What kinds of tests are available?
The standard HIV test used in Ontario is a fourth generation combination test that detects both HIV p24 antigens and antibodies reactive to both HIV types 1 and 2. Antigens can be detected very early after infection, while antibodies may take up to three months to appear. This means that you should seek testing and the counselling that comes with it early on. If your test is negative or non-reactive, you will be asked to test again at a date three months from your risk of exposure. If after three months, and no other risk of exposure, your test results are negative or non-reactive, you do not have HIV. It usually takes two to three weeks for an HIV test to be completed and results returned to you.
In Ontario, there are three ways to get tested for HIV: nominal, non-nominal and anonymous testing.
You may request either a nominal or non-nominal test from any doctor or nurse that does HIV testing.
Nominal testing means you are tested using your name on all paperwork including lab requisitions.
If your nominal test is positive for HIV, the testing laboratory will report your HIV infection, your name, date of birth, gender, and contact information to Public Health. Your local public health unit will contact you for counseling and support, and will refer you to HIV-related services.
Non-nominal testing, sometimes referred to as confidential testing, means that while the clinic or doctors office will have your personal information on file, a code is used on paperwork like lab requisitions. This helps protect your confidentiality especially in situations where your may have family or friends that work in the lab, clinic or hospital setting that might see your paperwork and you don’t want them to know what you are being tested for or what the results are when they come back.
Anonymous testing means you are tested without having to give your name or personal information and will take the standard two to three weeks for results.
Point-of-Care testing, which simply requires a drop of blood from a finger prick with test result available in a few minutes, is also considered anonymous since no name is attached to the test.
If your rapid test is non-reactive, it means HIV is not showing in your blood at the time of the test. It can take up to 3 months (see above) for HIV to show in your blood, and the counselor will talk to you about doing a follow-up test to make sure you do not have HIV.
If your rapid test is “reactive”, a second test is needed to confirm your HIV status. While this can be done anonymously, it is important to understand that until a nominal or non-nominal test has been done which confirms that you are the person with HIV you will not be able to seek treatment. Talk with your doctor, nurse or counsellor and make an informed decision.
Am I at risk?
Transmission of HIV can occur when you are exposed to a body fluid with enough of the virus in it for you to become infected. These are most commonly blood, semen, vaginal fluids, rectal secretions, and with infants, breast milk.
You should get tested for HIV if you:
- have had sex of any kind without a protective barrier (like a condom or dental dam) with a person who is HIV positive or whose HIV status you don’t know,
- have shared needles, mouth pieces/pipes, piercing or tattoo equipment with a person who is HIV positive or whose HIV status you don’t know,
- or if you think that you may have been exposed to HIV or any other sexually transmitted infection (STI).
What else do I need to know before I get tested?
A simple blood test is all you need. Any doctor, nurse practitioner, or midwife in Ontario can order an HIV test (see HIV testing section). Counselling should happen before and after every HIV test performed, regardless of your results. This is to:
- assess your risk for HIV
- make sure you fully understand the testing process
- tell you what you need to know if you do test positive for HIV
- make sure that you and those around you are safe
Some information adapted from: HIV and AIDS Legal Clinic Ontario. (2013). HIV Testing. Retrieved from: http://www.halco.org/areas-of-law/health/hiv-testing