All About Testing

A practical guide to everything about testing

These days, with thanks to technology, there are more ways than ever to get tested for HIV.

Here is all you need to know about the different types of HIV tests available and some considerations you should keep in mind.

5 Facts About Testing

  1. It takes time for HIV to be detected in the body
    Most people who’ve been exposed to HIV will test positive within one month after exposure, but a small number of people take up to three months.
  2. You’re highly infectious during the ‘window period’
    That’s the time between HIV infection and the production of antibodies. A lot of HIV transmission occurs because guys don’t know that they have HIV developing in the window period.
  3. Testing negative after three months is a good sign
    A negative test at three months after an initial test will almost always mean a person does not have HIV, given there’s been no risk of HIV transmission in the meantime.
  4. Your HIV test results are confidential
    If you’re worried about the confidentiality of your results, you should know that all testing in private GPs and public clinics is governed by Privacy Law. Talk with your GP or clinic about this when testing. At some clinics you don’t need a Medicare card and in some cases you don’t even have to give your real name if you don’t want to.
  5. HIV and STI testing is available free of charge at many sexual health clinics
    In many cases HIV testing is free and you don’t need a Medicare card. You can find your nearest testing site in NSW here.

What Tests Are Available?

Rapid HIV Test

A rapid HIV test involves drawing a small amount of blood normally via a finger prick with a result usually available within 30 minutes.

There are three possible results; negative, reactive and invalid. These results are only preliminary and blood will still need to be collected from your arm and sent to a laboratory to confirm the result.

  • Negative – HIV antibodies were not detected in the sample. It’s important to note that people within the HIV window period might also receive a negative result
  • Reactive – HIV antibodies were detected in the sample, but this result needs to be confirmed with laboratory-based blood testing
  • Invalid – In the unlikely case that the test shows an invalid response, it simply means something went wrong with the test itself. This result is not an indication of the person’s HIV status and they would be offered a repeat rapid HIV test

Rapid HIV testing is available at many locations in NSW or if you are in Sydney you can also visit a[TEST].

HIV Antibody Test

The HIV antibody test is the most common test gay men will have during a sexual health check.

If you have contracted HIV, your immune system will start producing antibodies reacting to the virus within 2-12 weeks following exposure. These antibodies are detected by the test, and if you test positive, another test will be done to confirm the result.

Antigen Test

An antigen test will detect HIV infection at an earlier stage than an HIV antibody test. It tests for quantities of a protein known as the p24 antigen, which is part of the HIV virus and produced in high amounts early on after contracting HIV. In Australia, most labs currently test for both HIV antibodies and the p24 antigen.

Dried Blood Spot (DBS) Test

A DBS test is a free, accurate and convenient way to test for HIV in the comfort and privacy of your home.

It involves collecting a few drops of blood from your finger and allowing the blood to dry on a test card. You then send the card away to get tested and wait around a week to get the result back. You can register for a DBS HIV test here.

HIV Self-Test (HST)

HST devices also allow you to perform an initial screening test by yourself at home. It’s a simple process – involving a mouth swab or finger prick – which produces a result in less than 30 minutes.

To help increase testing rates, the Australian Government amended regulation to allow HST devices to be sold in Australia. However, any such device needs to be approved by the Therapeutic Goods Administration and this is yet to occur. This means it’s currently illegal to sell HST devices in Australia.

It is, however, legal to buy HST devices from overseas for personal use in Australia. If you do this, there are some things to consider:

  • Research the device to ensure that it has been approved by a reputable regulator
  • Devices vary in terms of their quality and accuracy. They may also suffer from exposure to heat during international shipping which could affect the performance of the test
  • It’s unlikely that HST devices purchased from overseas will have Australian-specific information on what to do with your results
  • As these devices are screening tests, the possible results are ‘reactive’, ‘negative’ (non-reactive), or ‘invalid’. Any reactive result needs to be confirmed by a blood test conducted by a healthcare professional
  • HST devices work by detecting HIV antibodies, which the immune system produces anywhere between two weeks to three months after exposure to the virus. Because of this window period, HST devices may not provide a conclusive result until up to three months after a risk of exposure
  • If you are considering self-testing for HIV, it’s important to know who to contact so you can be linked to care, support and diagnostic testing services, should the test be reactive. For this reason, we also suggest that people not test alone and test at times when relevant support services are operating

Pre-test discussion checklist

If you are testing at a GP or a sexual health clinic (i.e. getting a rapid HIV test, antibody test or antigen test), you’ll have a few minutes’ chat with your healthcare provider about the following:

  • What the test means and the implications of a positive or negative result
  • Your behaviour since your last test to gauge how likely it is you may have been exposed to HIV
  • Your understanding of HIV, how it is transmitted and how to protect yourself
  • The support available to you after your result
  • The window period of the test you are taking and if you need to be retested

Some clinics provide an express service where you enter some of this information directly on a computer before seeing the nurse, which cuts down on the length of the discussion, meaning you get out of there quicker!

Need to talk?

If you’ve had a recent risk event, you can take PEP to prevent infection, but only if it’s taken within 72 hours after exposure to HIV. Call the PEP Hotline on: 1800 737 669.

If you want to talk to someone about a positive or reactive result, call:

ACON

Phone: (02) 9206 2000
Free Call: 1800 063 060
TTY: (02) 9283 2088

HIV Diagnosis Priority Service available Monday to Friday.

When you call, inform that you’re newly diagnosed and ask to speak with a counsellor or health promotion officer. You’ll get a call back within one working day of your initial call.

NSW Sexual Health Infolink

Free Call: 1800 451 624
TTY: 02 9221 6515

Service available Monday to Friday 9am to 5:30pm.

Lifeline

Free Call: 1800 184 527 or 13 11 14

If you want to talk to someone outside business hours, Lifeline’s Crisis Counselling Service is available 24-hours.

Australia’s Policy on Testing

In September 2011, The Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) launched the National HIV Testing Policy, which was later updated in February 2017. For more information about the National HIV Testing Policy visit http://testingportal.ashm.org.au