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HIV is a life-changing condition, but early testing and effective treatment enable many people with the infection to live healthy, active lives.

Some people have HIV screening every so often, while others seek testing only after possible exposure. Also, healthcare providers test for HIV during pregnancy.

Routine testing is essential for anyone with a known HIV risk factor.

Self-testing is now widely used, and it has approval from the World Health Organization (WHO). The convenience and privacy can encourage people to test, meaning that more people with the infection receive HIV treatment and take precautions early on.

Experts in the United States encourage people to see self-testing as a first step. If the result is positive, the person should see a doctor for another test to confirm the result.

It is also essential to use an approved kit and to follow the instructions carefully.

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Home testing for HIV might involve self-sampling or self-testing.

In either case, only use a test that has the approval of the Food and Drug Administration (FDA), as other types may not be reliable.

Self-sampling

This test kit contains equipment for collecting a sample of blood, urine, or saliva.

The person mails their sample to a lab, which returns the result either to the person or their healthcare provider after a few days.

These tests are highly sensitive and can provide accurate results soon after the infection takes place.

What is a fourth-generation HIV test?

Self-testing

A person can do this test entirely at home. The OraQuick In-Home HIV test is the only option with FDA approval. It involves taking a saliva swab and produces results in 20–40 minutes.

However, this test is less reliable than self-sampling, and the FDA only recommend it as a first step to further testing.

An older test, called the Home Access HIV-1 Test Service, was discontinued in 2019.

No HIV test is 100% accurate, but using one correctly improves the chances of getting an accurate result.

One factor to bear in mind is how much time has passed between the possible exposure and the test, known as the “window period.”

HIV only becomes detectable on a test after some time has passed. In most cases, a person should only take a home test at least 90 days after possible exposure to the virus.

Tests that use blood from a vein may detect HIV earlier, but these are only available from healthcare providers.

Self-sampling

An HIV information charity based in the United Kingdom notes that, while there is little published evidence to confirm this, tests with samples sent to a lab are likely to be accurate. They add, however, that any results require confirmation with further tests.

Factors that may reduce the accuracy include:

  • not leaving time for the cleaning alcohol to dry on the skin before taking the sample
  • not collecting enough blood
  • a delay in sending the sample
  • exposure of the sample to extreme weather conditions

Research published in 2014 found that when a healthcare professional was involved in HIV testing, the results were likely to be 99.3% accurate. Tests done without a healthcare professional were likely to be 92.9% accurate.

Self-testing

In a few cases — around 1 in 5,000 — the OraQuick test may produce a false-positive result.

Moreover, in around 1 in 12 cases, it produces a false-negative result. In other words, it will show that HIV is not present when, in fact, it is.

A false-negative result may occur if a person uses the test:

  • within 3 months, or possibly longer, after exposure to the virus
  • while taking medication to manage or prevent HIV infection

This is one reason why the FDA consider home testing to be just a first step toward an accurate result.

Home testing kits are available without a prescription:

  • online
  • at pharmacies
  • through healthcare providers
  • through some community-based organizations
  • from laboratories

Before buying a test online, check the type of test and what it involves. Also, some tests are not available in every state.

OraQuick is available for purchase through the company’s website. The cost is currently $39.99, plus shipping and handling. The company uses unmarked packaging to preserve purchasers’ privacy.

In the U.S., the Affordable Care Act ensures that HIV testing is covered by health insurance without a copay.

Reasons for choosing a home test might include:

  • a need for privacy
  • limited access to healthcare facilities
  • limited time for visiting these facilities
  • limitations on movement and facilities, due to COVID-19
  • having a known HIV risk factor and testing regularly

Anyone who may have had exposure to HIV should take a test.

A few days after exposure, some people experience:

These could be symptoms of acute HIV infection, the earliest stage. The symptoms may disappear after a few days, but they can last several months.

People should also test if they are pregnant or have a diagnosis of:

Learn more about the early signs and symptoms of HIV.

Whatever the result of a home test, a person usually needs to follow up with a test at a clinic. Until this second test confirms the result, take precautions to prevent the transmission of the virus.

If confirmation testing gives a positive result:

  • Make a treatment plan with a healthcare provider.
  • Receive testing for other STIs and for TB.
  • Take steps to protect overall health, such as by attending to any other health issues and following a healthful diet.
  • Seek counseling and support.
  • Talk to any sexual partners about getting tested.
  • If applicable, quit smoking and limit the use of alcohol and any recreational drugs.
  • If applicable, receive help for any substance abuse disorder.

Ways to prevent transmission of the virus include:

  • using condoms or dental dams during every sexual encounter
  • talking openly with any partners about HIV
  • taking medications as directed
  • discussing the use of pre-exposure medications with sexual partners who have not had positive test results
  • if applicable, not sharing needles or any drug equipment

HIV is a lifelong condition, but current treatments can dramatically reduce the impact of the condition on a person’s health and lifestyle, especially if the treatment begins early.

Antiretroviral therapy can reduce levels of the virus in the body so that they are no longer detectable. At this point, the virus cannot transmit to another person.

What is it like to live with HIV?

Self-testing for HIV might involve using a saliva swab and waiting 20–40 minutes for a result or taking a sample of blood, saliva, or urine and sending it to a lab for diagnosis.

Self-testing can give a person an idea of their HIV status, but the result needs to be confirmed with a test from a healthcare provider.

Always follow the testing instructions closely to increase the chances of an accurate result.