HIV Counseling and Testing :: Obtaining a specimen

What methods are used for getting specimens for HIV antibody testing?

Blood Test
A small amount of blood is drawn from the arm and taken to the lab to be tested. These tests must be performed by a laboratory staff, using sterile equipment and so are only performed in medical settings.

Oral Test
Oral tests can be performed in a doctor's office, clinic, or any other outreach or agency environment, as long as there is privacy. To use an oral HIV test, a swab is placed between the cheek and gum where it is gently rubbed until moist. The swab is collecting oral mucosal transudate, tissue from the inside of the mouth that regenerates regularly. The swab is then placed in a vial and sent to a medical lab for testing. The result is 99.7% accurate, compared to a blood test, which is 99.9% accurate. Saliva is not used in oral testing.

Urine-Based Tests
A urine-based test is also available for screening in a doctor's office or clinic. However, it is somewhat less accurate than the blood or oral tests. Like other tests, the specimen is sent to a lab where an ELISA and Western Blot tests are run. The conditions for testing most of the time are more challenging than for oral tests, so access to this type of testing is limited to a medical setting. Many of these tests can also take part of the urine specimen to test for other STD's.

Other Options

Rapid HIV Test
A rapid test for detecting antibodies to HIV was first approved in the U.S. in 1996. This test produces very quick results, usually in 10 minutes, much faster than the standard HIV test results (ELISA and Western Blot) that are not available for one to two weeks. These rapid tests are increasingly being used because of the faster turnaround time. They also use a blood specimen.

The U.S. Food and Drug Administration currently has licensed only one rapid HIV test called the Single Use Diagnostic System for HIV-1 (SUDS™). Several others are in development. The availability of rapid HIV tests may differ from one place to another.

The rapid HIV test is an ELISA test. Instead of being analyzed in large batches along with other individual tests, the rapid test is analyzed alone. The slightly higher cost is outweighed by a fast result, which reduces the number of people who never return to find out their results.

If the result is negative a person can leave the testing site. However, if the rapid test is positive, other tests, including the Western blot, will be used to confirm the results before the person is told of the presence of HIV infection.

Home Test Kit
Consumer-controlled test kits (popularly known as "home test kits") were first licensed in 1997. Although home HIV tests are sometimes advertised through the Internet, currently only the Home Access Express HIV-1 Test System manufactured by the Home Access Health Corporation is approved by the U.S. Food and Drug Administration (FDA). The accuracy of home test kits other than Home Access - many of which are available online - cannot be verified.

The approved Home Access test kit can be found at most local drug stores. The testing procedure involves pricking your finger with a special device, placing drops of blood on a specially treated card, then mailing the card in to be tested at a licensed laboratory. Customers are given an identification number to use when phoning for the test results. Callers may speak to a counselor before taking the test, while waiting for the test result, and after getting the result.

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