HIV Screening: Tests, Lab vs. Home, and More

Medically reviewed by Timothy J. Legg, PhD, CRNP on June 9, 2016Written by Elizabeth Connor on June 9, 2016

Does a Pap smear test for HIV?

A Pap smear screens for cervical cancer by looking for abnormalities in the cells of a woman’s cervix. It’s often done at the same time as tests for other sexually transmitted infections (STIs). Your doctor may also ask you if you want HIV testing.

Since its introduction in the United States in 1941, the Pap smear, or Pap test, is credited with dramatically reducing the rate of death due to cervical cancer. While cervical cancer can be fatal if you don’t get treatment for it, the cancer grows slowly. The Pap test detects changes in the cervix early enough for effective intervention.

Guidelines recommend that women ages 21 to 65 receive a Pap smear every three years. The guidelines allow for a Pap smear every five years for women ages 30 to 65 if they’re also screened for human papillomavirus (HPV), which is the virus that can cause cervical cancer.

What happens if abnormal cells are detected?

If your Pap smear shows the presence of abnormal cells on the cervix, your doctor may recommend a colposcopy. A colposcope uses low magnification to illuminate abnormalities of the cervix and surrounding area. At that time, your doctor also may take a biopsy, which is a small piece of tissue, for laboratory examination.

In recent years, it has become possible to test for the presence of HPV DNA directly. Collecting a tissue sample for DNA testing is similar to the process of taking a cervical biopsy and may be done at the same visit.

Check out: HIV and women: 7 common symptoms »

What HIV tests are available?

Everyone between age 13 and 64 should get an HIV test at least once. You can screen for HIV using at-home testing, or you can get this test at your doctor’s office. Even if you get tested for STIs annually, you can’t assume that any specific test, including a test for HIV, is part of a routine screen.

If you want an HIV screening, you should voice your concerns to your doctor. You and your doctor can discuss what STI you should be screened for and when. The right screening schedule for you depends on your health, behaviors, age, and other factors.

Which lab tests screen for HIV?

If you’re screened for HIV at a doctor’s office, you likely will have one of three lab tests:

  • an antibody test, which uses blood or saliva to detect cells formed by your immune system in response to HIV
  • an antibody and antigen test, which checks your blood for protein associated with HIV
  • an RNA test, which checks your blood for any genetic material associated with the virus

Recently developed rapid tests don’t require the results to be analyzed in a lab. The tests look for antibodies and can return results within 30 minutes or less.

The initial test likely will be an antibody or antibody/antigen test. Blood tests can detect a higher level of antibody than found in saliva samples. This means that blood tests can detect HIV infection sooner.

If you test positive for HIV, follow-up testing will be done to determine if you have HIV-1 or HIV-2. Doctors usually determine this using an RNA test.

Which home tests screen for HIV?

The U.S. Food and Drug Administration has approved two home HIV screening tests. This includes the Home Access HIV-1 Test System and the OraQuick In-Home HIV Test.

With the Home Access HIV-1 Test System, you take a pinprick of your blood and send it off to a lab for testing. You can call the lab in a day or two to receive your results. Positive results are routinely retested to ensure that the result is accurate. This test is less sensitive than one that uses blood from a vein, but it’s more sensitive than one using a mouth swab.

The OraQuick In-Home HIV Test uses a swab of saliva from your mouth. Results are available in 20 minutes. If the result is positive, you’ll be referred to testing sites for a follow-up test to ensure accuracy.

What you can do now

Getting tested early is the key to effective treatment. “We recommend everyone get an HIV test at least once in their lives,” says Michelle Cespedes, M.D., a member of the HIV Medicine Association and an associate professor of medicine at the Icahn School of Medicine at Mount Sinai. “The result of that is that we pick up people before their immune systems are ravaged,” says. “We get them on treatment sooner rather than later to prevent them from ever being immunocompromised.”

If you think you’re at risk for HIV, you should assess your options. You can either schedule an appointment with your doctor for lab testing or purchase an at-home test. If you chose to do at-home testing and you have a positive result, you can ask your doctor to confirm this result.

From there, they can work with you to assess your options and determine next steps.

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