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By Medical Author: Dr. Karthik Kumar, MBBS

By Medical Reviewer: Pallavi Uttekar

According to the Centers for Disease Control and Prevention (CDC), everyone between the age of 13 and 64 years should get tested for human immunodeficiency virus (HIV) at least once in their lifetime, and more often for those at higher risk. HIV testing is very important for individuals who are sexually active, particularly those who have multiple partners.

Regardless of your background, here are common reasons to consider for HIV screening:

• If you recently had unprotected sex with a new partner, it’s a good idea for both partners to get tested for sexually transmitted diseases, including HIV.

• The CDC recommends that every pregnant woman must be screened for HIV.

• You should get tested before starting post-exposure prophylaxis (PEP) in cases of sexual assault and occupational needle prick injuries.

• You should get tested after completing PEP.

• You should get tested quarterly while taking pre-exposure prophylaxis (PrEP).

Certain groups of people are considered at a higher risk of HIV exposure and, therefore, should be tested for HIV at least once a year. These include: 

• People who have unprotected intercourse with multiple sexual partners, or who have unprotected intercourse with someone who has multiple sexual partners.

• Sexual partners of people who are HIV-positive.

• People who inject drugs intravenously or use shared needles, and their sexual partners.

• People who already have tuberculosis or hepatitis.

HIV tests are strongly recommended for:

• People who are planning to become pregnant or learn that they are pregnant.

• Those seeking treatment for a sexually transmitted infection or disease.

• Individuals who begin treatment for tuberculosis.

• Any baby born to a woman who is HIV-positive.

What are the early symptoms of HIV infection?

Not everyone who is infected with HIV will develop early symptoms, known as acute HIV infection. Two to four weeks after exposure to HIV, some people may develop flu-like symptoms that last from a few days up to several weeks.  These symptom include:

• Fever

• Chills

• Sore throat

• Muscle aches

• Night sweats

• Rash on torso

• Unexplained tiredness

• Swollen glands or lymph nodes

• Dry cough or shortness of breath (not from a cold)

• Unexplained weight loss

• Persistent diarrhea or unusual spots on the skin or in the mouth

These symptoms are not specific to HIV - other infections may cause the same symptoms.  The presence or absence of symptoms does not predict whether you have HIV or not, and only an HIV test can detect whether a person is or is not infected with HIV. If these symptoms don’t go away, or get worse, you should see a doctor. 

What are the different types of HIV screening?

Human immunodeficiency virus (HIV), the virus that leads to the immune system disease called acquired immunodeficiency syndrome (AIDS), is life-threatening. There are several screening methods to confirm HIV.

Rapid Antibody/Antigen HIV test:

• This type of test is useful for individuals who want same-day results from their evaluation.

• The accuracy level of this test is as high as that of a standard test. If an individual tests negative, then there is no need for additional evaluation if they have no further risk and/or the window period has passed.

Standard testing:

Nucleic acid-based test (NAAT) 

• This test looks for the actual virus (viral load) in the blood. This test is very expensive and is only used for HIV screening if a person recently had high-risk exposure with an HIV-positive person, or to screen a person who has early symptoms of HIV infection. An NAAT can detect HIV infection as soon as 10 to 33 days after exposure.

• The only difference between a standard examination and rapid testing process is that the former requires several days after completion of the process to produce results.

Tests for early detection:

• This evaluation is meaningful if you have had a recent incident such as exposure to HIV, or are having unprotected sex with an HIV-negative partner.

• This HIV test cuts the duration of the window period, and can be performed as early as 10 to 12 days after exposure.

• This examination checks for the presence of the virus (viral load) causing the infection. 

HIV antibody test:

• An antibody test is the most popular screening test. It examines antibodies that are present in blood and saliva.  Antibodies are generally present within three months in people who have the infection. For this reason, it is advisable for people at high risk for HIV to get the test done every three months.

• Indirect immunofluorescence or western blot assay examines the presence of antibodies.

• Antibody tests can detect the infection as early as 23 days after exposure. 

• The only self-test approved by the US Food and Drug Administration (FDA) is the antibody test, which is offered under a variety of manufacturer names.

HIV antigen/antibody test:

• This HIV test can detect the presence of antibodies and antigens in blood. It can detect the presence of the infection much sooner than the antibody-only test.

• If you have HIV, an antigen called p24 is produced even before antibodies develop. Antigen/antibody tests are recommended for testing performed in labs, and are now common in the United States. An antigen/antibody blood test can usually detect HIV infection 18 to 45 days after exposure.

Home testing kit for HIV:

If you suspect you may have HIV, you can also opt for a home testing kit. For home use, two sample collection methods are available.

1. The first type is the home collection kit that requires pricking your finger to collect a blood sample. The sample is then sent to the lab for testing. You can obtain the results in a few days.

2. You may choose  the other type of home-testing solution that tests your saliva. A test stick is used to swab the gums. The test stick is then inserted into a tube and the results are revealed in just 20 minutes.