HIV Testing; The Only Way Women Can Find Out They Have It

Let’s stop the spread of HIV through increased testing and early intervention.

She was ten weeks pregnant. She came for a sonogram to confirm her pregnancy. I called her the next day to tell her she was HIV positive.

In the United States, before effective treatment was available, about 25% of pregnant HIV + mothers passed the virus to their babies. Today, with early detection and adequate HIV treatment, the risk of passing HIV to a baby is less than 1%.

Testing and early intervention are the keys to success. Thanks to more HIV testing and new medicines, the number of children infected with HIV during pregnancy, labor and childbirth, and breastfeeding has decreased by 90% since the mid-1990s.

Despite improvements, the Centers for Disease Control and Prevention estimates that more than 1.2 million Americans 13 years and older are living with HIV.

One in four people living with AIDS in the United States in 2014 was a woman. An estimated 128,778 women have died of AIDS since the beginning of the epidemic in 1981.

Getting tested is the only way to find out if you have HIV. Testing is crucial for early intervention with new antiviral drugs to help people live a long and prosperous life and reduce the risk of passing HIV to future sexual partners.

Together, we can stop the spread of HIV.

Who should get tested for HIV?

According to the U.S. Preventive Services Task Force, HIV testing is recommended for women:

Older than 15. All women and girls older than 15 need to be tested at least once.
If Pregnant. Every pregnant woman should have an HIV test as early as possible in the pregnancy.

Because HIV often causes no symptoms, many women have HIV without knowing it. But even if HIV causes no symptoms, it still affects the immune system. The earlier we treat it, the more we can help.

When should I get tested for HIV?

Anyone who might have been exposed to HIV can get tested. But testing right away may not pick up early HIV infection. The first HIV test taken soon after exposure may say that you do not have HIV even if you do. HIV tests look for antibodies, the body’s natural immune response to a foreign invader, that your body may not have developed yet.

If you contract HIV, your body will begin to develop antibodies within three to 12 weeks. The time between being exposed and developing antibodies is called the “window period.”

Newer tests can detect HIV earlier by looking for the virus itself instead of the antibodies. By testing for the viral load (the amount of HIV in your blood) and a marker on the virus called p24 antigen. This more costly test is much more sensitive and can detect HIV within ten days of exposure.

How can I get free HIV testing?

Many clinics and doctors’ offices have free or low-cost HIV testing. If you have health insurance, you qualify for free HIV testing under the Affordable Care Act (the health care law).

HIV screening and counseling for women are covered without cost-sharing in most private health insurance plans. Medicaid also covers certain recommended preventive services, including HIV screening for women at higher risk for HIV, without cost-sharing or deductibles.

HIV testing for people with Medicare is usually covered once every twelve months. Pregnant women with Medicaid can get up to three HIV tests for free during pregnancy.

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The Three HIV Tests explained

There are three types of tests: nucleic acid tests (NAT), antigen/antibody tests, and antibody tests. HIV tests are performed on blood or oral fluid. They may also be performed on urine.

Nucleic acid tests (NAT) look for the viral presence in blood. This type of test can determine if a person has HIV and how much virus is present. While a NAT test can detect HIV sooner than other tests, this test is costly and not routinely used for screening.
An antigen/antibody test looks for both HIV antibodies and antigens. Antibodies are produced by your immune system when you’re exposed to viruses like HIV. Antigens are foreign substances that cause your immune system to activate. If you have HIV, an antigen called p24 is produced even before antibodies develop.
HIV antibody tests only look for antibodies to HIV in your blood or saliva. In general, blood antibody tests are more accurate than saliva. Most rapid tests and the only currently FDA approved HIV self-test are antibody tests.

Talk to your health care provider about what type of HIV test is right for you.

How soon after exposure can a test detect HIV?

No HIV test can detect HIV immediately after infection. Post-exposure prophylaxis (PEP) medication may be prescribed to those with high-risk exposures.

The time between when a person may have been exposed to HIV and when a test can tell for sure whether they have the virus is called the window period. The window period varies from person to person and depends on the type of test used to detect HIV.

A nucleic acid test (NAT) can tell you if you have HIV infection 10 to 33 days after exposure.
An antigen/antibody test can detect HIV infection 18 to 45 days after exposure.
Antibody tests can take 23 to 90 days to detect HIV infection after an exposure.