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HIV Testing: Should I Get Tested for Human Immunodeficiency Virus?
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
HIV Testing: Should I Get Tested for Human Immunodeficiency Virus?
Get the facts
Your options
- Have a blood or saliva test for HIV.
- Do not have the test.
If you believe you've been exposed to HIV, it's important to be tested.
Key points to remember
- Many health experts and provincial health organizations in Canada recommend HIV testing for everyone. Other experts and organizations, including the Public Health Agency of Canada (PHAC), recommend having a screening test for HIV if you have a high risk of infection.1 HIV tests are also recommended for all pregnant women.
- You may not need to be screened for HIV if you aren't sexually active and if you and your doctor have determined that you have a very low risk for getting HIV.
- HIV may not cause symptoms early on. And people who have early symptoms may mistake them for the flu or mononucleosis. So without a test, you may not know that you have an infection.
- If you have a test that shows that you have HIV, you can take steps to prevent spreading HIV to others.
- You may be afraid to be tested for HIV. But if there's any chance you could be infected, it's very important to find out. HIV can be treated, and early treatment can slow down the virus and help you stay healthy.
- Getting treatment may lower the chance that you will give the infection to a sex partner who doesn't have the infection or to your baby, if you are pregnant.2
- It can take as little as 2 weeks or as long as 6 months from the time you become infected with HIV for the antibodies to be found in your blood. If you think you have been exposed to HIV but you test negative for it, you should be tested again. Tests given at 6, 12, and 24 weeks can be done to be sure you aren't infected.
- If your test shows that you have HIV, your sex partner(s) will need to know and get tested.
What is HIV?
Human immunodeficiency virus, or HIV, is a virus that attacks the immune system. This makes it hard for the body to fight infection and disease. HIV is the virus that causes AIDS (acquired immunodeficiency syndrome). But having HIV doesn't mean that you have AIDS.
HIV often causes flu-like symptoms soon after a person gets infected. These early symptoms go away in a few weeks. After that, signs of illness may not appear for many years. But as the virus multiplies in the body, symptoms reappear and then remain. Fatigue, weight loss, fever, night sweats, diarrhea, and other symptoms are common.
Treatment of HIV may prevent or delay HIV from developing into AIDS. If HIV isn't treated and progresses to AIDS, symptoms get worse and the body is less and less able to fight infections like pneumonia and tuberculosis.
Medicines are the main treatment for HIV. A doctor would likely prescribe several antiretroviral medicines, sometimes called antiretroviral therapy, or ART. By fighting the virus, these medicines can help the immune system stay healthy and delay or prevent AIDS. And they may help a person live longer.
What is the test for HIV?
An HIV test checks for HIV antibodies in the blood. If HIV antibodies are found, the test is considered positive.
Most doctors use two blood tests, called the ELISA and the Western blot assay. If the first ELISA is positive (meaning that HIV antibodies are found), the blood sample is tested again. If the second test is positive, the doctor will do a Western blot to be sure.
Most test facilities will have the ELISA test results in 2 to 4 days. Results of the Western blot take longer, 1 to 2 weeks. Rapid antibody tests are available that give results right away. But positive results of the rapid test need to be confirmed by the ELISA or Western blot test.
Even if HIV antibodies aren't found, you may need to be tested again, especially if you think you have been exposed. This is done to make sure that HIV antibodies don't appear at a later time. It can take as little as 2 weeks or as long as 6 months from the time you become infected with HIV for the antibodies to be found in your blood. Tests given at 6, 12, and 24 weeks can be done to be sure you aren't infected.
During this period, an infected person can still spread the infection even though his or her test was negative.
You can get HIV testing in most public health units, hospitals, and HIV care clinics, or through your doctor's office.
Who should consider having an HIV test?
Many experts and provincial health organizations in Canada recommend HIV screening for everyone. The Public Health Agency of Canada (PHAC) recommends screening for HIV if you engage in high-risk behaviour.1
High-risk behaviour means that you:
- Are a man who has sex with other men.
- Have multiple sex partners, especially partners who inject drugs.
- Inject drugs or steroids, especially if you share needles, syringes, cookers, or other equipment used to inject drugs.
- Have high-risk partner(s) (a man or woman who has multiple sex partners or injects drugs, or a man who has sex with men).
- Have or have recently had a sexually transmitted infection, such as syphilis or genital herpes.
- Have had tattooing, piercing, or acupuncture with unsterilized equipment.
Some expert opinions may vary, and your doctor may recommend testing based on your personal history.
Even if you don't think you're at risk, it's worthwhile getting tested once. In some cases people who've had a positive test didn't believe they had a high risk before having the test.
The Society of Obstetricians and Gynecologists of Canada (SOGC) and the Canadian Paediatric Society (CPS) recommend that women who are pregnant or thinking of becoming pregnant consider being tested for HIV.3, 4 Early treatment with antiretroviral therapy (ART) can reduce the risk of passing HIV to your baby.
What are the benefits of getting tested?
Getting tested can help find an infection early or when you have no symptoms. This is important so that:
- You can take steps to avoid spreading the infection.
- You can tell your sex partner(s) so they can be tested, get treatment if needed, and avoid spreading the infection.
- You can start treatment right away or as soon as needed. Treatment can help your immune system stay healthy and delay or prevent AIDS. And it may help you live longer. AIDS is the last and most severe stage of HIV infection. Treatment also lowers the chance that you will give the infection to a sex partner who doesn't have the infection.5
- If you are pregnant, you can get early treatment that can reduce the risk of passing HIV to your baby.
What are the risks of getting tested?
If your test shows that you have HIV, your sex partner(s) will need to know and get tested, which may affect your relationship.
If you have HIV, provincial law requires your doctor or the place where you had the test to report it to the provincial health authority. Some provinces allow anonymous reporting (the person's name or other identifying information is not provided). Other provinces require confidential reporting (identifying information is provided but only to authorized public health officials).
With an ELISA test, you could have a false-positive test result, which shows that you have the disease when you actually don't. This could cause you unneeded worry until you have more tests to confirm that you don't have the disease.
Why might your doctor recommend that you have an HIV test?
Your doctor may want you to be tested if:
- You're sexually active.
- You have never had an HIV test.
- You have a high risk for getting HIV.
- You're pregnant.
Compare your options
Compare
What is usually involved? |
| |
What are the benefits? |
| |
What are the risks and side effects? |
|
- You have a blood or saliva test or some other test.
- You may have a follow-up test to confirm the results of a positive test or to check again if you have a negative result.
- If the test shows that you have an infection, you can take steps to avoid spreading the disease to others.
- You can tell others so they can decide whether to be tested.
- If you're pregnant, you can start treatment to avoid spreading the infection to your newborn.
- A test could find an infection early so you can start treatment and prevent or delay an HIV infection from progressing to AIDS.
- Getting tested may give you peace of mind.
- If you have HIV, your doctor may have to report it to the provincial health authority. The health authority may contact your sex partner(s).
- Telling people that you have HIV may be hard for you and can affect your relationships and other aspects of your life.
- There is a very small chance that your test could give a false-positive result, which means that the results show that you have an infection when you don't.
- Your test could give a false-negative result, which means that the results show that you don't have an infection when you do. It can take up to 6 months for antibodies to develop after a person is first exposed to the virus.
- You take steps to avoid getting or spreading HIV.
- You consider getting tested in the future if your lifestyle changes or you become at risk for HIV.
- You won't have to decide whether to tell other people that you have HIV.
- You won't have the risk of getting a false-positive or false-negative test result.
- You won't have a test you don't need (if you know you're not at risk for HIV).
- If you have HIV, you won't find out, and you may spread the infection to others.
- If you're pregnant and have HIV, you could spread the infection to your newborn.
- You won't be able to tell other people that they are at risk and might want to get tested. They could spread the infection to others.
- You could risk not getting early treatment that will help you prevent or delay HIV from progressing to AIDS.
Personal stories
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
Personal stories about considering getting tested for HIV
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
My partner and I have been together a few months. I've had several HIV tests over the years and all were negative, including one I had in the beginning of our relationship. My partner said since I'm HIV-negative, he doesn't need a test. But my doctor said that's not true. He suggested that I talk to my partner about the kind of sex he had previously and ask him to get tested with me. I'm going to do that.
Kevin, age 25
I don't plan to have a test now. I talked with my doctor at my last physical, and she said my risk of HIV was very low since I'm a widow and not sexually active.
Jocelyn, age 60
I've never had an HIV test, and I'm getting ready to start college. I fooled around some in high school, and sometimes we used protection. My mom and I talked, and I've decided to have a test. I'm pretty scared about doing something like that, but she says she'll go with me.
Heather, age 18
What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to get tested for HIV
Reasons not to get tested for HIV
I'm in a high-risk group for getting HIV.
I don't think I have a high risk of getting HIV.
I'm worried that I could have been exposed to HIV.
I have no reason to think that I might have been exposed to HIV.
I'm worried that if I have HIV and don't find out early, I won't start treatment soon enough.
I don't believe that I need treatment for HIV.
I want to be sure that I'm not spreading HIV to anyone.
I don't think there's any chance I could be spreading HIV to anyone.
My other important reasons:
My other important reasons:
Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having an HIV test
NOT having an HIV test
What else do you need to make your decision?
Check the facts
I don't have any symptoms of HIV, so I don't believe I need a test.
- TrueNo, that's not right. You could have HIV and not have symptoms. Or you might mistake early symptoms for the flu or mono. But those symptoms go away, and then you may not have other symptoms for years. During that time, the virus will multiply in your body and damage your immune system.
- FalseYes, that's right. You could have HIV and not have symptoms. Or you might mistake early symptoms for the flu or mono. But those symptoms go away, and then you may not have other symptoms for years. During that time, the virus will multiply in your body.
- I'm not sureIt may help to go back and read "Get the Facts." You could have HIV and not have symptoms. Or you might mistake early symptoms for the flu or mono. But those symptoms go away, and then you may not have other symptoms for years. During that time, the virus will multiply in your body.
I'm a newlywed, and I just found out I'm pregnant. My doctor and I discussed my having an HIV test, but I think it's unnecessary since my husband and I have only had sex with each other for the last year and a half. Do I really need the test?
- YesYes, that's correct. Experts recommend the test for all pregnant women. Unless you've been tested, you can't be sure that either your husband or you are free of the virus. If a test shows that you have HIV, treatment and doing things like avoiding breast-feeding can help you prevent passing the infection to your newborn.
- NoNo, that's not right. Experts recommend the test for all pregnant women. Unless you've been tested, you can't be sure that either your husband or you are free of the virus. If a test shows that you have HIV, treatment and doing things like avoiding breast-feeding can help you prevent passing the infection to your newborn.
- I'm not sureIt may help to go back and read "Get the Facts." Experts recommend the test for all pregnant women. Unless you've been tested, you can't be sure that either your husband or you are free of the virus. If a test shows that you have HIV, treatment and doing things like avoiding breast-feeding can help you prevent passing the infection to your newborn.
Decide what's next
Do you understand the options available to you?
Are you clear about which benefits and side effects matter most to you?
Do you have enough support and advice from others to make a choice?
Certainty
How sure do you feel right now about your decision?
Check what you need to do before you make this decision.
Use the following space to list questions, concerns, and next steps.
Your Summary
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
Your decision
Next steps
Which way you're leaning
How sure you are
Your comments
Your knowledge of the facts
Key concepts that you understood
Key concepts that may need review
Getting ready to act
Patient choices
Credits and References
| Credits | Healthwise Staff |
|---|---|
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
| Primary Medical Reviewer | Brian D. O'Brien, MD - Internal Medicine |
| Specialist Medical Reviewer | Peter Shalit, MD, PhD - Internal Medicine |
- Public Health Agency of Canada (2010). Get tested for HIV. Available online: http://www.phac-aspc.gc.ca/aids-sida/info/4-eng.php
- U.S. Department of Health and Human Services (2009). Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Available online: http://www.aidsinfo.nih.gov/contentfiles/AdultandAdolescentGL.pdf.
- Keenan-Lindsay L, Yudin M (2006). HIV screening in pregnancy. SOGC Clinical Practice Guideline No. 185. Journal of Obstetrics and Gynaecology Canada, 28(12): 1103–1107.
- Canadian Paediatric Society (2008). Position statement from the Infectious Diseases and Immunization Committee: Testing for HIV infection in pregnancy. Paediatrics and Child Health, 13(3): 221–224.
- U.S. Department of Health and Human Services Panel on Antiretroviral Guidelines for Adults and Adolescents (2011). Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Available online: http://www.aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf.
HIV Testing: Should I Get Tested for Human Immunodeficiency Virus?
- Get the facts
- Compare your options
- What matters most to you?
- Where are you leaning now?
- What else do you need to make your decision?
1. Get the facts
Your options
- Have a blood or saliva test for HIV.
- Do not have the test.
If you believe you've been exposed to HIV, it's important to be tested.
Key points to remember
- Many health experts and provincial health organizations in Canada recommend HIV testing for everyone. Other experts and organizations, including the Public Health Agency of Canada (PHAC), recommend having a screening test for HIV if you have a high risk of infection.1 HIV tests are also recommended for all pregnant women.
- You may not need to be screened for HIV if you aren't sexually active and if you and your doctor have determined that you have a very low risk for getting HIV.
- HIV may not cause symptoms early on. And people who have early symptoms may mistake them for the flu or mononucleosis. So without a test, you may not know that you have an infection.
- If you have a test that shows that you have HIV, you can take steps to prevent spreading HIV to others.
- You may be afraid to be tested for HIV. But if there's any chance you could be infected, it's very important to find out. HIV can be treated, and early treatment can slow down the virus and help you stay healthy.
- Getting treatment may lower the chance that you will give the infection to a sex partner who doesn't have the infection or to your baby, if you are pregnant.2
- It can take as little as 2 weeks or as long as 6 months from the time you become infected with HIV for the antibodies to be found in your blood. If you think you have been exposed to HIV but you test negative for it, you should be tested again. Tests given at 6, 12, and 24 weeks can be done to be sure you aren't infected.
- If your test shows that you have HIV, your sex partner(s) will need to know and get tested.
What is HIV?
Human immunodeficiency virus, or HIV, is a virus that attacks the immune system. This makes it hard for the body to fight infection and disease. HIV is the virus that causes AIDS (acquired immunodeficiency syndrome). But having HIV doesn't mean that you have AIDS.
HIV often causes flu-like symptoms soon after a person gets infected. These early symptoms go away in a few weeks. After that, signs of illness may not appear for many years. But as the virus multiplies in the body, symptoms reappear and then remain. Fatigue, weight loss, fever, night sweats, diarrhea, and other symptoms are common.
Treatment of HIV may prevent or delay HIV from developing into AIDS. If HIV isn't treated and progresses to AIDS, symptoms get worse and the body is less and less able to fight infections like pneumonia and tuberculosis.
Medicines are the main treatment for HIV. A doctor would likely prescribe several antiretroviral medicines, sometimes called antiretroviral therapy, or ART. By fighting the virus, these medicines can help the immune system stay healthy and delay or prevent AIDS. And they may help a person live longer.
What is the test for HIV?
An HIV test checks for HIV antibodies in the blood. If HIV antibodies are found, the test is considered positive.
Most doctors use two blood tests, called the ELISA and the Western blot assay. If the first ELISA is positive (meaning that HIV antibodies are found), the blood sample is tested again. If the second test is positive, the doctor will do a Western blot to be sure.
Most test facilities will have the ELISA test results in 2 to 4 days. Results of the Western blot take longer, 1 to 2 weeks. Rapid antibody tests are available that give results right away. But positive results of the rapid test need to be confirmed by the ELISA or Western blot test.
Even if HIV antibodies aren't found, you may need to be tested again, especially if you think you have been exposed. This is done to make sure that HIV antibodies don't appear at a later time. It can take as little as 2 weeks or as long as 6 months from the time you become infected with HIV for the antibodies to be found in your blood. Tests given at 6, 12, and 24 weeks can be done to be sure you aren't infected.
During this period, an infected person can still spread the infection even though his or her test was negative.
You can get HIV testing in most public health units, hospitals, and HIV care clinics, or through your doctor's office.
Who should consider having an HIV test?
Many experts and provincial health organizations in Canada recommend HIV screening for everyone. The Public Health Agency of Canada (PHAC) recommends screening for HIV if you engage in high-risk behaviour.1
High-risk behaviour means that you:
- Are a man who has sex with other men.
- Have multiple sex partners, especially partners who inject drugs.
- Inject drugs or steroids, especially if you share needles, syringes, cookers, or other equipment used to inject drugs.
- Have high-risk partner(s) (a man or woman who has multiple sex partners or injects drugs, or a man who has sex with men).
- Have or have recently had a sexually transmitted infection, such as syphilis or genital herpes.
- Have had tattooing, piercing, or acupuncture with unsterilized equipment.
Some expert opinions may vary, and your doctor may recommend testing based on your personal history.
Even if you don't think you're at risk, it's worthwhile getting tested once. In some cases people who've had a positive test didn't believe they had a high risk before having the test.
The Society of Obstetricians and Gynecologists of Canada (SOGC) and the Canadian Paediatric Society (CPS) recommend that women who are pregnant or thinking of becoming pregnant consider being tested for HIV.3, 4 Early treatment with antiretroviral therapy (ART) can reduce the risk of passing HIV to your baby.
What are the benefits of getting tested?
Getting tested can help find an infection early or when you have no symptoms. This is important so that:
- You can take steps to avoid spreading the infection.
- You can tell your sex partner(s) so they can be tested, get treatment if needed, and avoid spreading the infection.
- You can start treatment right away or as soon as needed. Treatment can help your immune system stay healthy and delay or prevent AIDS. And it may help you live longer. AIDS is the last and most severe stage of HIV infection. Treatment also lowers the chance that you will give the infection to a sex partner who doesn't have the infection.5
- If you are pregnant, you can get early treatment that can reduce the risk of passing HIV to your baby.
What are the risks of getting tested?
If your test shows that you have HIV, your sex partner(s) will need to know and get tested, which may affect your relationship.
If you have HIV, provincial law requires your doctor or the place where you had the test to report it to the provincial health authority. Some provinces allow anonymous reporting (the person's name or other identifying information is not provided). Other provinces require confidential reporting (identifying information is provided but only to authorized public health officials).
With an ELISA test, you could have a false-positive test result, which shows that you have the disease when you actually don't. This could cause you unneeded worry until you have more tests to confirm that you don't have the disease.
Why might your doctor recommend that you have an HIV test?
Your doctor may want you to be tested if:
- You're sexually active.
- You have never had an HIV test.
- You have a high risk for getting HIV.
- You're pregnant.
2. Compare your options
| Get tested for HIV | Don't get tested for HIV | |
|---|---|---|
| What is usually involved? |
|
|
| What are the benefits? |
|
|
| What are the risks and side effects? |
|
|
Personal stories
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
Personal stories about considering getting tested for HIV
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"My partner and I have been together a few months. I've had several HIV tests over the years and all were negative, including one I had in the beginning of our relationship. My partner said since I'm HIV-negative, he doesn't need a test. But my doctor said that's not true. He suggested that I talk to my partner about the kind of sex he had previously and ask him to get tested with me. I'm going to do that."
— Kevin, age 25
"I don't plan to have a test now. I talked with my doctor at my last physical, and she said my risk of HIV was very low since I'm a widow and not sexually active."
— Jocelyn, age 60
"I've never had an HIV test, and I'm getting ready to start college. I fooled around some in high school, and sometimes we used protection. My mom and I talked, and I've decided to have a test. I'm pretty scared about doing something like that, but she says she'll go with me."
— Heather, age 18
"I've been single for about a year now. I started seeing someone a few months ago, and we've used protection every time we've had sex. I had an HIV test that was negative before I started seeing her, and she says she's had a test too. My doctor offered me an HIV test as part of my physical, but I can't see why I should get tested again. I've never had any sexually transmitted infections, and I've only had one sex partner since my divorce. I'm going to skip it for now, but if things change, I'll consider it."
— Brian, age 45
3. What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to get tested for HIV
Reasons not to get tested for HIV
I'm in a high-risk group for getting HIV.
I don't think I have a high risk of getting HIV.
I'm worried that I could have been exposed to HIV.
I have no reason to think that I might have been exposed to HIV.
I'm worried that if I have HIV and don't find out early, I won't start treatment soon enough.
I don't believe that I need treatment for HIV.
I want to be sure that I'm not spreading HIV to anyone.
I don't think there's any chance I could be spreading HIV to anyone.
My other important reasons:
My other important reasons:
4. Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having an HIV test
NOT having an HIV test
5. What else do you need to make your decision?
Check the facts
1. I don't have any symptoms of HIV, so I don't believe I need a test.
- True
- False
- I'm not sure
2. I'm a newlywed, and I just found out I'm pregnant. My doctor and I discussed my having an HIV test, but I think it's unnecessary since my husband and I have only had sex with each other for the last year and a half. Do I really need the test?
- Yes
- No
- I'm not sure
Decide what's next
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
Certainty
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
- I'm ready to take action.
- I want to discuss the options with others.
- I want to learn more about my options.
3. Use the following space to list questions, concerns, and next steps.
| By | Healthwise Staff |
|---|---|
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
| Primary Medical Reviewer | Brian D. O'Brien, MD - Internal Medicine |
| Specialist Medical Reviewer | Peter Shalit, MD, PhD - Internal Medicine |
- Public Health Agency of Canada (2010). Get tested for HIV. Available online: http://www.phac-aspc.gc.ca/aids-sida/info/4-eng.php
- U.S. Department of Health and Human Services (2009). Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Available online: http://www.aidsinfo.nih.gov/contentfiles/AdultandAdolescentGL.pdf.
- Keenan-Lindsay L, Yudin M (2006). HIV screening in pregnancy. SOGC Clinical Practice Guideline No. 185. Journal of Obstetrics and Gynaecology Canada, 28(12): 1103–1107.
- Canadian Paediatric Society (2008). Position statement from the Infectious Diseases and Immunization Committee: Testing for HIV infection in pregnancy. Paediatrics and Child Health, 13(3): 221–224.
- U.S. Department of Health and Human Services Panel on Antiretroviral Guidelines for Adults and Adolescents (2011). Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Available online: http://www.aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf.
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Last Revised: June 7, 2012
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