HIV Screening: What to Know

Medically Reviewed by Jonathan E. Kaplan, MD on April 14, 2022
4 min read

An HIV screening test checks to see if you’ve been infected with the HIV virus. About 1.2 million people in the U.S. have HIV. But about 1 in 7 people don’t know their HIV status. Also, about 40% of new infections are spread by people who are unaware of their HIV status or haven’t had a test.

Research shows that routine HIV screening can help curb the virus from spreading. Also, if HIV is not caught early and treated, it may lead to AIDS.

Routine screening. The CDC recommends that if you are between the ages of 13-64, you get screened for HIV at least once as part of routine health care. But if you have high risk factors for HIV, you should get tested at least once a year or more frequently.

You might be at high risk for HIV if:

  • You’re a sexually active man who has sex with men.
  • You or your sexual partners inject drugs.
  • Your sexual partner is bisexual.
  • You have sexual partners who have HIV.
  • You have multiple sexual partners.
  • You have sex with partners whose HIV status is unknown.
  • You have sex in exchange for money or something else.
  • You are getting treatment for hepatitis, tuberculosis, or sexually transmitted diseases such as chlamydia, syphilis, or gonorrhea.

The CDC recommends if you are a man who has sex with men, you should get screened every 3-6 months. HIV can also spread from mother to baby during birth and through breast milk. If you’re pregnant, your doctor should order an HIV test.

Even if you don’t specifically ask for an HIV test, you may be advised about HIV screening when you go to a doctor for other reasons. Routine HIV screenings are excellent ways to detect HIV infection early and one of the best methods, along with avoiding risky behaviors, to prevent or slow down HIV infection. There are two types of approaches to routine testing for HIV:

Opt-in. A doctor or nurse will ask you if you’d like an HIV test during a routine visit. You’ll have to provide permission for it, usually in writing.

Opt-out. During your routine visit, a doctor or nurse will notify you that an HIV test is included in the standard preventative screens unless you specifically decline or postpone the test. Opt-out HIV testing, also known as universal screening, is an evidence-based strategy that encourages more testing. The CDC recommends it for adults, adolescents, and pregnant people.

For pregnant people, the recommendations include:

  • Universal opt-out HIV tests early in pregnancy
  • A second test in the third trimester, especially if you’re at high risk for HIV
  • HIV test at labor and delivery if you didn’t get one during the early stage

According to research, routine opt-out screenings are highly effective because they can:

  • Lower stigma associated with HIV testing
  • Promote early HIV diagnosis and treatment
  • Lower risk of transmission
  • Reduce cost

With nearly 15% of those with HIV unaware of their status, experts say regular, routine tests can improve detection of new HIV infections. It can also lower the infection rate and get HIV-positive people started on antiretroviral therapy sooner. This can improve overall quality of life for those living with HIV and prevent transmission of HIV to others.

Justifications for routine screening include:

  • Infection and other serious health problems are detected before symptoms develop.
  • HIV is easily detectable with reliable, inexpensive, and acceptable screening tests.
  • If you are diagnosed with HIV, you can start treatment early and improve life expectancy.
  • The benefits of early detection outweigh screening costs.

HIV screening is usually done as part of regular preventative tests during your annual visit to the doctor. But if you’re more likely to have HIV or think you could’ve been exposed, ask your doctor for a test.

You can also get screened for HIV at several testing sites such as:

  • Community health centers or clinics
  • Sexual health clinics
  • Local health department
  • Family planning clinics
  • VA medical centers
  • Substance abuse prevention or treatment programs

Many pharmacies carry FDA-approved self-testing home kits. You can also buy them online. If you test positive on a self-test, tell your doctor about it. They might do a follow-up test for accurate results.

HIV testing is covered by most health insurances without a copay or approved as part of yearly preventative services at no cost to you. If you don’t have insurance, call your local health clinic. They can point you to free testing sites.

To find a testing site near you, visit or Get Tested.

Possible exposure to HIV. If you think you’ve been exposed to HIV, let your doctor know. They’ll screen you for the virus. If you test negative, your doctor may check to see if you need a medication called PEP (post-exposure prophylaxis). You’ll need follow-up HIV testing for 4-6 months.

If you’re considering taking PrEP (pre-exposure prophylaxis), a medication that’s taken to prevent HIV infection, you’ll need to be tested before you can take it. Once you start PrEP, doctors recommend getting an HIV test every 2-3 months, depending on what type of PrEP you get. The new, injectable type of PrEP (long-acting cabotegravir) is given every 2 months and requires an HIV test each time.

If you do become infected with HIV, within 2-4 weeks after infection, you may notice flu-like symptoms such as:

  • Fever
  • Chills
  • Rash
  • Night sweats
  • Muscle aches
  • Sore throat
  • Fatigue
  • Swollen lymph nodes
  • Mouth ulcers

The symptoms may last a few days or several weeks. But you may not have any symptoms during the early stages of infection. If you develop symptoms, get an HIV test as soon as possible.