What to know about rapid, at-home HIV tests

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HIV does not always cause symptoms in the early stages. This is why anyone who thinks they may have been exposed to the virus should receive a medical consultation. When symptoms do occur, they typically appear 2–4 weeks after exposure to the virus.

HIV can spread through blood, semen and “precum,” rectal fluids, vaginal fluids, and breast milk.

Without treatment, HIV progresses to stage 3, which people commonly refer to as AIDS. However, current treatments can prevent this and boost health and immunity.

For most people, within about 6 months of effective treatment, the viral load in the body is undetectable. At this point, HIV cannot pass on to others.

Anyone with a high risk of contracting the virus might consider pre-exposure prophylaxis as a preventive measure. Post-exposure prophylaxis, which a person takes after exposure to the virus, may also be an effective option.

This article explains how rapid HIV tests work and provides some general information about HIV testing.

In the United States, many at-home HIV tests are on the market. Choosing one that is safe and reliable is key.

The OraQuick In-Home HIV Test is the only option that the Food and Drug Administration (FDA) has approved. It works by testing fluids from the mouth and can deliver results in 20 minutes.

There are three main types of HIV tests:

1. nucleic acid tests (NATs)
2. antigen/antibody tests, also called fourth-generation tests
3. antibody tests

NATs are not rapid. They require a healthcare professional to draw a blood sample and send it to a laboratory for analysis. This can take a few days. These tests measure the viral load — the amount of HIV in the blood.

Some antigen/antibody tests are likewise slow because they also involve drawing and analyzing a blood sample from a vein. But other versions of these tests require only a small blood sample from a finger prick. They take about 20–30 minutes.

Most rapid HIV tests are antibody tests, the third category above. They work by analyzing blood or oral fluids and usually take 20–30 minutes. The OraQuick In-Home HIV Test is one example.

Different HIV tests work in different ways. For instance, NATs detect the amount of the actual virus in a blood sample. Antibody tests check for specific proteins that the immune system produces in response to HIV exposure.

Antigen/antibody tests do the same and also check for antigens. These are molecules or foreign substances in viruses, and other pathogens, that activate an immune system response. For example, p24 is a protein inside the HIV virus, and certain tests can detect it.

It is important to remember that no HIV test can detect the virus immediately after exposure. Antibody tests can only detect HIV 23–90 days after exposure to the virus, the Centers for Disease Control and Prevention (CDC) report. The antibody/antigen tests can detect HIV much earlier, as soon as 2 weeks after exposure, the CDC notes.

Another factor to consider is that HIV tests are never 100% reliable. For instance, the FDA reports that the OraQuick In-Home HIV Test gives one false-positive result for every 5,000 tests in people without HIV — and one false-negative result for every 12 tests in people with HIV.

As the FDA notes, a person should see a doctor if their test result is positive. A doctor can confirm the result with further testing and develop a treatment plan.

Even if a person tests within the window when results are most likely to be accurate, they may still receive an inaccurate result. This is why professional follow-up testing is crucial.

Also, at-home tests can produce false-negative results due to any errors in their use or any medications a person is already taking to treat or prevent HIV.

Most rapid and self-tests are antibody tests that can detect the infection 23–90 days after exposure to the virus.

The CDC recommends that everyone aged 13–64 take an HIV test at least once in their lifetimes. Because some situations can increase the chances of contracting HIV, it may be best to get tested once a year. This might apply, for example, to:

• anyone with another sexually transmitted infection
• men and some trans women who have sex with men
• people with multiple sexual partners
• people who have shared needles or syringes with others
• anyone who has had hepatitis or tuberculosis

While a negative test result often means that a person does not have HIV, some people with the virus may not develop antibodies within 2 months, and so may receive a false-negative result on an antibody test.

For this reason, anyone who suspects that they were exposed to HIV but received a negative result might test again after 3 months.

Different tests have different instructions. OraQuick provides these instructions for its FDA-approved at-home HIV test:

1. Avoid eating, drinking, or using oral care products 30 minutes before the test.
2. Remove any dentures.
3. Swab the gums using the pad provided to collect the oral fluid sample.
4. Insert the pad into the test tube, which is the upper part of the test kit.
5. Read the result after 20 minutes.

Contact the company’s support team with any questions or about any problems using the kit.

Suspected exposure to HIV can be worrying. Taking a rapid test at home can help reduce uncertainty as a person waits for an appointment with a professional.

Also, as the World Health Organization (WHO) notes, the convenience of testing from home may increase rates of testing, particularly among people who are less likely to visit clinics, such as adolescents.

But it is crucial for anyone who may have HIV to receive attention from a medical professional.

As the FDA notes, a person should not rely solely on at-home test results. Having a test at a clinic is more likely to give accurate results. One reason is that the person performing the test has professional training.

Healthcare professionals can also provide prescriptions and counseling about the next steps. The WHO calls on community organizations, too, to provide counseling about what to do when an at-home test is positive or negative.

Whether the result of an at-home test is positive or negative, it is crucial to get a follow-up test from a healthcare professional, because these tests are more accurate. This is especially important for people who suspect that they have had exposure to HIV.

If clinical testing is negative, it is usually safe for a person to conclude that they do not have the infection. If clinical testing is positive, the doctor will recommend the next best steps.

Although having an HIV diagnosis can be stressful and frightening, many people who receive effective treatment have life expectancies that are similar to those of people without HIV.

Below, learn about the accuracy, price, process, and availability of these tests.

The CDC reports that by the end of 2018, about 1.2 million people in the United States had HIV, but 1 in 7 of these people were unaware of it.

Rapid HIV tests are an important tool to slow the spread of HIV. Testing from home can help reduce uncertainty while a person waits for an appointment with a healthcare professional. But is important to receive follow-up testing in a clinical setting, especially after suspected exposure to the virus.

With effective treatment, many people with HIV have life spans comparable to those of people without the infection.