What is Rapid HIV Testing?

Rapid HIV testing is considered a significant improvement in helping to detect, treat and hopefully prevent HIV. When the first HIV tests became available, one main issue involved with them was the time it took to get results. People who took the tests had to have a brief counseling session when they were tested, and then needed to return to the lab, clinic or doctor’s office where they received the test to hear the results. This could take several days, and there were a high percentage of people, over 10% who never returned to get their results.

The medical community much desired creation of rapid HIV testing that would allow people to get test results on the same day, and preferably within the same hour that the test was administered. This would give time for counseling prior to and after the test, in addition to making certain that almost all people tested would remain at the testing facility to hear results. In 2006, the US Food and Drug Administration (FDA) approved four different types of rapid HIV testing: OraQuick®, Reveal®, UniGold®, and Multispot®. Of these, the OraQuick® may be preferred because the test can be performed on saliva samples, eliminating need for an initial blood draw. UniGold® is also convenient since blood used can be from a finger stick instead of a blood draw, though venipuncture may be preferred for a larger testing sample.

Most of these tests take at least 20 minutes before results can be read. One disadvantage thus far about rapid HIV testing is that there do seem to be a higher number of false positives associated with the tests. This would mean that people who test positive, especially if they can’t identify exposure to the virus, should have a different type of test to confirm the results.

False-negatives can also occur, and they may simply reflect that the person has not had time to develop antibodies to HIV. If exposure occurred less than three months ago, it may be necessary to retest in a couple more months to confirm negative results. There are a few tests that don’t evaluate HIV antibodies, but instead look at other elements to determine presence of infection; these tests might be done sooner if HIV infection is strongly suspected.

There are many guidelines for who should get rapid HIV testing or another form of HIV test. The US Centers for Disease Control (CDC) has some helpful guidelines regarding this. People should get tested if they have shared needles, or injected drugs (including steroids) with others. They should also consider testing if they have had unprotected sex, engaged in prostitution (even just once), been treated for sexually transmitted diseases or tuberculosis, or had unprotected sex with anyone who has engaged in any of the above behaviors. Those who know they have been exposed to blood or bodily fluids of an HIV infected person should also be tested.