Fact Sheet: HIV Counseling and Testing

Knowing your HIV status is the first step in seeking medical intervention and gaining access to effective treatment and prevention strategies.

Why Should I Be Tested for HIV?

Typically, the time between HIV infection and the development of symptoms is lengthy -- sometimes ten years or more. Knowing your HIV status has two vital benefits: First, if you know you are HIV infected, you may receive medical treatment even before symptoms appear. Second, you can take all necessary precautions to prevent spreading HIV to others.

Where Can I Get Tested for HIV?

Common testing locations include health departments, hospitals, private doctors, family planning or sexually transmitted disease clinics, mobile sites, drug treatment facilities, and sites specifically dedicated to HIV testing. Choose a testing place that also provides 1) HIV/AIDS counseling about the meaning of the test results; 2) advice on how to protect yourself and others; and 3) referrals to the AIDS-related resources available in your area.

Can I Keep My Test Results Private?

Three types of testing are generally available:

Anonymous HIV testing means that no name is given to the testing center. Instead, the person tested is given a unique identifier code and is the only one who is made aware of the test results. Anonymous testing is not available in all states.

Home "collection kits" are available. You do not reveal your name. Instead, each kit comes with a unique identification number. Kits can be purchased over the counter or by mail in all states. Home tests are generally quite accurate. However, since this does not offer the benefit of in-person counseling; you should see an HIV/AIDS counselor.

Confidential HIV testing involves recording and confidentially reporting names of those who test positive to public health authorities. Confidentiality laws/regulations protect against disclosure of the information. Laboratory staff and, in some states, state health department personnel will have access to test results. If you sign a release form to have your physician notified, the results will become part of your medical record. In this case, the information may be seen by health care workers, insurers or employers. Your status may also become known if you make a health insurance claim or apply for life or disability insurance. Confidential testing is available in all states.

What If I Test Positive for HIV?

If you test positive for HIV, early medical treatment and a healthy lifestyle can help you stay well, delay the onset of AIDS, and prevent some life-threatening conditions. If you are HIV-positive, follow these steps immediately to protect your health:

• See a doctor, even if you do not feel sick. There are many drugs to treat HIV infection which may help you maintain your health.

• Seek counseling to help deal with the news and join a support group.

• Get tested for tuberculosis and hepatitis C. Undetected cases can cause serious illness, but they can be successfully treated if caught early.

• Don't smoke cigarettes, drink too much alcohol, or use drugs. These can weaken your immune system and allow the virus to duplicate itself more rapidly. [See the Fact Sheet "Treatment Information"]

Where Can I Get Information About Treatment?

If you are HIV positive, your doctor or medical service provider should be an important source of information on treatment options. [See the Fact Sheet "Treatment Information" and the "National Hotlines" section]

When and How Often Should I Be Tested for HIV?

Because the tests commonly used to detect HIV infection actually look for antibodies produced by your body to fight HIV, you should wait a reasonable period of time after possible exposure before being tested.

Most people develop detectable antibodies within 3 months after infection (the average is 25 days). In rare cases, it can take up to 6 months. Therefore, the Centers for Disease Control and Prevention currently recommends testing at 3 months and 6 months after the last possible exposure (unprotected vaginal, anal or oral sex or needle sharing).

During the 6 months between exposure and the test, it is important to protect yourself and others from further possible exposures to HIV. Testing should never take the place of prevention.

Some people should be tested periodically, including prostitutes or others who have multiple sex partners, people who inject drugs; and the HIV-negative sexual partner of an HIV-positive person.

Who Should Be Tested?

Testing and counseling for early diagnosis of HIV infection are recommended for the following:

• People who consider themselves at risk for infection

• People who have had unprotected sex with a person of uncertain HIV serostatus

• Women of childbearing age who are at risk of infection

• Pregnant women

• Women who plan to become pregnant

• People who have sexually transmitted diseases or who have been sexually abused

• Spouses, sex partners, and needle-sharing partners of injecting drug users

• Tuberculosis and Hepatitis B and C patients

• Patients who received blood transfusions between early 1978 and mid-1985

How Long Does It Take to Get Test Results?

Results from the most commonly used HIV antibody screening test, the ELISA, can be available within several days to several weeks. A "rapid test" will soon be available for screening. It produces quick results, usually within 5 to 30 minutes. These tests can be performed on blood, urine or oral fluid samples.

How Accurate Are HIV Test Results?

The tests are more than 99% accurate. The most commonly used tests are the ELISA and the Western blot. If the ELISA shows the sample is positive for HIV, then the Western blot is done to confirm that initial result.

How Do I Interpret HIV Test Results?

A positive result on an HIV test means that HIV antibodies are present and you are HIV positive. The onset of AIDS may take up to 10 or more years. Drug treatments are available that can further delay the development of AIDS.

A negative result usually indicates that you are not infected with HIV. However, you should be re-tested in six months if you have engaged in high-risk behavior during the past six months because it can take that long for your immune system to produce enough antibodies.

If I Test HIV Negative, Does that Mean My Partner Is Also Negative?

No. Your test results reveal only your HIV status. Because infection with HIV may not occur every time there is an exposure, your test does not reveal whether or not your partner is infected. Your partner must also be tested.

• Testing should never be used in place of protecting yourself from infection.

Why Should I See an HIV/AIDS Counselor?

An HIV/AIDS counselor can provide information and emotional support and help interpret HIV test results. Counseling can be provided either in person or over the telephone.

If you learn you are HIV-positive, the counselor can explain treatment options, discuss lifestyle changes to help keep you healthy longer and give advice on methods to avoid spreading HIV to others. If you learn you are HIV-negative, a counselor can give advice on strategies to avoid future infection.

Universal Screening for All Pregnant Women

The American College of Obstetricians and Gynecologists and the Centers for Disease Control and Prevention have announced a campaign for universal HIV screening of all pregnant women. Testing would not be mandatory but physicians are encouraged to include it as part of standard prenatal care. This would ensure that women who test positive are treated early in their pregnancy. Early treatment with combination antiretroviral regimens can lower rates of transmission from a mother to her fetus from 25% to between 2% and 0%.

• Because anyone can be at risk of HIV, it is difficult for physicians and patients to predict which women may be infected.

• Many women do not believe they are at risk for HIV because they are not aware of the health status and/or the sexual and drug practices of their sex partners (often including their husbands).

• Out of the approximately 91% of U.S. children with AIDS who have been born to HIV-infected mothers, one third of their birth mothers had reported that they had no risk factors for HIV.

• HIV testing of all pregnant women would be kept voluntary and confidential.