HIV tests, the samples do not need to be sent to the labs and the person can get the results at home only within 20-30 minutes.
  • As the home test kit can be purchased online also, it is a good option for people who cannot go to the pharmacy, or for people who are homebound or live far from the medical centers.
  • The accuracy of the FDA approved tests is similar to that of the antibody tests conducted in clinics.
  • HIV home tests could facilitate improving early detection of HIV in people. Early diagnosis implies early treatment, which allows individuals to expect a comparatively normal life span.
  • Based on availability and cost, self-testing methods are helpful for individuals who experience substantial impediments to healthcare and masses living in remote and rural communities where healthcare is not always confidential and anonymous.
  • Cons of In-Home HIV Tests:
  • There is a concern that people who get positive results through home HIV tests will not opt for confirmatory testing.
  • In-home HIV tests are costlier than getting tested at a clinic. Several local healthcare centers provide free HIV testing or conduct HIV tests on a sliding fee scale.
  • In case of false negative test result, an individual might continue having unprotected sex with an HIV positive partner, who he/she erroneously believes to be HIV negative.
  • There is a possibility that, when doing a self-test, a person may not observe scrupulous attention and not follow the instructions accurately which may result in false results

What to do if you test positive?

If the test results of a patient are positive through an oral HIV test, then they should first undergo a follow-up test to confirm the result. A positive result obtained from the Home Access HIV-1 Test and the other laboratory tests implies that a confirmatory testing for HIV-1 is already included in the tests and all confirmation testing is over prior to releasing the result. When a person has correctly been diagnosed with HIV, the next step to follow is consult a doctor. Being HIV positive does not always imply that the person has AIDS. By consulting the doctor, medication and treatment should be started as early as possible to prevent the situation from turning chronic. With the proper medical care and healthy lifestyle, even an HIV positive person can live a productive long life. The person should develop awareness about what it means to be HIV positive and seek HIV support group or counseling service to cope with the diagnosis of the infection. The person should also get himself/herself tested for other STDs.

What to do if you test negative?

A negative HIV result implies that at the time of taking the specimen, there were no HIV antibodies in the sample. This may mean that the individual is not HIV infected. However, there is an exception to this if the sample was taken during the window period described above. Again, if the negative result was from the oral HIV test, then a confirmatory lab test is preferable. If the negative result is from other lab based tests then it is an accurate negative. However, this in no way means that the person is now immune to the virus, and hence it is critical to continue protecting oneself from possible infection.

Many HIV tests are available today that can help a person detect the presence of HIV antibodies in his/her body. Based on the accuracy level and convenience of access, the person may choose how to conduct the HIV test, but would also be recommended to undergo a confirmatory second test in case of oral HIV test, especially if it returns a positive result.

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