Which HIV Tests Should I Use?
- NATs detect HIV ribonucleic acid (RNA).
- Antigen/antibody combination tests detect HIV p24 antigen as well as HIV immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies.
- Antibody tests detect HIV IgM and/or IgG antibodies.
Access more information on US Food and Drug Administration (FDA)-approved HIV assays used for screening.
The improved diagnostic tests available today reduce the time to diagnosis and treatment of early HIV infection by decreasing what is known as the window period.1,2 Following an exposure that leads to HIV infection, the amount of time during which no existing diagnostic test can detect HIV is called the eclipse period.1 In contrast, the window period is the time between a potential HIV exposure and an accurate test result.
The NAT can detect HIV the earliest, followed by the antigen/antibody combination test, and lastly, the antibody test, as shown in the figure below.
Additional Centers for Disease Control and Prevention guidance and updated recommendations on HIV testing using FDA-approved tests are available here.
For patients who want to test at home or in a private location, there are two types of HIV self-tests:
- Rapid Self-Test. Done entirely at home or in a private location and can produce results within 20 minutes. Your patients can buy a rapid self-test kit at a pharmacy or online at the website below. The only rapid self-test currently available in the United States is an oral fluid test. To learn more, visit the OraQuick website.
- Mail-In Self-Test. Includes a specimen collection kit that contains supplies to collect dried blood from a finger stick at home. The sample is then sent to a lab for testing, and you or another health care provider communicate the results. Mail-in self-tests can be ordered by any health care provider or from various online merchant sites.
1 Hurt CB, Nelson JAE, Hightow-Weidman LB, Miller WC. Selecting an HIV test: a narrative review for clinicians and researchers. Sex Transm Dis. 2017;44(12):739-746. https://journals.lww.com/stdjournal/Fulltext/2017/12000/Selecting_an_HIV_Test__A_Narrative_Review_for.5.aspx
2 Branson BM, Owen SM, Wesolowski LG, et al. Laboratory testing for the diagnosis of HIV infection: updated recommendations. Centers for Disease Control and Prevention. Published June 2014. Accessed June 28, 2018. https://stacks.cdc.gov/view/cdc/23447