Understanding Your HIV Testing Results: What They Mean & What to Do Next

Human Immunodeficiency Virus (HIV) testing is lifesaving, and HIV treatment and prevention medication is available. HIV is often present without symptoms so getting tested is the only way to know your HIV status. When you know your HIV status you can take steps to maintain your health and protect your loved ones.

HIV Testing is Important

Early Testing Matters

Infections like HIV (Human Immunodeficiency Virus) are often present without any symptoms. When HIV is untreated it can cause very serious health harms and can develop into AIDS (Acquired Immunodeficiency Syndrome). While there is no cure for HIV, there is treatment available. With treatment, many people who have received an HIV diagnosis live long and healthy lives. Treatment can also lower a person’s risk of transmitting the virus to their sexual partners and loved one’s.

How HIV Spreads

HIV is spread when certain bodily fluids from a person with HIV come into contact with another person’s bloodstream or mucous membrane (there are mucous membranes in the rectum, vagina, penis, and mouth).₁

HIV is most commonly spread through:

• Unprotected anal or vaginal sex
• Injecting drugs with equipment that is not sterile (sharing needles or syringes)
• During childbirth or breastfeeding.₁

Using condoms during vaginal or anal sex and using safer injection practices if injecting drugs protect you and your partners from HIV and other diseases like Hepatitis C and other STIs.

Accessing HIV Testing

HIV testing is often available nationally at low or no cost regardless of insurance status.₃ In New York City anyone, regardless of their immigration history or insurance status, who is 12 years and older can access confidential HIV testing.₂ Regardless of a person’s age, a healthcare provider may be able to provide confidential HIV testing. Discuss with your primary care provider or pediatrician if you have any questions about accessing HIV testing.

Everyone between the ages of 13 – 64 should get tested for HIV at least once, and with each new sexual partner.₃ Some people may be at a greater risk of getting HIV and should get testing more regularly. Talk to your healthcare provider if you have any questions about your risk for HIV.

HIV Testing & Your Rights

Confidentiality

New York State Health Law protects the confidentiality and privacy of individuals who have been tested for HIV, diagnosed with HIV or HIV/AIDS-related illness, or treated for HIV/AIDs-related illness.₄ In some states, including New York State, if a person tests positive for HIV, the health care provider is required to notify the health department.₄ Anonymous HIV testing is available at some testing sites.

Declining an HIV Test

You have the right to decline an HIV test. New York State Public Health Law mandates the offer of HIV testing to everyone age 13 or older in New York State. However, HIV testing is voluntary, meaning you have the right to refuse the test and this decision should not affect the quality of care that you receive and your access to other healthcare services.₄

HIV Discrimination

Discrimination based on HIV status is illegal in New York State.₄ There are also some federal protections against discrimination based on HIV status.₅ To learn more about the state-by-state differences in how the laws protect or criminalize people who have HIV, check out The Center for HIV Law & Policy.₆

What to Expect From Your HIV Test

Types of HIV Tests

There are three main types of HIV tests: HIV antibody tests, HIV antibody/antigen tests, and NAT tests (nucleic acid tests).₃ Even though HIV tests are all accurate, it can take weeks after the exposure before the tests can find HIV in your body.

Understanding Your HIV Test Results

What Your Test Result Means

• If you test HIV positive: A positive test almost always indicates a diagnosis of HIV infection.
• If you test HIV negative: This means you are not living with HIV. There are some cases when your provider will suggest a second test to confirm.
• If your results are inconclusive: This means your test did not produce a conclusive result. You will need to be re-tested for HIV.

Next Steps After an HIV Test

What to Do If You Test HIV Positive

Receiving a positive test can be life-changing, but know that there are many resources available to support you during this time.

Receiving a diagnosis

The provider ordering your HIV testing or their representative will give you the final interpretation of diagnostic testing and they will schedule an appointment for you for follow-up HIV care. The testing provider will also talk to you about your options for notifying sexual or needle-sharing partners.

Talking to partners about HIV exposure

Notifying a partner of HIV exposure is an important way to care for each other’s health and to prevent further spread of HIV. HIV symptoms are not easy to spot on our own but the health risks are very serious. Talking to partners about HIV exposure ensures they can access testing, early prevention medications like PEP (post-exposure prophylaxis), and treatment like ART (antiretroviral therapy) as soon as possible.

This doesn’t mean the conversation will be easy, but it is important. In some states there are laws that require a person who tests positive for HIV to inform their sexual or needle-sharing partners of HIV exposure.₇ In New York State, Partner Services Specialists help diagnosed individuals plan the best way to notify their sex and/or needle-sharing partners who have been exposed to an STI or HIV.₈

Sharing your HIV status with anybody else is your choice. It may be a hard process to share your HIV diagnosis with others, but you might also find support from talking to trusted loved ones or others who are living with HIV. To learn more about starting these conversations visit Talk HIV.₉

During your first appointment for HIV care

Most importantly, go to your first appointment for HIV care as soon as possible. You will have time to find an HIV-specific healthcare provider and an HIV care team after you start treatment.₁₀ At this first appointment your doctor will likely review your health history, conduct a physical exam, do additional lab testing, and discuss HIV treatment options.₁₁

Starting treatment with HIV medicine like ART as soon as possible is the best way to keep yourself and your partners healthy. Treatments for HIV are now very effective with little to no side effects. When starting HIV treatment it can be as straightforward as taking just one pill a day.

What to Do If You Test HIV Negative

If you took an HIV test due to a known HIV exposure: You may need a second HIV test. HIV tests cannot detect HIV immediately after infection. Depending on the test type it can take 10 – 90 days after exposure for the test to be able to detect the infection. Talk to your provider about your “infection window period” to determine when you should take your second test.₃

If you took an HIV test for regular screening: This means you are not living with HIV. Continue taking steps to protect yourself from HIV.

Preventing HIV Transmission

Treatment is Prevention

HIV treatment ART (antiretroviral therapy) is a medication that a person with HIV can take to lower the amount of HIV virus in the body.

When the amount of virus in the body (viral load) is low, a person is less likely to get sick from HIV. When a person’s HIV viral load becomes low enough that it is undetectable, the HIV is no longer transmissible via sex. An undetectable viral load also prevents transmission through pregnancy and reduces the likelihood of transmission through drug injection equipment.₁₂

Prevention Medications

PrEP and PEP are medicines that a person without HIV can take to prevent HIV infection.₁₃ Both of these medications require a prescription. If you are concerned about your risk of HIV, talk to a healthcare provider about PEP or PrEP.

• PEP (Post-Exposure Prophylaxis) is a very effective emergency medication that a person can take within three days of possible HIV exposure to prevent HIV infection. The sooner PEP is started after exposure, the better. Once started, it should be taken each day for 28 days in order to be effective. This medication should not be taken regularly.₁₄
• PrEP (Pre-Exposure Prophylaxis) is a medication that a person at risk for HIV can take regularly to prevent HIV. PrEP is a safe and highly effective medication for preventing HIV when it is taken as prescribed.₁₅

Minimize Risk of HIV Exposure

Beyond medication, there are ways to reduce HIV risk in your daily life. HIV is commonly transmitted through anal sex, vaginal sex, and using non-sterile injection drug equipment like needles or syringes.

To reduce risk of HIV transmission during sex:

• Use internal or external condoms consistently and correctly. This is an effective way to prevent HIV, other STIs, and pregnancy.₁₆
• Choose sexual activities that have lower risk of transmitting HIV. For example, oral sex has very low risk for HIV transmission especially compared to anal or vaginal sex.₁₃
• Abstain from sex. Abstinence is 100% effective for preventing HIV, STIs, and pregnancy.
• Get tested and treatment. Get tested for other STIs and for HIV with every new sexual partner. A person is at a greater risk for HIV when they have another STI.₁₃

To reduce risk of HIV transmission during drug injection:

• Reduce, quit, (or never start) using injection drugs.₁₃
• Use less risky drug consumption alternatives. Snorting, smoking, or swallowing drugs also has risk but these consumption methods are less likely to lead to HIV or Hepatitis C.₁₇
• Use only new, sharp, and sterile needles or syringes.₁₃ For low or no-cost access to sterile needles or syringes in NYC visit the NYC Health Map or call 311. For national sterile syringe services, visit NASEN. For free Naloxone visit NEXTDistro.
• If a new sterile needle cannot be found, clean your syringes or needles with bleach.₁₃ A new sterile syringe should always be the first option, but if one is not available, it is safer to use a syringe that has been cleaned with water and bleach than to use a syringe that has not been cleaned.₂₁ This CDC fact sheet includes steps for cleaning syringes. 

Where to Get HIV Testing & Healthcare Support in NYC

Affordable HIV Testing and Prevention at CBWCHC

The Charles B. Wang Community Health Center (CBWCHC) offers confidential and low-cost HIV testing in Manhattan’s Chinatown and Flushing, Queens. Providers in our Internal Medicine, Pediatrics, and Obstetrics & Gynecology departments can provide confidential rapid testing and standard blood testing. They can also talk with you about your HIV risk, discuss prevention medications like PEP or PrEP, and connect you to other low or no-cost HIV prevention resources like condoms.

• Schedule an appointment with an Internal Medicine Provider. 
• Schedule an appointment with a Pediatrics Provider.
• Schedule an appointment with an Obstetrics & Gynecology Provider. 

CBWCHC accepts most major health insurance plans and offers fee discounts for people without insurance based on family size and income. Services are provided regardless of a patient's ability to pay or their immigration history.

FAQs:

1. Who Can Take PrEP?

PrEP is a safe and effective medication for preventing HIV. PrEP does not interfere with Hormone Medication or Birth Control. PrEP is an option for people regardless of gender, sex, or sexuality. Adolescents and adults can take PrEP.₂₂ Talk to your doctor about your specific health risks, concerns, and to decide if PrEP is right for you.

Consider taking PrEP if you do not have HIV and any of the following apply to you. If you:

• Are worried you may be exposed to HIV
• Do not always use condoms during sex
• Recently had a sexually transmitted infection (STI)
• Recently took emergency PEP to prevent HIV
• Inject drugs and share syringes or other injection equipment
• Have a partner who has HIV and a detectable or unknown viral load
• Have a partner who may have HIV or who refuses to get an HIV test.₂₂

2. If someone I know injects drugs, can I get Naloxone?

Naloxone does not prevent HIV but it is a safe medication that can reverse an opioid overdose. It only works when a person has used opioids but it will not cause any harm if the person has not used opioids. Naloxone is available without a prescription.₂₃ If you or someone you know uses opioids, Naloxone is available and it can save a life.

• For more information on Naloxone, or to find resources in NYC, visit NYC.gov.₂₃
• To order free Naloxone or fentanyl test strips in NYC, visit Matters. They also have a map for finding local public health vending machines.₂₄
• To order free Naloxone or find other harm reduction services nationally, visit NextDistro.₂₀

3. Where can I find HIV care services in NYC?

In New York State, HIV care and treatment services are available to everyone living with HIV, regardless of their ability to pay or immigration history.₂₅

• To find knowledgeable and LGBTQ-friendly providers and community-based organizations offering HIV treatment, search the NYC Health Map or call 311.₁₈
• To find HIV health care and other related services in New York City like mental health care, legal services, or housing services, visit the maps maintained by HIV Health & Human Services Planning Council of New York.₂₆
• To find nationally available HIV health care services like treatment, visit the locator at HIV.gov.₂₇