African American
Gay Men's
Health Initiative

Testing Modalities

Anonymous

In anonymous testing, the person being tested does not give his/her name and is usually given a number when s/he tests and to obtain his/her test results.

Anonymous Testing: Pros

• Complete anonymity.
• Test results are only given to the person testing and s/he can tell anyone s/he wants.
• Some locations offer rapid or standard testing.
• Verbal consent may be all that is needed.

Anonymous Testing: Cons

• No copy of test result is given.
• Test results are not valid for court, medical or other legal purposes.
• There are not many anonymous test locations.
• If you lose your identification number, you will not be able to get your test results.
• If the result is positive, you may be requested to provide personal information so that you can be referred to a doctor for medical care.
• No anonymous testing is done at doctors' offices.

Confidential

In confidential testing the individual testing provides his/her name and contact information.

Confidential Testing: Pros

• Written consent is needed; you cannot be tested confidentially without your permission.
• A copy of the test results is provided.
• Test results can be shared with a partner.

Confidential Testing: Cons

• Personal information is recorded.
• Positive test results are reported to the local health department, California State Office of AIDS and to the Centers for Disease Control and Prevention.*

Any person seeking HIV testing must be given enough information on the difference between anonymous/ confidential testing and the different types of tests offered, so s/he will be able to make an informed decision about HIV testing.

* Check local and state guidelines regarding reporting of confidential tests.

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Different Types of Tests

Standard Testing

Blood draw or oral sample. Results are usually available in one week.

Rapid Testing

Oral fluid collected from gum line of mouth. Results are usually available in 20 minutes.

How Testing Occurs:

Blood Draw

Vein puncture to draw blood for standard HIV testing. Finger stick used to capture blood for rapid HIV testing. Vein puncture can also be used for rapid testing.

Oral Fluid Collection

Oral mucosal fluid collected from gum area of mouth can be used for standard OraSure HIV testing or for OraQuick rapid HIV testing.

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How Does HIV Testing Work?

In the early stages of HIV infection, the virus itself is difficult to detect. Rather than looking for the virus, HIV testing usually involves looking at the body's reaction to the presence of the virus. The measure of the amount of virus in an individual's blood stream is called the viral load.

Antibodies are produced by the body in reaction to the presence of a virus. In an HIV antibody test, the presence of antibodies in response to the presence of HIV is measured. The most common HIV antibody tests are ELISA (EIA) and Western Blot. These tests can now be performed on samples of oral (mouth) fluid.

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What Do HIV Test Results Mean?

If an HIV antibody test is negative, no antibodies were detected. A negative test can indicate that a person is not infected with HIV (s/he is HIV negative), or that s/he has been exposed but the immune system has not had time to produce antibodies. Antibodies to HIV may take up to six months to develop after the initial exposure.

A positive HIV antibody test means that the body has been exposed to HIV (and the body has produced antibodies in response to this exposure). A test result is not reported as positive until it has been confirmed three times, including the use of a different type of test. When a person has a positive HIV test, it does not mean that the person has AIDS or that the person will have AIDS in a certain amount of time; it only means that the person is infected with HIV.

An HIV antibody test may also be indeterminate or inconclusive. In this case, the presence or absence of HIV antibodies cannot be confirmed. An indeterminate test should be repeated three to six months later with a new blood sample.

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What are the Different Types of HIV Tests?

ELISA

The ELISA (Enzyme Linked Immuno Sorbent Assay), or EIA, is the most commonly used HIV antibody test. It is a highly sensitive test, meaning that all (or nearly all) infected people will test positive.

Western Blot

The Western Blot test is most commonly used to confirm a positive ELISA test. It is more specific than the ELISA test, so all or nearly all people who are not infected will test negative. The two tests combined result in nearly 100 percent accuracy.

Other Tests

Other diagnostic tests include PCR (Polymerase Chain Reaction), which can detect the virus before the body produces antibodies, and viral culture, where a culture of the virus is produced from a blood sample. Additional tests may be used to assess the functioning of the immune system as a measure of the progression of HIV disease.

Regardless of what type of specimen is used (blood or oral fluid), ELISA is the first test performed. If the first ELISA test is positive, two additional ELISA tests are performed on the same specimen. If both of these tests are also positive, a Western Blot test is performed. A person is said to have a positive antibody test (to test positive) only when each of these tests is positive. HIV antibody test results may take from two to six weeks to be returned.

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HIV Testing Locations

For testing locations across Los Angeles County, click here.