There are now many options for finding a free HIV test. In April 2015, the first HIV home-testing kit also became available to purchase online. This fact sheet, based on information from Public Health England, provides important information about getting an HIV test.
1. Why should I have an HIV test?
If you are at risk for HIV infection you should have an HIV test. If you are at high HIV risk you should have repeat HIV tests regularly. If you are infected with HIV, testing regularly will mean you are diagnosed early. This enables you to access the highly effective treatment and care you will need to prolong your life and protect your sexual partners.
2. Who should have an HIV test?
Taking an HIV test is the only way to find out if you are HIV negative or HIV positive. If you are
HIV positive early diagnosis will mean that your treatment will have better outcomes, and the risk of onward transmission to other people will be reduced. If you think you may have been at risk, you should have an HIV test. Get tested regularly for HIV if you are one of those most-at-risk:
- Men who have sex with men are advised to have an HIV test and Sexually Transmitted Infection (STI) screen at least annually, and every three months if having unprotected sex with new or casual partners.
- Black-African men and women are advised to have an HIV test, and a regular HIV test and STI screen, if having unprotected sex with new or casual partners.
It is very important to use a condom correctly and consistently, and especially until all partners have had a negative sexual health screen.
Unprotected sex with partners believed to be of the same HIV status (also known as ‘serosorting’) is unsafe. For HIV positive partners, there is a high risk of acquiring other STIs and hepatitis. For HIV negative partners there is a high risk of HIV transmission (a fifth of HIV positive men who have sex with men are unaware of their infection) as well as acquiring STIs and hepatitis.
3. Where can I get an HIV test?
It is very easy to get an HIV test throughout the UK. You can:
a. Ask your doctor. An HIV test involves having blood taken, or sometimes even a small finger prick. Most General Practitioner doctors (GPs) are able to arrange to have blood taken and sent to a laboratory for an HIV test, and to get the result back within two to three days. There is no need for a lengthy discussion about HIV testing.
b. Go to a sexual health or genitourinary medicine (GUM) clinic and ask for a test. You don’t need a referral from your GP and you can go to a clinic anywhere in London or the UK. Sexual health clinics will not share your testing information with other NHS services. A number of clinics in London offer ‘fast-track’ testing while you wait, which means the results of the HIV test can be given very quickly. Those clinics will take a follow-up blood specimen to investigate any immediate results that need more information.
c. Use an HIV testing service in a non-clinical venue (for example in a community centre, bar or football stadium). Often these are provided by NHS outreach clinics and some HIV charities. These tests are free, confidential and safe. You will be given appropriate advice and referred into other NHS services if necessary.
d. Request a self-sampling kit online. There are a number of self-sampling HIV test services available over the Internet in London, such as SH:24 (although this is only available to residents of Lambeth and Southwark). You will receive a free self-sampling kit in the post and be asked to take a blood or saliva specimen yourself, then post it back to a laboratory. After a few days you will either receive a negative result via SMS message, or a health-care professional will call you if the result is reactive, and advise you what to do next.
e. Purchase a home-testing kit For details see Question 5: What is HIV self-testing?
4. Will I have to pay for an HIV test?
Testing for HIV (and other STIs) is free at your GP, at a sexual health clinic or from an outreach service. Even if you are an international student, a short-term visitor, a migrant from abroad, or an asylum seeker – no matter what your residency status – having an HIV test is free and confidential.
If you wish to take a test for HIV you can find a HIV test near you here.
5. What is HIV self-testing?
If this result of your home HIV test is reactive it indicates that you may have HIV, but you will need to visit a sexual health service, to confirm the test result and get medical advice. If you are then diagnosed HIV positive, you will be referred for HIV care and treatment, which is free to everyone in the UK – no matter what residency status you have.
6. Should I use an HIV self-test?
If you are considering a self-test for HIV, before you test it is important to think about what you will do when you receive the test result, whether it is negative or reactive (positive).
a. Consider what knowing your HIV status will mean to you
b. Want an immediate test result in the privacy of your home
c. Be able to obtain a reliable self-testing kit, and
d. Be able to read and follow the test kit instructions.
Self-testing for HIV is different from consulting a healthcare worker who can advise you about testing, give you support and help you access laboratory tests of the highest quality.
7. How do I get a self-test kit for HIV?
Self-test kits in the UK must meet very strict quality standards approved by the proper authority such as the Medicines and Healthcare Regulatory Agency [MHRA] for the UK, and European Medicines Agency [EMA] for the European Union [EU].
Self-test kits can also be obtained from outside the EU over the internet but these will not have been through the same regulatory process of the MHRA or the EMA.
8. How do I know I am buying a reliable self-test kit for HIV?
HIV self-test kits available to purchase in the UK must meet a number of requirements concerning test performance, labelling and instructions for use. All tests that meet these required standards will be given a CE mark. This means that when used as intended, CE marked self-test kits will work properly and be acceptably safe. So you should check for the CE mark:
It should be noted no self-test kit is 100% reliable, and the CE mark does not guarantee that the test is suitable for your health needs. You should consult your GP or visit a sexual health service if your concerns or symptoms persist, or if you have any worries about your health.
9. How soon can I use an HIV self-test kit?
If you have engaged in high-risk behaviour (for example sex without a condom with a partner who is HIV positive or whose HIV status is unknown; injecting drug use with equipment that may have been used by someone else) within the past 3 months, HIV testing kits may not detect recent HIV infection. Instead we recommend that you visit a clinic to take a highest quality HIV test.
If an HIV test is performed during this window period, a person who has recently become infected with HIV may receive a “false negative” test result.
Different tests have different window periods. Laboratory HIV tests used as part of clinic services usually have a shorter window period than HIV self-test kits. More information about HIV can be found here.
10. What about other sexually transmitted infections and drug use?
Some of these infections have no symptoms, so regular screening is recommended.
11. How does self-testing for HIV differ from self-sampling?
Self-sampling HIV test kits are also available in the UK. The person who is testing takes a sample (saliva or blood from a finger prick), and then sends it to a laboratory for testing. Results are given by text message or a phone call from a healthcare worker.
Self-testing kits for HIV are not the same as self-sampling. The individual takes a sample, tests it themselves using the kit, and obtains their result immediately. There is no need to send the sample to a laboratory, and you read the result yourself.
12. What types of HIV tests do sexual health clinics use?
All clinics will use 4th generation laboratory tests. These are the recommended tests for routine clinical use in the UK providing the most up to date and accurate HIV tests available.
Although HIV self-sampling and self-testing kits are convenient, most self-test kits for HIV are 3rd generation, which are not as reliable as 4th generation tests. The window period of a 3rd generation test is longer than the 4th generation tests available at clinics. This means that a person who has recently acquired HIV could test positive with a 4th generation test, but negative with a 3rd generation test.
13. Can I use an HIV self-test kit to test for other sexually transmitted infections?
No. Self-test kits for HIV only test for HIV infection. Other STIs such as syphilis, gonorrhoea, herpes and chlamydia cannot be identified using an HIV test. If you have engaged in high-risk behaviour, such as sex without a condom, then you may also be at risk of other STIs and should have other tests for these. Find further advice and information on sexual health here.
14. How can I reduce my risk of getting or transmitting HIV and other STIs?
a. Using a condom correctly and consistently, and until all partners have received a negative STI and HIV screen.
b. Reducing your number of sexual partners and avoiding overlapping sexual relationships.
c. Having an HIV test. Early HIV diagnosis prolongs your life through treatment and protects your sexual partners.
- Men who have sex with men should have an HIV test and STI screen at least annually, and every three months if having unprotected sex with new or casual partners.
- Black African men and women should have an HIV test and a regular HIV and STI screen if having unprotected sex with new or casual partners.
If you often find yourself in need of an HIV test (because of regular risk exposure) you should contact local sexual health promotion services.
15. What is PEP?
Post-exposure prophylaxis (PEP) may stop someone developing HIV infection if they have been exposed to the virus. However, it doesn’t always work.
You might have been exposed to HIV if you have:
• had unprotected sex (sex without a condom)
• had sex where you experienced condom failure
• have shared or been injured by an HIV-infected needle.
PEP is a month-long course of anti-HIV medication. Treatment must be started as soon as possible following potential exposure to HIV, and will only be prescribed within 72 hours (three days) of that risk.
PEP medication can make HIV infection less likely. However, it is not a cure for HIV and it does not work in every case.
PEP also has side effects, including:
• nausea and/or vomiting
16. Where can I get PEP?
PEP is only available on prescription. You can get PEP by going directly to:
• a sexual health (GUM) clinic
• an A&E department of a hospital
GPs do not usually prescribe PEP.
If you ask for PEP, the medical professionals who assess you will ask questions to find out more about your risk of exposure to HIV, including questions about who you had sex with, their HIV status (if known) and whether you had oral, vaginal or anal sex.
There is still no vaccine or cure for HIV. You shouldn’t rely on PEP to prevent HIV, because it doesn’t always work. Using a condom is still one of the most effective ways to prevent the spread of sexually transmitted infections (STIs), including HIV.
17. What is PrEP?
PrEP stands for Pre-Exposure Prophylaxis. Like PEP, it involves taking HIV anti-retroviral medication as a way of preventing HIV infection.
PrEP is different to PEP in both the type of HIV drugs used and also in the fact that PrEP is taken (on an ongoing basis) by individuals who are HIV-negative to prevent them from acquiring HIV.
So far PrEP has only been available for free in the UK as part of clinical trials. It is not currently available on the NHS.
A decision on making PrEP available through the NHS is expected in spring 2016.