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HIV Testing And Counseling

When To Have An HIV Test

Sunday, April 21, 2013 - 15:36

Contributing Author: Guy Slowik FRCS

The CDC recommends people should have an HIV test if they answer "yes" to one or more of the following questions:

  • Having three or more sexual partners in the last 12 months
  • Have received a blood transfusion prior to 1985, or have a sexual partner received a transfusion and later tested positive for HIV
  • Not sure about one's sexual partner's risk behaviors
  • Being a male who has had sex with another male
  • Using street drugs by injection, especially when sharing needles and/or other equipment
  • Having a sexually transmitted disease (STD)
  • Being a healthcare worker with direct exposure to blood on the job

People should consider an HIV test if:

  • They have engaged in an activity that has an HIV infection risk factor
  • Knowing their HIV status would help them find the medical care to prevent or delay a life threatening illness
  • Knowing the result of a test would help protect sexual partners
  • The test would help them make decisions about pregnancy and childbirth
  • Taking the test would resolve their anxiety over wondering if HIV infection is present

Need To Know:

When first infected with HIV, a person may have no symptoms at all. Some people experience a brief flu-like illness a few weeks after becoming infected. These early signs of infections, including fever, headache, sore throat, swollen lymph glands, and rash are similar to those of more common illnesses. Therefore, people do not recognize they have been infected with HIV.

Some people remain symptom-free for years but during this time they can spread the infection to others. After this time, more serious infections may occur, including rare cancers and pneumonia. As HIV progresses to AIDS, people may experience fatigue, swollen lymph nodes, chronic diarrhea, night sweats, fevers higher than 100 degree F and persistent headaches.

The CDC recommends all patients coming for HIV testing have pre- and post-test counseling. Most counseling and testing centers follow policies of confidentiality and for many states anonymous testing. Anonymous testing means the person tested is the only one who will know the test result. The laboratory and even the healthcare provider does not know the person's identity.

Counseling Procedures

Before a person has an HIV test, he or she should be given materials to read before entering a group or private session with a counselor or doctor. The healthcare professional may ask why you want to be tested. The counselor should also ask you about your background and sexual history. This will help you and the counselor determine whether HIV testing is appropriate.

If testing is appropriate, the counselor or doctor should:

  • Describe the test and how it is done
  • Explain AIDS and the ways HIV infection is spread
  • Discuss ways to prevent the spread of HIV
  • Explain the confidentiality of the test results
  • Discuss the meaning of possible test results
  • Ask what impact the test result will have
  • Address the question of whom you might tell about the result
  • Discuss the importance of telling your sex partner(s) and/or drug-using partner(s) if the result indicates HIV infection

If these questions are not covered, or you have other questions, ask them. Come prepared with questions that have been of concern.

Also ask the doctor or counselor how they report the test result. If the test result is negative, the post-test counselor should talk to you about how to avoid behaviors that will put you at risk.

Informed consent means that the patient has the right to refuse any medical procedure, to be fully informed about it, and to agree to it. Patients should be asked to read a statement saying that they have been informed about the HIV-antibody testing procedure, they understand it, and they consent to having it done.


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