This free tool from HIV.gov, in English or Spanish, can be used to look up HIV testing sites, housing assistance, health centers, HIV care, mental health services, substance abuse services, and family planning services by zip code.
- Anyone who has unsafe sex should get tested for HIV at least once a year
- Anyone who shares injection drug equipment should get tested for HIV at least once a year
- Sexually active gay, bisexual, and other young men who have sex with men (MSM) may benefit from more frequent testing (e.g., every 3 to 6 months)
There are many places, including a clinic, a doctor's office, or a mobile testing van, where youth can get an HIV test. There are a number of HIV tests currently in use:
- Antibody screening test (immunoassay) is the most common HIV test. It tests for the antibodies that your body makes against HIV. The immunoassay may be conducted in a lab or as a rapid test at the testing site. It may be performed on blood or oral fluid (not saliva). Because the level of antibody in oral fluid is lower than it is in blood, blood tests tend to find infection sooner after exposure than oral fluid tests do. In addition, most blood-based lab tests find infection sooner after exposure than rapid HIV tests.
- Antigen/antibody combination tests can find recent infection earlier than tests that detect only antibodies. These antigen/antibody combination tests can find HIV as soon as three weeks after exposure to the virus, but they are only available for testing blood, not oral fluid. Not all testing sites offer this test by default; people who believe that they have been recently exposed to HIV should let their health care providers know and ask if this type of test is available.
- Rapid test is an immunoassay used for screening and produces quick results, in 30 minutes or less. Rapid tests use blood or oral fluid to look for antibodies to HIV. If an immunoassay (lab test or rapid test) is conducted during the window period (i.e., the period after exposure but before the test can find antibodies), the test may not find antibodies and may give a false-negative result. All immunoassays that are positive need a follow-up test to confirm results.
- RNA tests detect the virus directly (instead of the antibodies to HIV) and thus can detect HIV at about 10 days after infection—as soon as it appears in the bloodstream, before antibodies develop. These tests cost more than antibody tests and are generally not used as screening tests, although a health care provider may order one as a follow-up test, after a positive antibody test, or as part of a clinical workup.
- Follow-up diagnostic testing is performed if the first immunoassay result is positive. Follow-up tests include: an antibody differentiation test, which distinguishes HIV-1 from HIV-2; an HIV-1 nucleic acid test, which looks for virus directly, or the Western blot or indirect immunofluorescence assay, which detects antibodies. Immunoassays are generally very accurate, but follow-up testing allows the client and health care provider to be sure that the diagnosis is right. If the first test is a rapid test and is positive, the client will be directed to get follow-up testing. If the first test is a lab test and is positive, the lab will conduct follow-up testing, usually on the same blood specimen as the first test.
Youth can also take a home HIV test. Currently, there are only two Food and Drug Administration-approved home HIV tests:
- The Home Access HIV-1 Test System is an anonymous home collection kit that involves pricking the finger to collect a blood sample, sending the sample to a licensed laboratory, and then calling for results as early as the next business day. If the test is positive, the manufacturer provides confidential counseling and referral to treatment. Tests conducted on the blood sample collected at home find infection later than most lab-based tests using blood from a vein, but earlier than tests conducted with oral fluid.
- The OraQuick In-Home HIV Test provides rapid results in the home. The testing procedure involves swabbing the mouth for an oral fluid sample and using a kit to test it. Results are available in 20 minutes. A positive result requires a follow-up test. The manufacturer provides confidential counseling and referral to follow-up testing sites. Because the level of antibody in oral fluid is lower than it is in blood, oral fluid tests find infection later than blood tests do. Up to one in 12 people may receive a false negative result with this test.
Youth HIV Facts
HIV Test Results
HIV test results fall under the same privacy rules as all medical information. Information about an HIV test cannot be released without permission. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) ensures that the privacy of individuals’ health information is protected while ensuring access to care. It is important to note, however, that not all HIV testing sites are bound by HIPAA regulations. Before suggesting that adolescent clients get tested, help them understand the HIV test site's privacy rules, as well as those regarding test results.
HIV tests can be taken either confidentially or anonymously. Most states offer both confidential and anonymous testing, however some states only offer confidential testing services.
- Confidential testing means that adolescents' names and other identifying information are attached to their test results. The results will go in their medical records and may be shared with their health care providers and insurance companies. Otherwise, results are protected by state and federal privacy laws.
- Anonymous testing means that nothing ties adolescents' test results to their names. When taking anonymous HIV tests, adolescents are given unique identifiers that allow them to get their test results. Not all HIV test sites offer anonymous testing. Contact your local health department or 1-800-CDC-INFO (800-232-4636) to see if there are anonymous test sites in your area.
If there are concerns regarding who can have access to test results, ask the testing center about its privacy policies and to whom they are required to report a positive result.
For youth that test HIV positive, the next step in the HIV care continuum is to get them connected to HIV health care providers who can offer treatment and prevention counseling to help them stay as healthy as possible and prevent passing HIV on to others. Because there is no cure for HIV at this time, treatment is a lifelong process. To stay healthy, youth living with HIV need to receive regular HIV medical care.
According to a March 2017 Guttmacher Institute State Policies in Brief, all 50 states and the District of Columbia allow most minors to consent to testing and treatment for sexually transmitted infections (STIs), including HIV testing and treatment. However, many states allow physicians to inform parents that a minor is seeking or receiving STI services if the physician deems it in the best interests of the minor.
Before referring adolescent clients to an HIV health care provider:
- Know the laws in your state,
- Ensure the HIV health care provider is youth-friendly and welcoming to lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth, and
- Help your client inquire about the clinic's privacy rules.
This March 2017 policy brief from the Guttmacher Institute outlines minors' access to STI services for all 50 states and the District of Columbia.
HIV Status Disclosure
Youth that test HIV positive will have to decide whether to share that information with other people.
If an adolescent client discloses that he or she is HIV-positive, here is a list of considerations from HIV.gov to help that client decide who else to tell:
- Think about the people you rely on for support, like family, friends, or coworkers.
- What kind of relationship do you have with these people? What are the pros and cons of telling them you are living with HIV?
- Are there particular issues a person has that will affect how much he or she can support you?
- What is that person's attitude and knowledge about HIV?
- Why do you want to disclose to this person? What kind of support can this person provide?
- For each person you want to tell, ask yourself if the person needs to know now—or if it’s better to wait.
It is also important for you to encourage your client to talk to current and past sexual partners about his/her HIV status. In addition, if they have shared needles with others to inject drugs, he/she will need to tell them too. If your client is afraid or embarrassed to tell them, the local health department can notify sexual or needle-sharing partners that they may have been exposed to HIV without using your client's name.
Remind your HIV-positive adolescent clients that they are not alone. Encourage them to talk to their health care providers about their status and the resources available to support them through the disclosure process.
This handbook, developed by Human Rights Campaign and AIDS United, provides up-to-date, actionable information and resources about HIV prevention, treatment, and care. The handbook also targets and debunks common myths about HIV/AIDS.