HIV Testing

• Monday – Thursday 8:30am – 4:00pm, Fridays 9:00am -1:00pm
• Counseling and testing available in Spanish and English
• SAAF offers both anonymous and confidential testing
• Oral test using swabbing inside of mouth/Bloodless
• Test results in 20 minutes
• Walk-in basis
• Free HIV testing and counseling

HIV Testing at a Glance

Up to 1 out of 4 people who have HIV don't know it. Knowing if you have HIV can be essential to your health. If you know you have HIV, you are more likely to get the care you need to stay healthy longer and you are more likely to do things that keep you from infecting others. If you know you don't have HIV, you can learn what you need to do to protect yourself and your partner(s) from getting it.

Testing for HIV has become faster and more convenient. Today, you have testing options. Here are some of the most common questions we hear people ask about HIV testing. We hope you find the answers helpful.

Highlights

• Should I Get Tested for HIV?
• How Do HIV Tests Work?
• What Kinds of HIV Tests Are Available?
• Can Minors/Youth Test for HIV without Parental Consent?
• Where Can I Get a Test for HIV?

Should I Get Tested for HIV?

HIV tests should be a normal part of health care. If you think you or your partner(s) may have been exposed to HIV, talk with a health care provider about testing. Talking about what risks you've taken can help you decide whether testing is right for you.

Certain activities and behaviors increase your risk for HIV/AIDS. You may want to get an HIV test if you have

• Had unprotected anal or vaginal intercourse with someone who has HIV/AIDS
• Shared needles, syringes or other drug paraphernalia with someone who has HIV/AIDS
• Had a sexually transmitted disease (STD)
• Received a blood transfusion or blood-clotting factor between 1978 and 1985.

It may be difficult to know for sure if your partner has taken any risks. If you have any question about your partner's HIV status, make sure you practice safer sex. Meanwhile, try to talk with your partner about whatever risks for HIV/AIDS you both may have taken. If you are both at risk, encourage your partner to get tested, too.

How Do HIV Tests Work?

When someone gets HIV, the body's immune system makes antibodies to try to fight the infection. Most HIV tests available today test for HIV antibodies, rather than looking for the virus. If HIV antibodies are present, it means that a person is infected with HIV, with the exception of newborns (Babies born to HIV infected women will automatically test positive for the HIV antibody, because you are testing the mother’s immune system, rather than the infants. It takes infants 12 -18 months to develop their own antibodies and immune system.).

One type of HIV test detects the virus itself, rather than antibodies to it. This is called an RNA or PCR test. RNA/PCR testing is more expensive and much less common than antibody tests. But RNA testing can detect HIV much earlier than antibody tests — in as little as 9 to 11 days after infection.

The Window Period

It can take up to three months after you are infected with HIV to develop antibodies. This is called the "window period." During the window period, HIV antibody tests may not show that a person has the virus. It is very important to remember that HIV can be passed to other people during the window period. Just because a person has developed a sufficient amount of HIV antibodies to be detectable, does not mean that the person is not HIV infected and that the person cannot infect others. Because of the window period, you should wait 3 months following your most recent exposure to HIV before getting tested. However, if you have never been tested and have previously been at risk, it might be prudent to take a baseline test now and then repeat the test at the end of the window period (3 months) after your most recent exposure. What Kinds of HIV Tests Are Available?

Currently, there are several ways to test for HIV. The most common are blood and oral swab HIV tests. Many settings now offer rapid HIV testing. A rapid test can use an oral swab or blood from a vein or finger prick. SAAF uses rapid oral swab tests. The results take as little as 20 minutes. However, rapid test results that show a preliminary positive on initial screening need to be confirmed with a follow-up test.

How is the Test Done?

The San Antonio AIDS Foundation uses OraQuick Advance Rapid HIV-1/2 Antibody Test to test for HIV (www.orasure.com). It tests for HIV 1 and HIV 2 antibodies using an ELISA test. The OraQuick Advance works much like a home pregnancy test. You are given a test stick, and quickly swab one time between your lips and gums across the top of your mouth and then flip the stick and swab once between lips and gums across the bottom of your mouth. More swabbing is not better. You then give the stick to the tester, who places it in a vial of solution, where it sits for 20 minutes. In the window of the stick there is a place for 2 lines. One blue line comes into the window, which is the control to show that the test is valid and working properly.

If you test negative, that is the only line that will appear. A negative test result means that this test did not detect HIV antibodies in your oral fluid. However, if you recently (within 3 months) put yourself at risk for contracting HIV, then you cannot rule it out and should re-test at 3 months following your most recent exposure. If you test preliminary positive, it means there may be HIV antibodies in your oral fluid. If you get a preliminary positive, you should take and will be offered a confirmatory test, called the Western Blot. This will require another lab specimen, either oral or blood, that will need to be sent to a laboratory to process. SAAF will get the test results within a week. If the Western Blot confirmatory test results are positive, then you are considered positive for HIV. If the confirmatory test results are “indeterminate” or “inconclusive”, then you should repeat the test in 3 months.

Anonymous vs. Confidential Testing

In most states you can find clinics that offer "anonymous" and/or "confidential" HIV tests. It may be important to you to know the difference between those two terms when you choose a clinic for the test.

• "Confidential" testing means that your name and other identifying information is attached to your test results. The results go in your medical record and may be shared with your insurance company. Otherwise, the results are kept private, just as most medical records are.
• "Anonymous" testing means that your name is never used — just an ID number. That number is attached to your test results. You get your results by matching the number. Usually the results aren't written down — they are just told to you. With anonymous testing, your test results are not part of your medical record.
• Please note, that while you can do the screening test for HIV anonymously, the confirmatory testing, which is done by an outside laboratory, requires your first and last name and date of birth in order for the lab to run the specimen. However, that identifying information is still confidential, meaning it is not shared with anyone other than with the lab, and the State and County/City Health Departments, which is required by law.

The San Antonio AIDS Foundation offers both anonymous and confidential testing. You can give written consent for an anonymous test with an X or your initials.

HIV Testing for Pregnant Women

The government now suggests that all pregnant women be tested for HIV, as part of their normal prenatal care. If a woman has HIV while pregnant, she can work with her health care provider to help reduce the risk that her baby will have HIV, too. With treatment and avoidance of breastfeeding, less than 2 out of 100 babies born to women who have HIV will be infected. Without treatment, about 25 out of 100 babies will be infected.

Can Minors/Youth Test for HIV without Parental Consent?

Testing for HIV is one of the only medical tests that a youth can request without parental or guardian consent. It is always recommended that youth bring with them a confidant or someone they can trust for support and it is preferable that their support is an adult. However, the San Antonio AIDS Foundation will test someone of any age, as long as the person believes s/he has been at risk for infection and understands the ramifications of what s/he is doing, i.e., finding out if s/he has an infection that can have dramatic consequences. Similarly, the San Antonio AIDS Foundation will not test an adult who is cognitively impaired to the extent that s/he does not understand the implications of getting an HIV test, or someone who is inebriated at the time of the test.

Where Can I Get a Test for HIV?

Tests are available from the San Antonio AIDS Foundation, other AIDS Service Organizations, most physicians, hospitals, the health department, and health clinics. Some provide tests for free, some at a sliding scale and some at cost. The San Antonio AIDS Foundation provides HIV tests for free. It may be best to arrange to take the test where you will be able to talk with someone, ask questions, and get information before and after you are tested. For more information on other HIV testing sites in Texas please visit www.HIVTEST.org or www.211texas.org.

Being Prepared

If you decide to be tested, talk about your plans with someone you trust, someone who will be there for you when you get the results — especially if it's not good news. This may not be something to keep entirely to yourself.

Take some time to think about how you will handle the results. What if you find out you have HIV? How will knowing that affect the way you take care of yourself? How will it affect your partner? What if you find out that you don't have HIV? How will you make sure you stay that way?