HIV Testing: Who Should Take It and How Often Should It Be Done?

Two wise men who said that “ignorance is bliss” and “better late than never” might not be so wise after all, especially when it comes to the human immunodeficiency virus (HIV). While being diagnosed and living with HIV are no longer considered a death sentence due to it being manageable and preventable now, it is always better to know than not to know and even wiser to detect it early than late. And the only way to be sure about our HIV status is to undergo HIV testing.

According to the Centers for Disease Control and Prevention (CDC), around 1.2 million people in the US are living with HIV but almost 1 in 5 people have no idea that they are infected. Owing to this fact, CDC encourages every person between the ages of 13 and 64 to take the HIV test at least once.

Ultimately, not only is the act of getting tested beneficial for knowing a person’s health status, it is also a form of care towards a person’s sexual partner to keep them healthy and safe:

  • If the test result comes back negative, it will put a person’s mind at ease and make them live life lighter and with more confidence.
  • Even if a person tests positive for HIV, being diagnosed early signifies that they can be subjected to proper medical care to better manage the disease so that it does not completely take control of the body.

Who should undergo HIV testing?

Besides people between the ages of 13 to 64, there are indisputably people who are more at risk of contracting the virus who should get tested more often. You will know if you have to get tested as soon as possible if you find yourself confirming yes to one or more of the conditions below:

  • You had unprotected vaginal sex or anal sex
  • You had vaginal or anal sex with a person diagnosed with HIV
  • You have had more than one sexual partner
  • You have injected drugs and shared injection equipment such as needles and syringes with others
  • You have provided sex to get drugs or money
  • You have been diagnosed with other STIs, STDs, hepatitis or tuberculosis
  • You have engaged in sexual activities with a person whose sexual history you are not familiar with or a person who ticks any of the above conditions

Getting tested at least once a year is a wise move if you regularly do one of the above conditions. More frequent and regular tests (once every 3 to 6 months) for those who are sexually active with multiple partners.

Taking the test even if you are not at high risk

You might be feeling that it is very unlikely for you to catch the virus because you are in a monogamous relationship or have been employing all feasible methods to prevent the disease such as wearing condoms and using HIV PrEP, but the quickest way to make certain that you are free from the virus and reduce anxiety is to get tested. It is also your partner’s responsibility to ensure your wellbeing and health by taking precautions and go for HIV testing when the situation calls for it.

HIV tests for pregnant women

It is imperative that pregnant women take the test so that the correct methods can be employed to prevent passing on the virus to the child if it turns out that the mother is HIV positive. If detected early during pregnancy and treated, according to CDC, the transmission risk can go as low as 1% or even less. Early detection of HIV infection in pregnant women has been proven to minimise the number of children born with HIV. Although it is better and more effective to treat soon-to-be mothers in the early stage of pregnancy, preventive treatment in the middle of labour or immediately after the babies are born still render health benefits.

Where you can get tested

HIV tests are carried by healthcare providers such as hospitals, medical institutions and health centers. You can also can get tested for HIV easily in a STD clinic in Singapore.

Types of HIV tests

Normally performed on blood or oral fluid and at times urine, there are three widely known types of HIV tests:

  • Nucleic acid test (NAT): NAT is a thorough examination to know whether or not a person has HIV. Performed on blood drawn from the vein, the result of this test is in-depth because it tells the amount of HIV copies (viral load) in a person’s blood. The downside to NAT is its costly price. This type of test is also not commonly used for routine testing and is utilised when someone has a possible or high-risk exposure to HIV or if they show early symptoms of HIV infection.
  • Antigen/antibody test: The antigen/antibody test includes pricking your finger or drawing blood from a vein to search for both antibodies and antigens. The result can come back in around 30 minutes. Antibodies are proteins produced by the body when it is exposed to the virus while antigens are substances that switch on the immune system. This test can detect the p24 antigen found in HIV positive people.
  • Antibody test: This test can be done on a person’s blood or oral fluid, only that if the antigen/antibody test looks for antibodies and antigens, this test only searches for antibodies. Results for blood directly drawn from a vein come back faster than from pricking a finger. As for oral fluid, this test can be executed by retrieving a swab of saliva.

Interpreting your test results

After taking the first step of getting tested, comes the big part: reading the results. There can only be two outcomes of the test: you have HIV or not.

  • If the result is negative: you may let out a sigh of relief, but it is best to not let your guard down because window period might apply if you experience a possible exposure to the virus prior to getting tested. Window period is the time between getting tested after a possible exposure and when a test can definitely tell if a person carries the virus. This period varies from person to person and depends on the type of test you take:
      • NAT: 10 to 33 days after being exposed
      • Antibody/antigen tests: 18 to 45 days when blood is drawn from a vein but can take up to 90 days when performed by pricking a finger
      • Antibody tests: 23 to 90 days

    You should get tested once again after the window period ends after a potential exposure because no HIV tests can detect the virus immediately after infection. If the potential exposure occurred in the last 72 hours, consult your healthcare provider about taking HIV post-exposure prophylaxis (HIV PEP). Remember that you can only be positive that you do not have HIV if your result comes back negative after retesting after the window period without another possible exposure during the window period.

  • If the test result comes back positive: you should immediately begin talking to a healthcare provider for medical treatment. Not every HIV case develops to AIDS (the most severe stage of HIV). Therefore, to prevent it taking over the immune system, antiretroviral therapy (ART) is administered to lower the amount of viral load. HIV positive people who diligently take HIV medicine as prescribed have the chance to live healthy and long years. In fact, if the levels of the virus are so low to the point that they become undetectable, it eliminates the risk of transmitting the virus to HIV negative partners.