You'd think people infected with HIV would want to know it. After all, they'll have the virus for the rest of their lives, as it affects the immune system's T cells and potentially leads to AIDS. But alarmingly, about one in five people living with HIV in the U.S. don't even know they're infected. How can this be? Perhaps people assume that such a significant virus would show obvious symptoms, but it doesn't. At least not for several years. The U.S. Centers of Disease Control and Prevention states that many people who are infected with HIV don't have any symptoms for a decade or more. Others simply experience flu-like symptoms a few weeks after exposure.
The only way to know if you're infected is to be tested. And it's not so scary – just some blood drawn or a cotton swab to the mouth. And it's not so stigmatized. In fact, the U.S. Preventative Services Task Force recommends that everyone between ages 15 and 65 be tested for HIV, even if they're not known to be at increased risk. Once tested, those confirmed to be HIV-positive can start controlling the virus with proper medical care. After all, early antiretroviral therapy can add years of life for those infected and lower their chance of infecting others, according to the CDC.
So call your doctor or find a clinic, and schedule your test. U.S. News talked to Michael Horberg, chair of the HIV Medicine Association and director of HIV/AIDS at Kaiser Permanente, about what to expect during the test. His responses have been edited.
What's my first step in getting tested for HIV?
Ideally, your first step is to talk to your doctor or your primary care provider, if they haven't already brought it up with you. Even if you don't have a perceived risk, they should ask you. You should have an honest conversation with him or her about your sexual activity and drug use, and they'll then order an antibody test. Then they'll draw blood, or they can swab your mouth if they're set up to test that way. Afterward, they'll arrange a way to get the results back to you, either through a follow-up visit or phone call. There's also the rapid test, and those results are available during that same visit, but in most cases, that test is only given when there's a perceived immediate risk.
Along with the test, they will probably talk about safer sex, and in most cases, it could be, "Keep doing what you're doing."
Sounds pretty painless. Is it a similar process for people who don't have a primary care doctor and find a nearby testing clinic through sites such as AIDS.gov?
Yes. Some test sites do the tests confidentially, while others are anonymous. The only thing you need to know about the anonymous test site is that if you are HIV-positive, then when you get linked to medical care later, they'll need to repeat the test with your personal information. In terms of the test itself, every clinic has their own protocol. If it's a more – for lack of a better word – traditional test, it'll be a blood test. If they're doing a rapid test, that could be by blood or by swab. There are also different generations of the antibody tests, and some require a follow-up test. So if your doctor gives you a confirmation test, don't worry.
Do I need to prepare in any way for the test?
Nope. The nice thing about this test is that it's not dependent on fasting or eating; you just have to be there to do the test. The hardest thing for a lot of people is just showing up.
What's the next step if I'm confirmed to be HIV-positive?
On the chance that you are HIV-positive, this is not the time to put your head in the sand and ignore the results. Be proactive, and find yourself good quality care, which you can do through organizations like the HIV Medicine Association. I know that's a scary moment, but with medicine today, there's no reason you can't live a long and healthy life if you're proactive.
What else should readers know about getting tested for HIV?
The test is very accurate. And knowledge is power. I know a lot of times we think, "If I don't think about it, then it can't be," but that's when you're at the greatest risk.