How Soon Is Now? (Rapid testing vs. confirmatory testing).

ImageYou have options.

It just depends on how long you want to wait. It may depend on how important it is for you to quiet the voices in your head, or how recently you had unprotected sex or shared needles, and need to know your status.

Rapid tests are fantastic, fast, and reliable ways of finding out if you’ve been exposed to HIV about 3 months ago, or longer.
It’s important to know that! If you had unprotected, risky sex two days ago, two weeks ago, it may not show up as a “positive” on a rapid HIV test.

Why is that? The HIV-rapid tests for HIV antibodies. It can take as long as 3 months for antibodies to HIV infection to show up in blood or saliva DNA samples.

A rapid test is still a great idea, and has made regular HIV testing a more viable, less stressful option. Results are generally available within 10 to 20 minutes, depending on the test sampling method. Accuracy of rapids is good, too.
Oraquick Rapid HIV test: (Taken from the http://www.oraquick.com/FAQs page on their website):

“Oral fluid HIV tests are very accurate. In studies, the OraQuick oral fluid test detected 91.7 percent of people infected with HIV, and 99.9 percent of people not infected with HIV. If you have more questions about oral fluid HIV tests, talk to your doctor or healthcare provider. He or she can help you figure out the best test for you.”

From the Unigold rapid HIV test: Results show up in 10 minutes, and must be read immediately. Reading test results earlier or later than 10 minutes may give erroneous results. So, it’s good advice NOT to take a bathroom break while you’re waiting for these results to show.  The accuracy of Unigold is close to 100% with whole blood (finger stick or venapuncture) at detecting HIV-1 antibodies at the 3 month mark. This test only tests for HIV-1 antibodies.

Want to know more and enjoy looking at tables and statistics as much as I do? Please go here:
http://www.aidsetc.org/aidsetc?page=cg-209_rapid_testing#t-1

Your other option is 4th Generation Confirmatory Blood Draw Testing. This, in my experience, is the most accurate and dependable method for detecting BOTH NEW, ACUTE HIV infection AND HIV INFECTION PAST THE AFOREMENTIONED 3-MONTH WINDOW PERIOD.

This 4th generation test will look for the HIV p24 antigen and the presence of HIV antibodies. In other words, the test looks for the virus itself, BEFORE antibodies form, AND also looks for HIV antibodies. Therefore, this test is good at finding a brand new case of acute HIV.

Why is this awesome for the treatment as prevention approach to HIV care?
Because, the sooner we can detect HIV infection, the sooner we can get that person into care, get them on medication to suppress the HIV virus, thereby lowering the infected person’s level of virus and making it much less likely that they will infect others.
*Note: A person is at their most infectious during the HIV “window period”–the period between initial infection and the presence of HIV antibodies. 97% of infected HIV patients show HIV antibodies within about 3 months. However, a person can have HIV virus, and a lot of it, within days after being exposed to HIV. 

North Carolina, and (as far as I know) most other states in the U.S. use 4th Generation testing today. It will detect the HIV p24 antigen after about 2 weeks and will also detect HIV antibodies at or before the 3 month mark.
For more, click on the video of Dr. Peter Leone,MD from UNC-Chapel Hill here: http://www.hivcombo.com/home.html

In NC, it takes about 10 days to process and return confirmatory results to the testing agency or clinic. At Triad Health Project in Greensboro, where I work as Director of Prevention and Education Services, we are getting our results back within 14 days or less.

So, to break it down:
A rapid HIV test: tests for HIV exposure 3 months ago or longer, results available within 10 to 20 minutes, depending on the test. Accuracy: Good, in most cases.

4th Generation Confirmatory blood draw testing: tests for HIV p24 antigen (virus) at the acute stage (about two weeks after exposure) AND tests for antibodies like the rapid test. In NC, results are available within two weeks, depending on the lab. Accuracy: Excellent in detecting negative and positive HIV results.

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