HIV can be a life changing condition, but early testing and effective treatment enable many people living with HIV to lead healthy, active lives.

Routine testing is essential for anyone with known HIV risk factors, such as sex with more than one partner since their last HIV test. Other risk factors include having sex with multiple partners without a condom, sharing equipment to inject drugs, or exchanging sex for money or items.

The Centers for Disease Control and Prevention (CDC) encourage people to see self-testing for HIV as a first step. If the result is positive, the person should speak with a healthcare professional for another test to confirm the result.

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

HIV is a virus that attacks the body’s immune system. People commonly contract this virus through anal or vaginal sex, or by sharing needles and syringes. People who are pregnant can also transmit the virus to their babies.

If a person does not get treatment for HIV, it can lead to AIDS. While HIV is not curable, people can reduce the likelihood of transmission to others through medication and by ensuring they use barrier methods of contraception when having sex.

Some individuals undergo HIV screening every so often, while others seek tests only after possible exposure. Healthcare professionals also test for HIV during pregnancy.

People can receive testing from doctor’s offices, city health clinics, and other clinical settings. Some of these places may offer free or low cost screenings. However, people can also use at-home test kits.

People commonly test themselves with screening methods that have approval from the World Health Organization (WHO). The convenience and privacy these kits offer can encourage individuals to test, meaning more people living with HIV receive treatment and take prompt precautions.

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

The most reliable self-sampling test, OraQuick, has approval from the Food and Drug Administration (FDA).

These self-tests look for virus antibodies — foreign substances that trigger a response from the immune system.

Self-sampling

  • Sample type: blood, urine, or saliva
  • Results time: usually a few days

Self-sampling kits contain equipment for collecting a sample of blood, urine, or saliva.

A person typically mails their sample to the lab, which returns the result either to them or their healthcare professional after a few days. These tests are highly sensitive and can provide accurate results soon after exposure.

However, there are no FDA-approved self-sampling kits. With this in mind, a person should look for kits that undergo processing by labs meeting Clinical Laboratory Improvement Amendments standards.

Self-testing

  • Sample type: saliva
  • Results time: 20–40 minutes

A person can perform a rapid test at home. The OraQuick In-Home HIV test is the only option with full 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 recommends further testing after this screening.

These self-tests should also not replace medical care from a healthcare professional. A person should always speak with a doctor about obtaining a proper diagnosis and appropriate treatment.

An older test called the Home Access HIV-1 Test Service underwent discontinuation in 2019.

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

One factor to consider 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. A person can take a self-test 23–90 days after exposure to the virus.

However, having a negative test result does not always mean a person does not have HIV. It can take up to 90 days, or rarely, longer, after exposure for the test to return positive results, so it is important to keep testing.

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


Self-sampling

NAM, an HIV charity from the United Kingdom, notes that, while there is little published evidence to confirm this, tests with samples that go to a lab are likely to be accurate. However, it adds 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
  • delays in sending samples
  • exposure of the sample to extreme weather conditions


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 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. It can also occur while a person is taking medication to manage or prevent HIV transmission.

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

In optimal conditions, at-home tests fair well. A 2018 meta-analysis of 25 international studies found that untrained individuals taking rapid self-tests to detect HIV gained results in agreement with tests involving healthcare professionals. However, blood-based tests had higher specificity and sensitivity than saliva tests.

The analysis concluded that self-testers can reliably and accurately perform HIV rapid diagnostic tests compared with trained healthcare workers.

HIV home testing kits are available without a prescription:

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

Before buying a test online, a person should check what that test involves. Additionally, some tests are not available in every state.

OraQuick is available for purchase through the company’s website. The cost is currently $38.99, plus shipping and handling. The company uses unmarked packaging to preserve user privacy.

In early 2022, California became the first U.S. state to require private insurers to cover HIV self-tests. Many cities and states will also send free tests to those who request them by mail.

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. However, if a person knows they have had acute HIV exposure or experienced sexual assault and have concerns about sexually transmitted infections (STIs), they should seek medical care. There is postexposure prophylaxis that can help prevent HIV.

Within 2–4 weeks of contracting HIV, some people experience:

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

While these symptoms may often be similar to symptoms of the flu or other viral illnesses, it is important to test for HIV if a person also has any risk factors for contracting this virus.

People should also test if there is a diagnosis of:

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, individuals need to take precautions to prevent the transmission of the virus.

If confirmation testing gives a positive result, a person should:

  • make a treatment plan with a healthcare professional
  • receive testing for other STIs and TB
  • take steps to protect overall health, such as attending to any other health issues and following a nutritious diet
  • seek counseling and support.
  • talk with any sexual partners about undergoing testing
  • quit smoking and limit the use of alcohol and any recreational drugs, if applicable
  • receive help for any substance misuse disorder, if applicable

Ways to prevent transmission of the virus include:

  • using condoms or dental dams during any sexual activities
  • talking openly with partners about HIV
  • taking medications as a doctor recommends
  • discussing the use of preexposure 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. However, current treatments can dramatically reduce the condition’s effects on a person’s health and lifestyle, especially with prompt treatment.

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.

Below, we answer some common questions about these tests.

How soon can OraQuick detect HIV?

The CDC states that antibody tests, such as OraQuick, may be able to detect HIV in a person within 23–90 days after exposure.

Is an oral HIV test accurate?

The FDA states that the OraQuick test is 92% sensitive to HIV antibodies. This means that this oral test would return a false negative in 1 out of 12 tests.

The organization goes on to state that this particular test has 99.98% specificity, which means that 1 in 5,000 tests will return a false positive.

However, a test’s accuracy depends on whether a person has HIV antibodies present. While these antibodies can take up to 6 months to develop, up to 97% of people will have HIV antibodies within 3 months of contracting HIV.

How do I tell a partner I have HIV?

A person may find it difficult to tell a partner about their positive HIV status. However, it is very important to share this information as any potential partners will require testing too. Additionally, people can discuss sex practices that may help reduce transmission.

People should ensure the conversation with a potential partner takes place in a safe space to reduce any anxiety. The conversation about HIV status should occur when all people have the time to discuss it, so it is important to do so when there are no other plans.

A person may wish to make a list of the topics they would like to discuss. Examples include when they first received a positive test and any medication they take to reduce transmission.

A partner is likely to have questions. It is important for both parties to listen and address any concerns. It is possible that some people will need to stop the conversation and continue it at a later date.

It is important to remember that people can turn to a healthcare professional for more advice on navigating a sexual or romantic relationship when one or more individuals have HIV.

Self-testing for HIV might involve using a saliva swab and waiting 20–40 minutes for a result. It may also involve 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. However, the result needs confirmation with a test from a healthcare professional.

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