How Often Should I Get Tested For HIV—And Other FAQs About HIV Testing 

Getting tested for HIV, or the human immunodeficiency virus, can be a daunting experience, especially for queer people still living with the trauma of the ongoing HIV/AIDS epidemic and decades of inadequate government responses.

Unfortunately, in many areas of the country, there is still stigma attached to HIV, despite major breakthroughs in testing capabilities and medical treatments that have made living a long life with it entirely possible. In fact, medications such as PrEP have created a world where you can be proactive in protecting yourself from HIV before having sex.

Still, even if you’re taking PrEP or practicing safe sex, regular HIV testing is important for the health of you and your community. An estimated 1.2 million people are currently living with HIV in the United States according to the U.S. Centers for Disease Control and Prevention, and of those, around 87% knew their HIV status. Disproportionately, Black and Latinx communities accounted for nearly two-thirds of all diagnoses in 2020. Rates of HIV are highest in cities according to the CDC, with the Northeast and South being the regions with the highest rates of transmission.

It can never hurt to remain up to date on your HIV status to better understand yourself and be as open in communication with partners.

If you’re considering getting tested for HIV, this guide is here for you to answer the following questions: Who should get tested for HIV? How often should I get tested for HIV? What questions should I ask my medical provider when I get tested? What should I expect before getting tested? What if I've been exposed to HIV? Are there ways I can protect myself from HIV?

The first answer is anyone who feels they are at risk for contracting HIV should get tested, not just the men who have sex with men (MSM) community.

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HIV can be transmitted from person-to-person through bodily fluids or blood. Those at risk for contracting the virus could include people who have had unprotected sex recently, shared needles during intravenous drug use, or come in contact with the open wound of an HIV-positive person. These are the highest risk activities for contracting HIV, according to Devin Blankenburg, a medical laboratory scientist who has worked for nearly a decade in a lab that does HIV testing.

“It is best to get tested right away to get on proper anti-viral medications,” Blankenburg tells Them.

Outside of these behaviors, the CDC recommends that everyone between the ages of 13 and 64 gets tested for HIV at least once. While the risks for HIV are low for most members of the population, they can almost never be zero. Knowing your status allows you to take control of your life, have better communication with sexual partners, and know what kind of treatment and prevention options there are.

“It can only impact your life if you don't know you are living with HIV and it has the opportunity to really hurt you,” Ace Robinson, co-hhair of the Federal AIDS Policy Partnership (FAPP) tells Them.

Getting tested yearly is a good start for those who are sexually active, though depending on your lifestyle testing more may be a good precautionary measure, says Dr. Allison Agwu, a professor of internal medicine and pediatric infectious disease at Johns Hopkins Medicine.

“Getting tested is not a one-time thing,” Agwu tells Them. “First, you know [your status], and then you should know again, and again because that status can change.”

The CDC states that “sexually active gay men and bisexual men” should get tested every 3 to 6 months. The rest of the population should get tested yearly, especially if they meet the following criteria:

1. You’re a man who has had sex with another man
2. You’ve had anal or vaginal sex with someone who has HIV
3. You’ve had more than one sex partner since your last HIV test
4. You’ve shared needles, syringes, or other drug injection equipment (for example, cookers)
5. You’ve exchanged sex for drugs or money
6. You’ve been diagnosed with or treated for another sexually transmitted disease
7. You’ve been diagnosed with or treated for hepatitis or tuberculosis (TB)
8. You’ve had sex with someone who has done anything listed above or with someone whose sexual history you don’t know

Blankenburg says that for those who are HIV-negative, testing regularly after potential exposures to the virus is important. But those who are HIV positive should consult with their doctor to determine a regular testing schedule to monitor their viral load.

Since the beginning of the AIDS epidemic, queer people have been associated with HIV due to being identified as some of the first government-reported cases of HIV. This initial misrepresentation led to increased marginalization of queer communities and concern that HIV was a “gay disease” despite how prevalent it has spread across all demographics. While HIV continues to affect queer people, it's important to note that many marginalized people face disproportionate burdens of HIV in the United States, including trans people, people of color, and people living in the American South. 

Feeling comfortable and free from any stigma is important when going in for a test for the first time. If you are nervous about getting tested, it's okay to ask the clinician plenty of questions to put yourself at ease.

Agwu suggests the following questions to help better understand the process:

• Is this part of all STI testing panels? Could it be?
• What kind of test is available? Cheek swab or blood draw?
• When will I get my results?
• What does each result mean?
• Is there a follow-up exam?
• How much will this cost?
• Is this test anonymous or confidential?

For those who feel uncomfortable visiting a doctor's office, and are worried about being probed, Robinson suggests looking out for local clinics in your area that do HIV testing. Robinson says most of these clinics have “a fun person who goes to the same places and lives in the same neighborhood as you” administering tests, making it a more relaxed space.

Previously, getting tested for HIV required a long intake form with questions that could be considered invasive by some, says Agwu.

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“We have done a lot of work to remove the fear & anxiety from getting testing,” Robinson says.

You may be asked by your clinician about your sexual history to better understand your risk for contracting HIV, and if it is a good idea to get a larger panel of tests for other sexually transmitted infections (STIs). Clinics may also ask for information about drug use or other activities that could increase your risk of contracting HIV. Agwu says these questions are solely for a clinician to help categorize what to expect when results are given and will not affect the quality of care you receive.

Rapid tests, which are oral swab and finger prick tests, can get your results within the same visit, according to the CDC. However, these tests are less reliable than a full blood-draw lab test, which usually produces results in a few days. The Food and Drug Administration says its approved at-home test’s reliability has a performance of around 92% sensitivity. This translates to a false negative test in about one of every 12 tests. You should still get tested in a clinic that offers laboratory testing to confirm your results. Self-HIV tests can be purchased at local pharmacies, and those looking to find a location in their area where tests should visit gettested.cdc.gov.

Who will know my results?

HIV tests have come such a long way you can now purchase at-home tests. This allows you to test in total privacy without any attachment to your medical record.

Similarly, some clinics offer anonymized tests, which produce a unique identifier for you to check your results without your name and other information being attached. This option, however, is not available at all clinics so be sure to ask before taking a test. Thanks to HIPPA laws in the US, all HIV tests are confidential. This means your information is shared with your medical records, which can be accessed by your doctor or health insurance but are protected from being shared to others.

If you receive a positive test from a confidential test, it may be sent to your local state health department to monitor HIV rates in your area. They will then send this information to the CDC without your personal information attached. The CDC does not share HIV information with anyone.

These situations happen in life and thankfully, in this current medical climate, there are options for anyone who is afraid they have contracted HIV.

“No matter what the result, you will still live your very best life,” Robinson says.

If you feel compelled to be tested right away, your HIV status may not be accurately reflected, says Agwu, because it takes some time for the virus to show up in tests. But, if you get tested within the first 98 hours of a risky situation, such as a broken condom, you can ask a clinician for access to post-exposure prophylaxis, also known as PEP. Taking these drugs immediately after possible exposure will help significantly lower your chances of contracting HIV. A clinician may also recommend getting a full STI testing panel as well.

It's unlikely that a positive test from a single encounter will show up on a test for two to four weeks, says Agwu. It is also important that you follow up with another test a month after your first one just to confirm your status.

There are a few preventative treatment options for those who want to reduce their chance of contracting HIV. Many clinics will offer Pre-Exposure Prophylaxis (PrEP) at low cost to those who test negative. If you are looking for a PrEP provider be sure to visit https://preplocator.org/.

“When I talk about a test being positive or negative, a negative result is an opportunity to go on PrEP, which can be a pill or even a shot that keeps you negative,” Agwu says.

PEP is another treatment option available for those who are looking to lower their risk of HIV after potential exposure. However, It is important to know that PrEP and PEP are proactive measures that can be taken to limit your risk of contracting HIV.

Being proactive is just one step as part of a holistic way to protect yourself from exposure. It is also crucial to be open with your partners about your HIV status, especially in situations that could lead to potential exposure. Regular testing helps you stay on top of your status and is important to protect yourself and your community.

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