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Everyone between the ages of 13 and 64 should be tested for HIV at least once in their lifetime, according to the Centers for Disease Control and Prevention (CDC).
Despite the CDC’s sweeping recommendation, fewer than 40 percent of adults in the U.S. have ever gotten an HIV test, according to a study published last year. And even though HIV testing is becoming more common in emergency rooms and community health centers, there has been no increase in testing at doctors' offices, the CDC reported in a June 26 study.
In the midst of the COVID-19 crisis, HIV may not be top of mind. But “HIV and sexual health services are always needed,” says Omi Singh, M.P.H., the director of testing at GMHC, an HIV care and advocacy nonprofit. “The current pandemic has not stopped that.”
HIV, the virus that leads to the immune-system disease AIDS, is most common among intravenous drug users and men who have sex with men, and the CDC recommends that people in these groups get tested at least once a year. Yet it’s not just these groups who are at risk.
For example, in 2018, a quarter of new HIV infections were found in heterosexual people. And Black Americans—who make up 13 percent of the population—accounted for 42 percent of all new HIV diagnoses.
“HIV testing is very important for any sexually active person,” says Alex Carballo-Diéguez, Ph.D., a professor of clinical psychology at Columbia University and a research scientist with the New York State Psychiatric Institute HIV Center for Clinical and Behavioral Studies.
And though infection rates are higher in certain groups, “no one is exempt from being at risk,” says Singh.
Regardless of your background, here are five reasons to consider getting screened.
1. You May Be at Risk Without Realizing It
The CDC estimates that about 1.1 million people live with HIV in the U.S. But about 1 in every 7 of them doesn't know he or she is infected. (You can be HIV-positive for a decade or more before experiencing any symptoms.)
Philip Chan, M.D., an assistant professor of medicine at Brown University and director of the Rhode Island STD Clinic, gives the example of a married couple in which one partner has been unfaithful. That would mean the other could have been exposed unknowingly.
“It’s uncomfortable talking to patients about these things,” Chan says. That may be one reason the rate of screening is so low, he says, and why he and others would like to see it become a more routine part of care.
2. Testing Is Convenient and Inexpensive
Under the Affordable Care Act (ACA), insurers must cover HIV screening without a copayment. Ask whether your doctor can administer the test in his or her office. Some community health centers, substance-abuse programs, and hospitals offer free testing. You can find a testing site in your area using this CDC tool.
Keep in mind, Chan notes, that although the test itself should be covered without a copay, an office visit to get the test may require one or may count toward your deductible.
Many clinics use a rapid HIV test, which will give you a result in about 30 minutes.
You can also test yourself at home using a kit you can buy at a retail pharmacy (or online)—an especially appealing option in the midst of the coronavirus pandemic, when some in-person testing centers may be closed.
The OraQuick HIV test, which has been approved by the Food and Drug Administration, usually costs about $40. (GMHC is currently offering free OraQuick tests to anyone in Connecticut, New Jersey, New York, and Pennsylvania, as are some other nonprofits and local health departments.) It involves an oral swab and returns a result in around 20 minutes.
Because most HIV tests check for antibodies the body produces to fight the virus, and these can take time to build up in your system, no HIV test is accurate right after you may have been exposed. For a blood test at a doctor’s office, it may take three to 12 weeks for it to be accurate. For an at-home saliva test, you’ll need to wait at least two to three months.
“Even if people get tested right after an exposure like condomless sex, they should reach out again 3 months later,” says Singh.
3. You’re Pregnant
The CDC recommends that every pregnant woman be screened for HIV. That’s because she can pass HIV to the developing fetus. But HIV medications can reduce that risk, Chan says.
If a woman starts taking these drugs, which lower the concentration of the HIV virus in her body, “then the transmission rate to the baby becomes basically zero,” he says.
4. You Have Early Symptoms of HIV
If you’ve recently had unprotected sex with a new partner, it’s a good idea to get tested for sexually transmitted diseases. But you may want to be especially diligent about getting an HIV test if, two to four weeks after possible exposure, you develop flu-like symptoms, such as a fever, chills, a sore throat, muscle aches, or swollen lymph nodes.
Some people newly infected with HIV may experience these symptoms, which can last a few weeks.
5. HIV Is Treatable—and Survivable
Technically, HIV still has no cure. But improvements in the drugs available to treat the virus mean that HIV-positive people using them can expect to live many years. A 2017 study in The Lancet medical journal found that life expectancy among some HIV-positive people who start antiretroviral therapy, which involves taking a combination of drugs meant to reduce the amount of the virus in the body, is almost as long as the general population.
“But the key is to start treatment early,” Carballo-Diéguez says. Delaying treatment means the virus will have more time to harm your immune system, putting you at risk for other infections.
If you do receive a positive result, talk with your doctor about starting antiretroviral therapy. Because it’s so effective at keeping HIV-positive people healthy, it's recommended for every person who has the disease, at any stage. The therapy also reduces the likelihood of transmitting the virus to others.
Whether a test finds that you are “HIV-negative or HIV-positive, there is a way forward,” says Singh. “You can continue to live a happy and healthy life.”
An Ounce of Prevention
Testing for HIV is important, but so is prevention.
According to the CDC, abstinence and monogamy with an uninfected partner can limit the risk of HIV, and "consistent and correct use of latex condoms is highly effective in preventing sexual transmission of HIV."
But those are not the only strategies that can help protect you against HIV.
Last year, the U.S. Preventive Services Task Force, an independent expert panel that makes recommendations to the government and medical organizations about preventive care, recommended that anyone at high risk for HIV use pre-exposure prophylaxis (or PreP).
PreP is a regimen of daily medications that can reduce the risk of HIV infection. (Visit the Task Force’s recommendation statement for the full list of people considered at high risk.)
—Additional reporting by Lauren F. Friedman
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