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• When to Offer Testing
• What Tests are Available
• When to get Tested  

HCET Home > On-line Training > HIV Risk Assessment in Women > 7. HIV Testing

When Should HIV Testing Be Offered?

• Whenever the client requests testing
• Routinely in areas where the seroprevalence is high
• If history reveals a present or past sex or drug use risk behavior
• If history reveals sex with multiple partners
• If history reveals sex with someone who has injected drugs
• If history reveals sex with a man who has sex with other men
• If history reveals unprotected sex with a partner of unknown status
• If client is pregnant or considering pregnancy
• If an STI is diagnosed
• If any genital ulcer disease is diagnosed
• If history reveals consensual or coerced sex with a stranger whose health history and HIV status is unknown
• If client had a blood transfusion between before 1985
• If the client has lived in an area of the world where HIV is endemic
• If the client has a history of a workplace or other injury that may result in HIV exposure
• If the client has infections or constitutional signs consistent with HIV infection (25)

What Kind of HIV Tests are Available? (28)

• Enzyme Immune Assay (EIA) or the enzyme-linked immunosorbent assay (ELISA)
  • If EIA test results show a reaction, the test is repeated on the same blood sample. If the sample is repeatedly reactive, the results are "confirmed" using a second test such as the Western blot.

• Western Blot
  • This more specific (and more expensive) test can tell the difference between HIV antibodies and other antibodies that can react to the EIA and cause false positive results. False positive EIA results are uncommon, but can occur. A person is considered infected following a repeatedly reactive result from the EIA, confirmed by the Western blot test.

• Radioimmunoprecipitation Assay (RIPA)
  • A confirmatory blood test that may be used when antibody levels are very low or difficult to detect, or when Western blot test results are uncertain. An expensive test, the RIPA requires time and expertise to perform.

• Dot-blot Immunobinding Assay
  • A rapid-screening blood test that is cost-effective and that may become an alternative to standard EIA and Western blot testing.

• Polymerase chain reaction (PCR)
  • A specialized blood test that looks for HIV genetic information. Although expensive and labor-intensive, the test can detect the virus even in someone only recently infected.

• Orasure©
  • Currently the only federally approved oral-fluid test.
  • Collects fluids from inside the mouth, and analyzes them using an EIA test and supplemental Western blot test if necessary. Oral fluid tests are offered at many HIV testing locations. Contact a location near you to find out if this test is available.

If you must refer for testing... ensure location, times, charge, access to the service, and follow up. Staff training is needed before offering HIV tests, including education regarding: HIV information, risk reduction counseling, administering test results, follow up, referrals for medical and emotional support, and partner notification issues

• If an individual becomes infected with HIV, it usually takes between three weeks and two months for your immune system to produce antibodies to HIV.

• If you think you were exposed to HIV, you should wait for two months before being tested. You can also test right away and then again after two or three months.
  • During this "window period" an antibody test will give a negative result, but you can transmit the virus to others if you are infected.

  • About 5% of people take longer than two months to produce antibodies. A confirming test six months after exposure is a good idea.

For more information, go to:

• National HIV Testing Resources
• The Body: HIV Testing

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URL: http://65.163.14.21/training/hiv/7testing.htm
 Last update: 03/05/08