Health and Life Sex and sexual health HIV HIV testing What is an HIV-status? Everyone has an HIV status; you are either HIV-negative or HIV-positive. Taking an HIV test won't change your status but it will let you know what it is. Not taking a test doesn't mean that you are HIV-negative; it simply means that you don't know your status. One in ten gay men with undiagnosed HIV don't know they have it. [1] Around 90% of gay men who are unsure of their HIV status are actually HIV-negative [2]. That’s a huge number of people worrying about nothing. Knowing your HIV status enables you to make informed decisions about your future, your relationships and the sex you have. If you have HIV you will be able to access treatment that will help you to live for longer and will also make you less likely to pass the virus on to your sexual partners. GMFA remain committed to promoting HIV testing and to reducing the number of people who are living with undiagnosed HIV infection. If you live in London, our friends at 56 Dean St provide a free home testing service for gay men living in England. You can access this service at:http://www.deanstreetathome.com/. Order a free test from Terrence Higgins Trust and read the results yourself within 15 minutes: Order test. If you live elsewhere visit www.test.hiv and enter your postcode. If you'd like to find out more about any of the questions listed below, just click on the "Read More" button. What are the benefits of knowing I am HIV-negative? The biggest benefit is knowing that you don’t have the virus. Knowing you are HIV-negative is a weight off your mind and for some men it helps motivate them to stick to safer sex. Getting a negative result may reassure you that you could stay negative.For some men in monogamous relationships, the greatest benefit of knowing that they don't have HIV is having sex without condoms and knowing that they won’t pass HIV to each other. Intimacy and sex go hand in hand for most people, and for some men, using a condom for sex feels like a barrier to intimacy. Taking an HIV test with your partner shows a level of commitment and care towards each other. Some studies have indicated that roughly a third of gay men recently infected with HIV thought that it happened while having sex with a regular partner [3]. This is often due to couples abandoning condoms without being certain that both partners are HIV-negative. What are the benefits of knowing I am HIV-positive? Some people fear that if they found out they had HIV they wouldn't be able to cope. Most people do cope. If you do not get your HIV diagnosed, you will not be able to access treatment, your health will eventually deteriorate and you will be more likely to die of an HIV-related illness. How long this takes can vary but usually takes around a decade. Without medication, HIV is still likely to be a death sentence. If diagnosed early enough you will have your disease progression monitored so that treatment can start whilst your immune system is still relatively strong and not vulnerable to opportunistic infections. This reduces your likelihood of developing AIDS-related problems and cuts your risk of some cancers and heart disease. If you are on treatment your viral load will be reduced which will make you much less likely to pass on the virus to your sexual partners. With effective treatment your viral load can become undetectable and you won't be able to pass on the virus sexually. What symptoms of HIV infection should I look out for? Taking an HIV test is recommended if you experience any symptoms linked to the early stage of HIV infection, also called primary infection or acute infection. Common symptoms in primary infection include a rash and fevers, especially when occurring together with: oral ulcers joint pain sore throat loss of appetite weight loss muscle pain feeling overly tired feeling sick Over 60% of people who get HIV will have at least one of these symptoms two to six weeks after becoming infected [4]; this is called seroconversion illness and can vary from severe or very mild.These symptoms can be linked to many other illnesses too (like the flu). If you recently had risky sex and experience these symptoms it's worth getting tested.After the first stages of HIV infection, it can be many years before you experience any other symptoms or ill health. HIV wears down the immune system and some people begin to experience swollen lymph nodes in the armpit or groin, or fever/night sweats, stomach upsets and diarrhoea. Shortness of breath or coughs usually occur later in the course of the HIV disease and can be a sign of bacterial pneumonia, which is common in untreated HIV infection. A weakened immune system is also more prone to other viruses, fungi or bacteria which can cause rashes on the skin and sores in the mouth. How often should I get tested? It is recommended that all sexually active gay men take an HIV test at least once a year [5], even if they always use condoms or are in a long term relationship. If you have unprotected sex with new partners you should test more often. If you have symptoms of HIV infection within six weeks of having unprotected sex, it is recommended that you test immediately.Even if you've tested negative in the past, you need to test regularly because a negative HIV test doesn't mean you can never get HIV; it just means that you've avoided HIV infection up until that point. Some people get infected with HIV the first time they fuck without condoms while others get it only after having lots of unprotected fucks.A negative HIV result could mean: You have not put yourself at risk of HIV infection You have put yourself at risk but have avoided HIV infection up to that point A negative HIV test result doesn't mean: You will never be infected with HIV You are immune to HIV The sex you are having is always safe enough The people you've had sex with are HIV-negative None of the people you've had sex with are HIV-positive What are the different tests available? HIV tests before 2008 only tested for antibodies. These may still be used in some clinics, but this test is not entirely accurate if you've been at risk in the last three months (the 'window period'). These days, most clinics use 'fourth generation' tests which tests for both p24 antigen and HIV antibodies, and usually give an accurate result a month after exposure to HIV [6]. When getting a sexual health screening, most clinics will give you an opt-out option from getting an HIV test so you can decline it a test if you don’t want to take it or if you are already HIV-positive. If they don’t ask you to test for HIV, ask for the test specifically. Most of the time you can also choose the type of HIV test you want, depending on when you last put yourself at risk. What other HIV-test options are there? Combined p24 antigen/antibody test: detects p24 antigen (protein found in HIV) about 2 weeks after infection also detects HIV antibodies (can take up to 3 months to be produced) p24 antigen shows up in the blood before HIV antibodies so HIV can be diagnosed earlier using this test Antibody test: tests for the body’s natural response to the virus (i.e. antibodies) can take up to 3 months to detect antibodies so this test is less accurate some clinics may still use this test if you have had no HIV risks in the three-month window period Antigen test: tests for p24 antigen (produce in excess in the first few weeks of infection) can be detected in the blood in 2-4 weeks after infection (sometimes longer) it is common for this test to be combined with an antibody test for accuracy Tests for HIV's genetic material: detects HIV’s genetic material (building blocks that make up the virus) detectable 9-12 days after infection this test is not routinely used because they are expensive and samples have to be sent to a lab before you get the results they can be used to confirm a positive result from an antibody or antigen test Rapid tests: give you a result in under an hour you do not have to return to the clinic to get the result can detect HIV antibodies through a saliva swab or blood from a finger prick saliva contains antibodies so HIV saliva tests are possible but you cannot get HIV from saliva rapid tests which detect both antibodies and the p24 antigen are available at some clinics, but these need a sample of blood. Home sampling: use a sample from the inside of your mouth taken with a swab you take the sample yourself at home and send it to a laboratory for analysis your results are then given to you by a doctor the window period for this test is 3 months If you are confused about which test to take or when to take it, there are three easy things to remember: HIV infection can now be detected one month after exposure if you inform your doctor when the last time you put yourself at risk was, it will enable him/her to advise you which HIV test is the most appropriate for you Where do I get tested? To find your nearest clinic and find more information, visit our London-based clinics section under Clinics and Prevention Services. Home testing: 56 Dean St provides a free home testing service for gay men living in England. You can access this service at: www.deanstreetathome.com. If you live elsewhere visit HERE and enter your postcode. Get a free HIV and STI home testing kit by clicking here.