Whats Involved In Testing For Hiv
Testing for HIV is a simple and pain-free process. It involves giving a small sample of blood or swab from your mouth. Your results will be confidential . The healthcare provider will explain the process and answer any questions you have. They are there to help you.
- The basics
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INSTI® HIV Self Test is designed as a single-use at home HIV test kit that allows you to get results in the comfort of your home and at a time that works best for you. Sample, pour and read your results immediately. Its that easy.
The test uses simple flow-through technology to detect HIV-1 and HIV-2 antibodies using a drop of human fingerstick blood. The test is intended for use by untrained lay users as a self test to aid in the diagnosis of HIV-1 and HIV-2 infection using a small drop of blood obtained through fingerstick collection procedures.
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How The Test Is Performed
The test requires the user to swab their gums to collect an oral fluid sample and use the materials in the kit to test the sample. The user must follow the test manufacturer’s instructions, which comes with the kit, to ensure an accurate test. A phone number is also included with the HIV self-test for anyone to call to get help with conducting the test. OraQuick’s website also has a step-by-step video to guide users through the test.
Users should not eat, drink, or use oral care products before starting the test. They should put the test stick they swabbed their gums with into the test tube provided by the kit. Wait 20 minutes, and one line will appear on the test stick if you are negative. If two lines appear, that means HIV antibodies have been detected.
Its important to take a follow-up test at a medical office to confirm the results.
OraQuick is an antibody test, and it takes 23 to 90 days after an exposure for antibody tests to detect HIV.
The expected performance of the test is 92% test sensitivity, according to the OraQuick package. The FDA explains that this equates to one false-negative result out of every 12 test results in people who are HIV-positive. Clinical studies have found that OraQuick produces one false-positive out of every 5,000 tests. This is why its important to take another test at a medical office to confirm the diagnosis.
Autoimmune diseases like lupus may interfere with the results, and may incorrectly produce a false-positive.
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When To Take A Rapid Hiv Test
According to the Centers for Disease Control and Prevention , everyone between 13 and 64 years old should be tested for HIV at least once in their life. People who have sex without condoms, have multiple sexual partners, or share drug equipment are at higher risk for HIV and should be tested more frequently, whether through regular or rapid testing.
If you think youve been exposed to HIV within the past 72 hours, contact your healthcare provider or medical professional about post-exposure prophylaxis, which is medication that can prevent HIV after a possible exposure.
After someone has been infected with the virus it can take about two weeks for HIV antigen to be detectable with current antigen tests, and more than three weeks to produce enough HIV antibodies to be detected by antibody tests. In a very small number of people, the process takes up to several months.
There are different window periods for different types of tests:
- Antigen and antibody tests take blood from a vein, and can detect HIV between 18 and 45 days after exposure
- Antigen and antibody tests done with blood from a finger prick can detect HIV between 18 and 90 days after exposure
- Antibody tests can take 23 to 90 days after an exposure to detect HIV. Most rapid tests and self-tests are antibody tests. In general, antibody tests that use blood from a vein can detect HIV sooner after infection than tests done with blood from a finger prick or with oral fluid
Are People Able To Understand Test Instructions And Use Self
A review identified 25 studies in which people used self-tests, with their results compared with those of a healthcare worker testing them at the same time. The original studies were done in a mix of North American, African, European and Asian countries. Fifteen studies used oral fluid-based tests, six used blood-based tests and four used both oral and blood specimens. Of note, several studies were evaluating professional assays that had not been adapted for use as self-tests performance could be better in commercially marketed tests.
The researchers found that most people could reliably and accurately use rapid tests. Using a statistical approach known as Cohens kappa in which 1 represents perfect agreement between the results of a self-tester and a trained health worker and less than 1 represents less than perfect agreement, results were highly concordant. The Cohens kappa was 0.98 in studies in which users first received a demonstration of how to do the self-test or to interpret its result. In studies in which this was not provided, it was 0.97. This means that in only a small minority of cases the self-tester and the healthcare worker got results that were different from each other.
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Are Rapid Pcr Tests Accurate
Although rapid PCR tests are widely accepted, their accuracy is still in question. While they are less likely than other tests to detect HIV, false positives can occur. They can also be caused by chance alone. There are still some exceptions to this rule, though. Many experts believe that positive results should be treated as true positives. Here are some reasons why. Hopefully, these findings will give you a better understanding of whether rapid PCR tests are accurate.
First, rapid tests do not magnify the virus. Thus, positive results can occur even if a person does not show symptoms. Another problem with these tests is that they do not provide enough information to confirm an infection. If you have an untreated COVID-19 infection, you must receive treatment and notify close contacts as soon as possible. Currently, a laboratory test called RT-PCR is used to diagnose the disease. However, the results take up to 24 hours to be available. Because of this, you have to take two rapid point-of-care tests to get a definitive answer.
A PCR test is sent to a lab and results are typically available in one to seven days. While the sensitivity and specificity of rapid PCR tests are high, the CDC says they are not always as effective as they should be, as the number of different types of COVID variants is increasing. A single negative result is reassuring, but it doesn’t mean that a patient is completely healthy.
What Is A False Positive Test Result
A false positive test is when the test result shows positive but the person is really negative. This can happen with antibody tests when the test picks up antibodies for other infectious agents.
Approximately 1.5% antibody tests are a false positive. The fourth generation tests have a much lower chance of a false positive.
This means that a small percentage of people who test positive on a rapid test may turn out to be HIV negative.
A second blood sample will be tested in a lab to look for this.
If your blood test was originally performed in a laboratory, a positive result would have already been confirmed before giving you this result.
All positive laboratory tests in the UK are routinely confirmed using a second type of test called western blot that is 100% accurate.
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Which Hiv Test Is The Most Accurate
When it comes to choosing the most accurate HIV test, both rapid and lab tests detect HIV with more than 99% sensitivity and specificity. That means theyll miss fewer than one out of every 100 people who actually have HIV, and fewer than one out of every 100 people without HIV will be given a false-positive result. The main difference between the tests is how long you need to wait to get an accurate result.
Rapid HIV test accuracy can be lower if youre still within the window period. Its not necessarily that the test is inaccurate. Its the timing of the test related to the exposure, says Promer.
NAT has the advantage of detecting HIV as soon as 10 days after infection. Some people may wonder, Why dont we just do that up front? she adds. Then explains, Its kind of resource-intensive and expensive. And the benefit is really just over a short period of time.
To pick up a very early infection, an antibody/antigen test plus an NAT test is the most reliable choice. For everybody else, I think the standard antigen/antibody test would suffice, Urbina says.
Do You Need An Hiv Test
In a word, yes. Everyone does. The CDC recommends that everyone 13 to 64 years old undergo HIV testing at least one time.
People with specific risk factors should be tested more often, including:
- Men who have been sexually active with other men
- People who have had more than one sex partner since their last HIV test
- People who have shared needles used for tattoos or body piercings
- People who have injected drugs or have shared needles or other drug-use items, such as water or cotton, with others
- Those who have accepted drugs or money in exchange for offering sex
- People who have been diagnosed with other sexually transmitted diseases
- Those who have been diagnosed with or treated for hepatitis or tuberculosis
- People who have had sex with a person who has at least one of the above risk factors
- People who have had sex with someone with an unknown sexual history
- People who have been sexually assaulted the test should be taken as soon after the assault as possible
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Hiv Testing In A Health Care Setting Or Lab
If you take a test in a health care setting or a lab, a health care provider or lab technician will take your sample . If its a rapid test, you may be able to wait for the results, but if its a laboratory test, it can take several days for your results to be available. Your health care provider or counselor may talk with you about your risk factors, answer any questions you might have, and discuss next steps with you, especially if your result is positive.
- If the test comes back negative, and you havent had an exposure during the window period for the test you took, you can be confident you dont have HIV.
- If your HIV test result is positive, the lab will conduct follow-up testing, usually on the same sample as the first.
Confirming Your Hiv Test Result
Whether your HIV test result is positive or negative, youll probably need follow-up testing. If you had a negative result but were still within the window period, get tested again after the window period endsabout three months after the date of your exposure.
If you get a positive test result at home, see a doctor or go to a clinic for an antibody/antigen test and an NAT to confirm the result. A rapid in-clinic test that comes up positive for p24 antibodies will also need to be confirmed with a lab test. If your test was done at a lab the first time around, it will automatically be repeated on the same blood sample.
The lab-based test will confirm that you dont have a false-positive result and determine which of the two HIV types you have:
- HIV-1 is the most common type in the United States and most of the world.
- HIV-2 is mainly found in West Africa, but it has also spread in the United States.
Its important to know which one you have. There are differences in terms of which antiretroviral treatments are effective against each type, Urbina says.
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Chances Of A Rapid Test Giving A False Negative
A examined the results of 64 test accuracy studies evaluating commercially produced rapid antigen or molecular tests.
The researchers found that the accuracy of the tests varied considerably. Heres a look at their findings.
Accuracy for people with COVID-19 symptoms
For people with symptoms of COVID-19, the tests correctly gave a positive result an average of 72 percent of the time. The 95 percent confidence intervals were 63.7 to 79 percent, meaning that the researchers were 95 percent confident that the average fell between these two values.
Accuracy for people without COVID-19 symptoms
The researchers found that people without COVID-19 symptoms correctly tested positive in 58.1 percent of rapid tests. The 95 percent confidence intervals were 40.2 to 74.1 percent.
Accuracy during the first week of symptoms versus the second
Rapid tests more accurately provided a positive COVID-19 result when administered during the first week of symptoms. The researchers found that rapid tests correctly identified COVID-19 in an average of 78.3 percent of cases during the first week.
In the second week, the average dropped to 51 percent.
Differences between brands
The researchers found a large range of accuracies between manufacturers of the tests.
Coris Bioconcept scored the poorest and correctly provided a positive COVID-19 result in only 34.1 percent of cases. SD Biosensor STANDARD Q had the highest score and correctly identified a positive COVID-19 result in 88.1 percent of people.
Home Testing May Play An Appropriate Role In Support Of Responsible Sexual Health Habits
Patients who know their current HIV status and are about to begin a sexual relationship with a new partner may be encouraged to obtain a home HIV test as 1 component of a comprehensive 3-way conversation covering such topics as shared risks, harm reduction, monogamy, birth control, and prevention of other sexually transmitted infections.
The following points may help prepare patients to anticipate and interpret home test results. First, the test does not detect the virus it detects the bodys immune response to that virus. Most people develop detectable antibodies within 6 weeks of infection 97% respond within 3 months . Conservatively speaking, a result obtained today is only a reliable indicator of ones HIV status 3 months ago . Second, a negative result does not imply reduced susceptibility to infection and is certainly not a green light to take greater sexual risks in the future. Third, a positive result requires immediate confirmation using a test that is not available for home use. Patients should contact a health provider immediately present themselves in person call an HIV hotline or use OraSures 24-hours-per-day, 7-days-per-week toll-free customer support center .
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Getting A Result Quickly
Many services offer rapid testing, which means a finger-prick test that will give you a result within minutes.
A self testing kit ordered online and done at home will normally give you a result up to 15 minutes, depending on the kit.
A blood sample taken at a testing centre will be sent to a lab, with results ready within a day or up to a week later.
If you use postal testing, the lab will normally contact you a week or so later with your result.
How Accurate Are At
At-home tests arent as accurate as gold standard PCR tests, but they still play a role in catching COVID-19 cases that otherwise would have gone undetected. Like other antigen COVID-19 tests, home COVID-19 tests have a higher chance of a false negative than a false positive meaning its more likely that the test will indicate you dont have COVID-19 when you do have it than report you do have it when you dont.
In an , researchers compared the validity of home antigen tests compared to PCR lab tests for detecting COVID-19 infection. Within days 0 to 12 of symptom onset, the home tests correctly identified 78.9 percent of people who did have the virus and correctly identified 97.1 percent of people who didnt have the virus.
When taken within 3 days of symptom onset, home tests correctly identified 96.2 of COVID-19 cases. The researchers found tests taken 3 days after symptoms appeared were almost as accurate as tests taken the day symptoms started.
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What Do I Do If My Results Are Positive
If your home HIV test results are positive, its important to follow up with a doctor as soon as possible. Healthcare professionals usually conduct two tests to confirm that you have HIV, so the results of this test are preliminary. Please call The Miriam Hospital Immunology Center at 401-793-2928 and ask for Dr. Philip A. Chan, or email .
If your second test is positive, your doctor will typically start you on anti-HIV medications right away. While HIV is serious, if you take these medications every day and take care of yourself, you can live a life that is just as full and active as someone who does not have HIV. Visit our page HIV Positive? Get Treated page for more information and resources.
The Accuracy Of Different Rapid Tests
A wide range of point-of-care tests have been manufactured in many countries, but only a few of them have been subject to rigorous, independent evaluations, and even fewer are marketed in the UK. Research on HIV tests is only occasionally published in medical journals. Informally, laboratory professionals may have insights into which tests perform best.
Because of the possibility that a positive result from a single HIV test is, in fact, a false positive, the result is described as ‘reactive’ rather than ‘positive’. If the result is reactive, this indicates that the test has reacted to something in the blood and needs to be investigated with follow-up tests.
It is important to verify that any test used is CE marked. This should mean that the test conforms to European health and safety legislation, although it does not necessarily mean that test performance has been independently evaluated.
There are variations in accuracy from one test to another, with some older tests that are not usually marketed in the UK having a sub-optimal sensitivity and specificity. However, evaluations by the World Health Organization of several rapid diagnostic tests that either have CE marks or are approved by the US Food and Drug Administration , indicate that most are extremely accurate. The key measures of accuracy are sensitivity and specificity .
“All HIV tests need to have reactive results confirmed with further tests.”
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