Pregnancy and HIV Testing

What Is HIV?

HIV, or human immunodeficiency virus, is the virus that causes AIDS (acquired immune deficiency syndrome). HIV weakens a person's immune system, reducing his or her ability to fight infections and cancers. A person can get HIV by coming into contact with an infected person's body fluids (blood, semen, vaginal fluids, breast milk), and HIV can be spread through:

  • Vaginal, oral, or anal sex
  • Sharing unclean needles to take drugs
  • Pregnancy (from an infected mother to baby)
  • Blood transfusions (since 1985, blood donations have been routinely tested for HIV, so infection from blood transfusions is rare)

You cannot get HIV from:

  • Touching or hugging someone who has HIV or AIDS
  • Public bathrooms or swimming pools
  • Sharing cups, utensils, telephones, or other personal items
  • Bug bites

How Can I Know If I Have HIV?

There are several types of tests that screen blood (and sometimes saliva) to see if you are infected with HIV.

Newer tests can detect the presence of HIV antigen, a protein, up to 20 days earlier than standard tests. This helps prevent spread of the virus to others and start treatment earlier. It is done with a pinprick to the finger.

Here's a look at available HIV tests:

Standard tests. These blood tests check for HIV antibodies. Your body makes antibodies in response to the HIV infection. These tests can't detect HIV in the blood soon after infection because it takes time for your body to make these antibodies. It generally takes two to 8 weeks for your body to produce antibodies, but in some cases it can take up to six months.

In standard tests, a small sample of your blood is drawn and sent to a lab for testing. Some of the standard tests use urine or fluids that are collected from the mouth to screen for antibodies.

Rapid antibody tests. Most of these are blood tests for HIV antibodies. Some can detect antibodies in saliva. Results are available in under 30 minutes and are as accurate as standard tests. However, it can take up to 8 weeks (or even longer) for your body to produce antibodies.

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Antibody/antigen tests. These tests can detect HIV up to 20 days earlier than standard tests. They check for HIV antigen, a part of the virus that shows up 2-4 weeks after infection. These tests can also detect HIV antibodies. A positive result for the antigen allows treatment to begin earlier and the patient to avoid infecting others. These are blood tests only.

Rapid antibody/antigen test. One antibody/antigen test delivers results in 20 minutes.

In-home test kits. These kits -- there are two available in the U.S. -- screen blood and saliva for HIV antibodies. You can buy them at your local store. The Home Access HIV-1 Test System requires a small blood sample that is collected at home and sent to a lab. The user, who may remain anonymous, can get results by phone in three business days. The OraQuick In-Home HIV Test can detect HIV antibodies in saliva, if the antibodies are present (which can take up to 6 months). The user swabs the upper and lower gums of their mouths, places the sample in a developer vial, and can get results in 20-40 minutes. A follow-up test should be done if the result is positive.

Why Should Pregnant Women Be Tested for HIV?

Doctors recommend all pregnant women get tested for HIV. Medications are available to prevent the spread of the virus to your unborn baby. In addition, steps can be taken during delivery to prevent spreading the infection. Some studies show a woman can further reduce the risk of spreading the virus to her baby by having a cesarean section before her water breaks, if her viral load is high or unknown. Moreover, your health care provider can take steps to help you stay healthy longer.

Is HIV Testing Required?

No. HIV testing is voluntary. Anyone is free to decline testing. Your decision to not get tested, or the test result itself, will not prevent you from getting health care during pregnancy.

Can I Change My Mind About HIV Testing?

Yes. If after giving the blood sample you decide against testing, inform the attending nurse or doctor. Patients who are not hospitalized (outpatients) can withdraw their consent up until they leave the facility. Hospital patients (inpatients) can withdraw their consent up until one hour after the blood sample has been drawn.

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What Do the HIV Test Results Mean?

A confirmed, positive test result means you have been infected with HIV. Being infected with HIV does not necessarily mean that you have AIDS. It can take many years for people with HIV to develop AIDS.

A negative test result means that no signs of HIV infection were found in your blood. A negative test does not always mean that you do not have HIV. Signs of HIV may not show up in the blood for several months after infection. For this reason, you should be tested again if you could have been exposed to HIV or are at risk for HIV infection.

What Happens to My HIV Test Results?

Your HIV test results become part of your medical record. Therefore, the results could be disclosed to third-party payers (such as medical insurance companies) and other authorized parties. A positive test result will also be reported to the appropriate health department.

How Can My HIV Test Results Be Kept Confidential?

Though HIV tests performed at most doctors offices become part of the patient's medical record, there are places you can go that provide confidential HIV testing. These places will perform HIV tests without even taking your name (anonymous testing). An anonymous HIV test does not become part of your medical record.

Should you discover that you have HIV, inform your medical providers so that you can receive proper care.

WebMD Medical Reference Reviewed by Nivin Todd, MD on December 5, 2017

Sources

SOURCES:

The March of Dimes.

The Mayo Clinic. 

CDC: National HIV and STD Testing Resources.

FDA Center for Biologics Evaluation and Research.

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