Where can I get tested for HIV infection?

Many places are providing testing for HIV infection. Common testing locations include local health departments, offices of private doctors, hospitals, and sites specifically set up to provide HIV testing.

It is important to seek testing at a place that also provides counseling about HIV and AIDS. Counselors can answer any questions you might have about risky behavior and ways you can protect yourself and others in the future. In addition, they can help you understand the meaning of the test results and describe what AIDS-related resources are available in the local area.

The CDC National AIDS Hotline can answer questions about testing and can refer you to testing sites in your area. The Hotline numbers are 1-800-342-2437 (English), 1-800-344-7432 (Spanish), or 1-800-243-7889 (TTY).

Consumer-controlled test kits (popularly known as "home test kits") were first licensed in 1997. Although home HIV tests are sometimes advertised through the Internet, currently only the Home Access test is approved by the US Food and Drug Administration (FDA). (The accuracy of home test kits other than Home Access cannot be verified). The Home Access test kit can be found at most local drug stores. The testing procedure involves pricking your finger with a special device, placing drops of blood on a specially treated card, then mailing the card in to be tested at a licensed laboratory. Customers are given an identification number to use when phoning for the test results. Callers may speak to a counselor before taking the test, while waiting for the test result, and when getting the result.

What are rapid HIV tests?

A rapid test for detecting antibody to HIV is a screening test that produces very quick results, usually in 5 to 30 minutes. In comparison, results from the commonly used HIV antibody screening test, the EIA (enzyme immunoassay), are not available for 1-2 weeks.

Only one rapid HIV test is currently licensed by the FDA for use in the United States. The availability of rapid HIV tests may differ from one place to  another. The rapid HIV test is considered to be just as accurate as the EIA.

Both the rapid test and the EIA look for the presence of antibodies to HIV. As is true for all screening tests (including the EIA), a reactive rapid HIV test result must be confirmed before a diagnosis of infection can be given.

Are there other tests available?

The EIA (enzyme immunoassay) is the standard screening test used to detect the presence of antibodies to HIV. The EIA should be used with a confirmatory test such as the Western blot. Tests that detect other signs of HIV are available for special purposes, such as for additional testing of the blood supply and conducting research. Because some tests are expensive or require sophisticated equipment and specialized training, their use is limited. In addition to the EIA, other tests now available include:

• Radioimmunoprecipitation assay (RIPA): A confirmatory blood test that may be used when antibody levels are very low or difficult to detect or when Western blot test results are uncertain. An expensive test, the RIPA requires time and expertise to perform.

• Rapid latex agglutination assay: A simplified, inexpensive blood test that may prove useful in medically disadvantaged areas where there is a high prevalence of HIV infection.

• Dot-blot immunobinding assay: A rapid-screening blood test that is cost-effective and that may become an alternative to conventional EIA and Western blot testing.

• p24 antigen capture assay: Also known as the HIV-1 antigen capture assay. This blood test was added as an interim measure by the FDA in 1996 to HIV-antibody testing to protect the blood supply further until other tests become available to detect early HIV infection before antibodies are fully developed. Because some activity of p24 antigen is unpredictable, this test is not useful for helping people find out if they have HIV.

• Polymerase chain reaction (PCR): A specialized blood test that looks for HIV genetic information. Although expensive and labor-intensive, the test can detect the virus even in someone only recently infected. To further protect the blood supply, the FDA has indicated that the development and implementation of tests for HIV genetic material such as PCR is warranted.

How long after a possible exposure should I wait to get tested for HIV?

The tests commonly used to detect HIV infection actually look for antibodies produced by your body to fight HIV. Most people will develop detectable antibodies within 3 months after infection, the average being 25 days. In rare cases, it can take up to 6 months. For this reasons, the US Centers for Disease Control (CDC) currently recommends testing 6 months after the last possible exposure (unprotected vaginal, anal, or oral sex or sharing needles). It would be extremely rare to take longer than 6 months to develop detectable antibodies. It is important, during the 6 months between exposure and the test, to protect yourself and others from further possible exposures to HIV.

If I test HIV negative, does that mean that my partner is HIV negative also?

No. Your HIV test result reveals only your HIV status. Your negative test result does not tell you whether your partner has HIV.

HIV is not necessarily transmitted every time there is an exposure. Therefore, your taking an HIV test should not be seen as a method to find out if your partner is infected. Testing should never take place in protecting yourself from HIV infection. If your behaviors are putting you at risk for exposure to HIV, it is important to reduce your risks.

What if I test positive for HIV?

If you test positive for HIV, the sooner you take steps to protect your health, the better. Early medical treatment and a health lifestyle can help you stay well. Prompt medical care may delay the onset of AIDS and prevent some life-threatening conditions. There are a number of important steps you can take immediately to protect your health:

• See a doctor, even if you do not feel sick. Try to find a doctor who has experience treating HIV. There are now many drugs to treat HIV infection and help you maintain your health. It is never too early to start thinking about treatment possibilities.

• Have a TB (tuberculosis) test done. You may be infected with TB and not know it. Undetected TB can cause serious illness, but it can be successfully treated if caught early.

• Smoking cigarettes, drinking too much alcohol, or using illegal drugs (such as cocaine) can weaken your immune system. There are programs available that can help you reduce or stop using these substances.

I'm HIV positive. Where can I get information about treatments?

We recommend that you be in the care of a doctor or medical service with experience treating people living with HIV. Your doctor can provide information and guidance.

Detailed information on specific treatments are also available from the HIV/AIDS Treatment Information Service (ATIS) at 1-800-448-0440.

You can obtain information on enrolling in clinical trials from the AIDS Clinical Trials Information Service (ACTIS) at 1-800-874-2572 (English and Spanish) and 1-800-243-7012 (TTY).

How many people have HIV & AIDS?

United States: The CDC estimates that between 650,000 and 900,000 people are living with HIV. Through December 1998, a total of 688,200 cases of AIDS has been reported to the CDC.

Worldwide: Based on estimates from the United Nations AIDS program (UNAIDS), approximately 47 million people have been infected with HIV since the start of the global epidemic. Through December 1998, an estimated 14 million children and adults have died, and an estimated 33.4 million people are living with HIV infection or AIDS.

UNAIDS estimates 5.8 million new HIV infections occurred in 1998. This represents almost 16,000 new cases per day. An estimated 2.5 million adults and children died of HIV/AIDS in 1998.

Why is the US Centers for Disease Control recommending that all pregnant women be tested for HIV?

There are now medical therapies available to lower the chance of an HIV-infected pregnant woman passing HIV to her infant before, during, or after birth. ZDV (zidovudine, also known as AZT or Retrovir) is the only drug which has been proven to reduce perinatal transmission. In 1998, the US Public Health Services released updated recommendations for offering antiretroviral therapy to HIV positive pregnant women.

HIV testing and counseling provides an opportunity for infected women to find out they are infected and to gain access to medical treatment that may help to delay disease progression. For women who are not infected, HIV counseling provides an opportunity to learn important prevention information to reduce the possibility of future exposures.

How safe if the blood supply in the United States?

The US blood supply is among the safest in the world. Nearly all people infected with HIV through blood transfusions received those transfusions before 1985, the year HIV testing began for all donated blood.

The Public Health Service has recommended an approach to blood safety in the United States that includes stringent donor selection practices and the use of screening tests. US blood donations have been screened for antibodies to HIV-1 since March 1985 and HIV-2 since June 1992. Blood and blood products that test positive for HIV are discarded and are not used for transfusions.

An estimated 1 in 450,000 to 1 in 660,000 donations per year are infectious for HIV but are not detected by current antibody screening tests. In August 1995, the FDA recommended that all donated blood plasma also be screened for HIV-1 p24 antigen. The improvement of processing methods for blood products also has reduced the number of infections resulting from the use of these products. Currently, the risk of infection with HIV in the United States through receiving a blood transfusion or blood product is very low.