The time between when a person may have been exposed to HIV and when a test can tell for sure whether they have HIV is called the window period. The window period varies from person to person and depends on the type of test used to detect HIV.  If you get an HIV test after a potential HIV exposure and the result is negative, the CDC recommends getting tested again after the window period.

No HIV test can detect HIV immediately after infection. If you think you’ve been exposed to HIV in the last 72 hours, talk to your health care provider about post-exposure prophylaxis (PEP), right away.
‍
A nucleic acid test (NAT) can usually tell you if you have HIV infection 10 to 33 days after exposure. It looks for the actual virus in the blood and involves drawing blood from a vein. The test can either tell if a person has HIV or tell how much virus is present in the blood (known as an HIV viral load test). While a NAT can detect HIV sooner than other types of tests, this test is very expensive and not routinely used for screening individuals unless they recently had a high-risk exposure or a possible exposure and have early symptoms of HIV infection.

An antigen/antibody test performed by a laboratory on blood from a vein can usually detect HIV infection 18 to 45 days after exposure. Antigen/antibody tests done with blood from a finger prick can take longer to detect HIV (18 to 90 days after an exposure). You may have also heard of antigen/antibody tests as “fourth-generation tests.” They look for both HIV antibodies and antigens. Antibodies are produced by your immune system when you’re exposed to viruses like HIV. Antigens are foreign substances that cause your immune system to activate. If you have HIV, an antigen called p24 is produced even before antibodies develop. Antigen/antibody tests are recommended for testing done in labs and are now common in the United States. This lab test involves drawing blood from a vein. There is also a rapid antigen/antibody test available that is done with a finger prick.

‍Antibody tests can take 23 to 90 days to detect HIV infection after exposure. Most rapid tests and self-tests are antibody tests. You may have heard of antibody tests also being called “third-generation tests.” In general, antibody tests that use blood from a vein can detect HIV sooner after infection than tests done with blood from a finger prick or with oral fluid. They only look for antibodies to HIV in your blood or oral fluid. In general, antibody tests that use blood from a vein can detect HIV sooner after infection than tests done with blood from a finger prick or with oral fluid. Most rapid tests and the only currently approved HIV self-test are antibody tests.

Ask your health care provider about the window period for the test you’re taking. If you’re using a home test, you can get that information from the materials included in the test’s package. If you get an HIV test after a potential HIV exposure and the result is negative, the CDC recommends to tested again after the window period for the test you’re taking to be sure.

You have several HIV testing options. Your health care provider, local clinic, and a hospital can utilize several body fluids to detect HIV. This includes blood, oral fluid, or urine. Blood may be drawn from the vein or via finger prick, depending on the test type.

You may also purchase a mail-in self-test kit to collect the specimen in the privacy of your own home. The sample is then sent to a lab for testing and the results are provided by a health care provider. Mail-in self-tests can be ordered through various online merchant sites. Your health care provider can also order a mail-in self-test for you.

OraQuick is a rapid self-test that can also be purchased at a pharmacy or online. Only rapid self-test currently available in the US is an oral fluid test. This is the same oral swab test offered at clinics and you may know your results in 20 minutes. Most kits are around $40. If you are a Florida resident, you can order a free OraQuick test through Know Your HIV Status.

The test reliability increases with time. The longer you wait from the time of exposure to the time of taking the test, the better the reliability. If no HIV antibodies appear in your blood within three to six months after exposure, and you haven’t participated in any other high-risk behaviors, there is a 99.9% likelihood that you do not have HIV. The Centers for Disease Control advises that you wait at least three months to take an initial HIV blood test. This will ensure very high reliability of the tests.

PrEP is a medicine that you can take that can lower your chances of getting HIV. PrEP stands for pre-exposure prophylaxis. PrEP is a way for people who do not have HIV but who are at a high risk of getting HIV. Instead, a pill is taken each day. PrEP reduces the risk of getting HIV from sex by about 99% when taken as prescribed. Although there is less information about how effective PrEP is among people who inject drugs, we do know that PrEP reduces the risk of getting HIV by at least 74% when taken as prescribed.

It may be helpful to speak to your health care provider about PrEP if you:
‍
· Don’t regularly use condoms.
· Have a sexual partner who has HIV (sometimes called sero-different couples).
· Have a sexual partner who is at high risk for getting HIV (like if they have anal or vaginal sex with other people without condoms, or they’re an injection drug user).
· Have anal or vaginal sex with many partners, especially if you don’t use condoms regularly.
· Recently had another STD.
· Do sex work that includes vaginal or anal sex.
· Have injected drugs, shared needles, or been in treatment for drug use in the past 6 months.

For locations to obtain PrEP, check out the nation-wide PrEP Locator, the Florida Department of Health’s HIV PrEP and nPEP Providers List or call the Florida HIV/AIDS Hotline for a referral.
PrEP 101
CDC PrEP Consumer Info Sheets

PEP (post-exposure prophylaxis) is a medicine to prevent HIV after a possible exposure. PEP should be used only in emergency situations and must be started within 72 hours after recent possible exposure to HIV. You take PEP 1-2 times a day for at least 28days. The medicines used in PEP are called antiretroviral medications (ART). These medicines work by stopping HIV from spreading through your body.

PEP is for emergencies. It can’t take the place of proven, ongoing ways to prevent HIV – like using condoms, taking PrEP, and not sharing needles or works. If your nurse or doctor gives you PEP, you’ll need to take medicine 1-2 times a day for at least 28 days (4 weeks). It’s important that you take every pill as directed and don’t skip doses, otherwise, PEP may not work as well.

If you need PEP, you can head to your nearest emergency room. You can also check out the Florida Department of Health’s HIV PrEP and nPEP Providers List or call the Florida HIV/AIDS Hotline for a referral.

Take Time to Process the News
HIV diagnoses may trigger an array of difficult feelings – this is perfectly normal. Receiving an HIV diagnosis can be life-changing. You may feel many emotions, such as sadness, hopelessness, or anger. Allied health care providers and social service providers can help you work through the early stages of your diagnosis. They are often available at your health care provider’s office. You can also call the Florida HIV/AIDS Hotline for short-term supportive counseling and referrals to local support services, such as support groups.

If you have a primary health care provider, that person may know how to treat HIV. A primary healthcare provider is someone who manages your regular medical care and annual tests. If your primary health care provider does not know to treat HIV, they can refer you to an HIV health care provider. Call the Florida HIV/AIDS Hotline if you need assistance with finding a local HIV health care provider. With the right treatment and care, you can live a long and healthy life with HIV.

It would also be beneficial to consider seeking out case management for HIV services. Being newly diagnosed can be confusing, so case managers are there to help you with navigating HIV care. They can help link you with health care, psychosocial, and other services provided by trained professionals. Case managers also help health care providers coordinate and implement care plans for their clients.

Get in care and take medicine to treat HIV (called antiretroviral therapy or ART). Taking HIV medicine can reduce the amount of HIV in the blood (called viral load). HIV medicine can make the viral load very low (called viral suppression). Viral suppression is defined as having less than 200 copies of HIV per milliliter of blood. HIV medicine can make the viral load so low that a test can’t detect it (called an undetectable viral load).

Getting and keeping an undetectable viral load (or staying virally suppressed) is the best thing you can do to stay healthy. Having an undetectable viral load also helps prevent transmission to others. If you have an undetectable viral load, you have effectively no risk of transmitting HIV to an HIV-negative partner through sex. Most people can get the virus under control within six months. Read more about U=U here.

Living with HIV and becoming sick from AIDS are two different events (read more about the difference between HIV and AIDS). For most people, it takes many years from the time someone begins living with HIV to the time that they develop symptoms of AIDS. Some people get sick sooner and others stay well longer, especially with treatment. However, there is almost always a significant period after transmission when an individual living with HIV will have no symptoms at all – often 10 years or more.

Keeping in mind the two separate events (living with HIV vs. actually developing AIDS) can help you to remember that there are also two separate periods when someone may show symptoms related to HIV.

The first period is during the first few weeks after HIV transmission. Some people may develop flu-like symptoms within the first month or so after getting HIV. These early symptoms can feel very much like the flu (fever, headache, weakness, fatigue, body aches, etc.), and they can be mild or severe. The flu-like symptoms typically last for only about a week and then go away on their own. Acute Viral Syndrome is not an ongoing condition that lasts for weeks and weeks or that comes and goes over a long period. It’s important to know the following:

1. Not everyone who has HIV will experience these early, flu-like symptoms of Acute Viral Syndrome. Many people will have no symptoms at all until years after becoming HIV+.

2. The symptoms of Acute Viral Syndrome are the same as the symptoms of the flu and many other illnesses. If you have these symptoms right after a possible exposure to HIV, it does not mean you have HIV, or even that you probably have it. The only way to find out if you have HIV is to get an HIV test.

HIV is still active but reproduces at very low levels. People may not have any symptoms or get sick during this phase. Without taking HIV medicine, this period may last a decade or longer, but some may progress faster. People can transmit HIV in this phase. At the end of this phase, the amount of HIV in the blood (called viral load) goes up and the CD4 cell count goes down. The person may have symptoms as the virus levels increase in the body, and the person has a higher risk of being diagnosed with AIDS. People who adhere to their HIV medication as prescribed and manage their health never move past this stage.

People receive an AIDS diagnosis when they are already living with HIV and their CD4 cell count drops below 200 cells/mm, or if they develop certain opportunistic infections, each with specific symptoms. For this reason, there isn’t a simple checklist of “AIDS symptoms”. Two people who are both sick with AIDS can have completely different sets of symptoms (or even no symptoms at all).

If you have symptoms that are bothering you or that aren’t going away, your best option is to be checked by a health care provider. Any symptom that could be a sign of AIDS could also be a sign of something else. Again, the only way to know if you are living with HIV is to take an HIV test.