Patient information from BMJ

HIV: testing

Last published:Feb 01, 2024

An HIV test tells you if you have HIV. Being tested can be worrying, but modern treatments have dramatically improved the outlook for people who test positive. 

If you think you have been exposed to HIV for any reason, see your doctor and get tested as soon as possible. If you test positive, early treatment leads to the best outcomes. 

What is HIV testing?

HIV stands for Human Immunodeficiency Virus. Infection with the virus damages your immune system and makes it harder to fight off some types of infection, it also makes it easier for some cancers to develop. 

Without treatment, HIV infection can lead to AIDS. AIDS stands for Acquired Immune Deficiency Syndrome.

AIDS is the name given to the group of infections and illnesses that develop as HIV gradually weakens your immune system. Without treatment, AIDS usually develops over 10 to 15 years after infection with HIV.

An HIV test can tell if you have been infected with the virus. There are a few different tests available depending on what you prefer. You can take these tests at home or at a clinic.

An HIV test will either use a blood or saliva sample to look for the virus. This could be a blood test, a small drop of blood from a finger pinprick, or a little saliva collected from your mouth. Depending on the type of test, you might get the results straight away or within a few days if it’s sent to the laboratory for testing.

If the test is positive for HIV, you will need to get an official blood test in a clinic if you didn’t the first time. A blood test is the most accurate test there is for diagnosing HIV. It can also show how severe the infection is i.e., how much the virus has multiplied inside the cells in your body.

But the accuracy of an HIV test will also depend on when you’re tested. If you’ve been very recently exposed to the virus, some tests might not pick it up. This is called the ‘window period’. Your doctor can give you more advice about this and when it’s best to get tested.

Who needs an HIV test?

Some people have an HIV test routinely in certain situations. For example, in most countries, all pregnant women have an HIV test.

And you might have to have an HIV test if you:

• Apply for certain types of life insurance

• Apply for certain jobs: for example, as a healthcare worker

• Have symptoms similar to those of HIV

• Have a health condition that is often linked to HIV, such as hepatitis

• Give blood.

Some people also ask to have an HIV test. This is usually because they think they might have been exposed to the virus. 

The main things that can expose you to HIV are: 

• Sharing needles when injecting illegal drugs

• Not using condoms when you have sex (i.e., unprotected sex)

• Having multiple sexual partners

• Being a man who has sex with other men 

• Having sexual partners who have HIV

• Being a healthcare worker and getting a needlestick injury.

If you ask your doctor for a test because you think you might have been exposed to HIV, they will start by asking you whether you've had any symptoms.

Some of the symptoms of HIV infection can feel a bit like a bout of flu that doesn’t go away. Symptoms that suggest HIV can include:

• Fevers and night sweats 

• Tiredness 

• Feeling generally unwell

• Sore throats and swollen glands in the throat

• Weight loss 

• Skin rashes 

• A fungal infection called candidiasis (thrush) in the mouth 

• Mouth ulcers 

• Diarrhoea 

• Headaches and muscle pain.

Before you are tested your doctor should talk to you about what will happen, however the test turns out.

HIV test results

If you test positive for HIV, your doctor should talk to you about treatment, how to keep yourself healthy, and how to keep your sexual partners safe. They can also support you to talk to your loved ones about HIV.

Your doctor will also want to examine you and run other tests to check on the level of your general health. This helps with decisions about what treatment you need. So your doctor might check:

• Your height and weight

• The glands in your neck and other areas, for any swelling

• Your skin, for any signs of rash, fungal infections, or other skin problems

• Inside your mouth, for thrush (candidiasis, a type of fungal infection)

• Your heart and breath sounds, for signs of heart or lung problems

• Whether you have any swelling in your abdomen

• Your genitals, for signs of STIs, and

• Your eyes.

Your doctor may also ask about your mental health. People dealing with mental-health problems sometimes struggle to look after themselves physically.

If you test negative for HIV, your doctor should discuss with you how to protect yourself from HIV in the future. This might include things like using condoms during sex and using clean needles if you inject drugs.

What will happen?

If you have an HIV test because you think you might have been exposed to the virus, it’s possible that your lifestyle means that you could be exposed to it again.

So, even if your test is negative, you and your doctor should make a plan to reduce your chance of being exposed to the virus in future.

If your test is positive, your doctor will want you to start treatment as soon as possible.

The main treatment for HIV infection is antiretroviral treatment (ART). It works very well, and most people who take it go on to live a long and healthy life. But for it to work you need to take it exactly as prescribed.

If you need to take ART, your doctor will explain exactly how you need to take your medication. For more information on ART, see our leaflet HIV: antiretroviral treatment (ART).

If you are upset or distressed by a positive test result, or if you are worried about telling your loved ones, your doctor can arrange for you to have counselling to help you.

Most people find that living well with HIV is easier if they have the support of the people closest to them.

Talking about HIV with your loved ones can be an important part of staying well.

It’s important that your sexual partners know that you have HIV. If you are anxious about telling them, talk to your doctor. Your doctor or another person (sometimes called a facilitator) may be able to help you talk to them, and to anyone else you are worried about telling.

Many organisations and support groups offer help and information to people with HIV and AIDS. For example, in the UK, the Terrence Higgins Trust (tht.org.uk) has been providing these services for many years.

Your doctor may be able to help you find support in your area, or you can easily search online.