HIV test

Overview

An HIV test checks for the human immunodeficiency virus (HIV) in your body. It looks for antibodies (proteins your body makes when you have HIV) or the virus itself. The test is usually done with a blood sample or an oral swab.

HIV testing is common and recommended for many people, especially those who have had unprotected sex, shared needles, or are pregnant.

Anyone can get an HIV test. It does not matter your age, gender, or sexual orientation. HIV affects people of all backgrounds.

Symptoms

Common symptoms

• Flu-like symptoms such as fever, sore throat, tiredness, and swollen glands (may appear 2 to 6 weeks after infection)
• Unexplained weight loss
• Night sweats
• Diarrhoea that lasts a long time
• Persistent cough or shortness of breath

Symptoms in children

• Children may have similar symptoms to adults, including failure to gain weight or grow as expected, frequent infections, or developmental delays.

Symptoms in older adults

• Older adults may have vague symptoms like fatigue, weight loss, or repeated infections, which can be mistaken for normal ageing.

Causes

Main causes

• HIV is caused by the human immunodeficiency virus, which attacks the body's immune system. The virus is spread through certain body fluids, such as blood, semen, vaginal fluids, and breast milk.

Risk factors

• Having unprotected vaginal, anal, or oral sex with someone who has HIV
• Sharing needles, syringes, or other equipment for injecting drugs
• Receiving blood transfusions or organ transplants in countries without strict screening (very rare in the UK)
• Being born to a mother with HIV (if she is not on treatment)
• Occupational exposure (e.g., needlestick injury in healthcare workers)

When to see a doctor

See a doctor urgently if:

• Within 72 hours of a high-risk exposure (unprotected sex, needle sharing, sexual assault) – you may need PEP.
• If you have symptoms that suggest acute HIV (like severe flu-like illness within 6 weeks of possible exposure).

Book a routine appointment if:

• Every year if you are sexually active and not in a mutually monogamous relationship, or if you inject drugs.
• If you are pregnant – HIV testing is routinely offered as part of antenatal care.
• If you have had a possible exposure more than 6 weeks ago and want to know your status.

Diagnosis

HIV is diagnosed with a blood test or an oral swab. The test looks for antibodies to HIV or part of the virus itself. Depending on the type of test, results can be available in minutes (rapid test) or up to a few weeks if sent to a lab.

Tests that may be done

• Rapid HIV test (finger-prick or oral swab, results in 20–30 minutes)
• Fourth-generation blood test (detects both antibodies and the p24 antigen, can be positive earlier than antibody-only tests)
• Nucleic acid test (NAT) – looks for the virus's genetic material; used mainly in certain situations

What to expect at your appointment

You will be asked about your risk and symptoms. The test is simple and quick. If the test is positive, a second confirmatory test is done to be sure. A negative result is usually accurate if you are past the window period (typically 4 to 6 weeks for modern tests). Your healthcare provider will explain what your result means.

Treatment

HIV is not curable, but it is a manageable condition. Treatment involves taking daily medication to keep the virus under control. This protects your immune system and prevents passing HIV to others.

Self-care at home

• Take your medication every day exactly as prescribed.
• Attend all follow-up appointments and blood tests.
• Stay healthy with a balanced diet, regular exercise, and good sleep.
• Avoid alcohol and recreational drugs that can interfere with treatment.

Medical treatments

The main treatment for HIV is antiretroviral therapy (ART). This is a combination of medicines taken daily (usually one or more tablets). The medicines stop the virus from multiplying, so your immune system can recover. Your doctor will prescribe a combination based on your individual needs. Never stop or change your medication without speaking to your healthcare provider.

When is surgery considered?

HIV itself does not usually require surgery. However, people with HIV may need surgery for other health conditions. Surgeons will take extra precautions to protect both you and themselves.

Living with this condition

With modern treatment, most people with HIV lead full, healthy lives. You will need to take medication every day and have regular checkups. It is also important to practise safe sex (condoms) to protect your partner, even if your viral load is undetectable.

Lifestyle tips

• Stay physically active and eat well to support your immune system.
• Avoid smoking and limit alcohol.
• Get vaccinated against infections like flu, hepatitis, and pneumonia.
• Join a support group to connect with others living with HIV.

Diet and exercise

A balanced diet rich in fruits, vegetables, whole grains, and lean protein helps keep your body strong. Regular exercise like walking, swimming, or yoga can improve your energy and mood.

Mental health and emotional wellbeing

A diagnosis of HIV can bring up many emotions – fear, anger, sadness, or relief. It is normal to feel this way. Talk to your doctor about counselling or mental health support. If you feel overwhelmed, reach out to a crisis helpline.

Prevention

Yes, HIV can be prevented. Using condoms correctly every time you have sex, not sharing needles, and taking pre-exposure prophylaxis (PrEP) if you are at high risk are effective ways. If you think you have been exposed, PEP (taken within 72 hours) can reduce the chance of infection.

Vaccines

There is currently no vaccine to prevent HIV. Research is ongoing.

Screening programmes

Regular HIV testing is recommended for people at higher risk, such as men who have sex with men, people who inject drugs, and people from countries with high HIV rates. Pregnant women are routinely tested to prevent mother-to-child transmission.

Complications

If left untreated

• Untreated HIV can progress to AIDS (acquired immunodeficiency syndrome), where the immune system is severely damaged.
• People with AIDS are at high risk for serious infections (opportunistic infections) and some cancers.
• HIV can also affect the brain, kidneys, and heart over time.

Long-term outlook

The outlook for people with HIV has improved dramatically. With early diagnosis and effective treatment, most people with HIV can expect to live nearly as long as someone without HIV. You can stay healthy, have relationships, and even have children without passing on the virus. The key is to get tested and start treatment early.

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