All About HIV Testing
A practical guide to everything about testing for HIV and STIs
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
- 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.
- 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.
- 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.
- 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.
- 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 HIV 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
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.
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)
The first HIV self-test is now approved by the TGA for sale in Australia. An HIV self-test is a finger-prick blood test that you can perform on yourself, at home or elsewhere, and receive results in 15 minutes. The testing kit comes as an easy to use device with directions. Australia only has one test approved for sale.
You can find and purchase the HIV self-testing kit in Australia by following the link here.
Or for more detailed information on approved HIV self-testing in Australia, visit the AFAO website.
It is encouraged that people use TGA-approved HST devices, for quality assurance and the provision of local contact information for support and follow-up.
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:
- These tests present more of risk in terms of safety and accuracy than HIV self-tests approved for sale in Australia
- As of July 2016, the World Health Organisation reports that 16 countries have HIV self-testing policies. It is important to research a device to ensure that it has been approved by a reputable regulator
- USAID (the United States Agency for International Development) maintains a list of rapid HIV testing devices approved for use in their programs (usaid.gov).
- It’s unlikely that HST devices purchased from overseas will have Australian-specific information on what to do with your results
- 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
- 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
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 some may take up to three months. This period is known as ‘the window period’.
The window period is 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. So, if you test negative at three months after your potential exposure to HIV, it will almost always mean you do not have HIV, so long as there has been no other risk of transmission in the meantime.
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:
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.
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 HIV 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