HIV testing in the LGBTQ community
Practicing safe sex is essential for everyone. However, individuals who engage in unprotected sexual practices are at a higher risk for exposure to certain sexually transmitted diseases — including human immunodeficiency virus (HIV).
Data from 2019 shows that nearly 70% of new HIV diagnoses in the U.S. were attributed to gay and bisexual men. However, transmission of HIV via practices like unprotected anal sex or unprotected vaginal sex is also high among heterosexual individuals engaging in opposite-sex practices. The bottom line is that unprotected sex is risky for everyone. We want to ensure you have the necessary resources. Let’s discuss HIV testing options for the LGBTQ community and frequently asked questions.
HIV testing options
The CDC recommends that all sexually active gay and bisexual men are tested for HIV at least one to two times per year. Anyone who engages in unprotected sexual practices or is otherwise concerned about being exposed to HIV should also be tested.
Understanding what types of HIV testing are available is the first step to practicing preventive sexual wellness. Currently, there are three types of HIV tests available, but testing and confirmation are done as a two-step process.
The antigen or antibody tests are done first. These are less expensive and have high accuracy but can also have false positive results. When using these types of tests, the goal is never to miss a diagnosis for someone who does have HIV so that they can be appropriately treated.
Next is the nucleic acid test (NAT), which is more expensive but has higher accuracy and is used as a confirmatory test. These tests determine whether the first test was a true positive or a false positive. NATs offer a qualitative yes or no answer to whether the individual has HIV. Once someone is confirmed to be HIV positive, a quantitative test can then be done to determine their viral load numbers.
The three types of HIV tests are explained in more detail below.
Antibody HIV test
An antibody HIV test detects HIV antibodies in your saliva or blood. Antibodies are produced by your immune system when exposed to viruses like HIV.
The quickest antibody HIV test is done using blood from your vein, but it can also be done with a saliva swab or finger stick. Antibody tests are the most common rapid and HIV self-test approved by the FDA.
Antigen/antibody HIV test
An antigen/antibody HIV test looks for antigens and antibodies in your blood. Antigens are foreign substances that trigger the activation of your immune system. An antigen called p24 will be present if you have HIV.
This type of HIV blood test is commonly conducted in labs in the U.S. and can be done by drawing blood from a vein or with a rapid test using a finger stick.
Nucleic acid tests (NATs)
Nucleic acids are naturally occurring chemical molecules that carry information in cells. A NAT looks for the actual HIV virus in your blood to determine whether you are HIV positive or negative, and then can determine how much virus is present, called the HIV viral load. It can detect HIV faster than other tests and is done by drawing blood from your vein, which a lab then analyzes.
This is a good test for people who believe they have had recent HIV exposure, are experiencing early HIV symptoms but have tested negative or are concerned about a false positive with an antibody or antigen/antibody test. It is used as a confirmatory test.
Importance of HIV testing in the LGBTQ+ community
HIV is a global public health crisis that can affect anyone but has a disproportionately higher prevalence among individuals engaging in unprotected sexual practices. While there have been improvements in prevention, detection and management, there is no cure or vaccine for the virus. Thousands of people contract HIV every year, yet many barriers exist that make it difficult to get these numbers down.
Fortunately, knowledge is power, which can help prevent the spread of HIV. Individuals who know they have HIV can receive treatment for it and be healthy for many years. The sooner HIV treatment starts, the more benefits can be experienced.
That’s because once HIV treatment is started, the amount of HIV in the blood can be decreased, which reduces symptoms and helps prevent it from being transmitted to other people. HIV will not be transferred to sexual partners as long as HIV treatment is taken as directed and the viral load remains suppressed and undetectable in the blood.
Additionally, an HIV medicine called PEP, which stands for Pre-Exposure Prophylaxis, has proven effective in preventing HIV among people who don’t have it and want to prevent its contraction.
Safe sex practices and post-exposure prophylaxis
Practicing safe sex is critical for everyone, regardless of sexual orientation. Sexually transmitted infections and diseases, including HIV, can be spread to anyone without appropriate preventive methods.
Some tips for practicing safe sex include:
- Having open and honest conversations with your partner about their sexual history and any concerns of previous exposure as well as current infections.
- Both partners undergo STD/STI screening, including HIV testing, before engaging in sexual activities.
- Fully treating curable STDs/STIs before sex.
- For incurable STDs, like HIV or herpes, speak with your doctor regarding medications that may help lower your chances of spreading it to a partner.
- Always using a condom, as these are highly effective for preventing the spread of STDs/STIs.
For individuals concerned that they may have been exposed to HIV, post-exposure prophylaxis (PEP) is a good preventive option when taken within 72 hours of possible exposure. Whether it was unprotected sex, a condom broke, or you experienced sexual assault, please contact your healthcare provider or emergency room doctor about getting a PEP as soon as possible. PEP is taken daily for 28 days.
Where to get an HIV test
Many places offer HIV testing, like community health clinics, sexual health clinics, family planning centers, local health departments, pharmacies, VA medical centers and some mobile HIV testing center sites.
You can also call 1-800-232-4636 or visit https://gettested.cdc.gov to search for HIV testing centers.
FAQs about HIV testing
Can you take an HIV test at home?
Yes, there are home HIV self-tests available that you can get from your pharmacy, local health department or online. An oral fluid test is the only home test for HIV approved by the FDA. This requires a swab of your gums and provides results in about 20 minutes.
Are HIV tests covered by insurance?
Under the Affordable Care Act, most insurance companies are required to cover certain preventive services. This includes HIV testing for individuals 15-65 or other ages who are at higher risk without a co-pay or additional cost.
Can a normal blood test detect HIV?
Most routine blood tests will not include an HIV screening unless you specifically request to add a sexually transmitted disease panel from your healthcare provider.
Visit Urgent Care for HIV testing needs
Our health system partners are equipped and happy to serve the LGBTQ+ community. This includes testing for HIV, STD/STI panels and prevention services around sexual health and wellness. Click here to find a local provider from one of our health system partners at a center near you.
Resource Links
https://www.cdc.gov/hiv/group/msm/msm-content/diagnoses.html
https://hivinfo.nih.gov/understanding-hiv/fact-sheets/hiv-and-gay-and-bisexual-men
https://www.hrc.org/resources/hrc-issue-brief-hiv-aids-and-the-lgbt-community
https://www.hiv.gov/hiv-basics/hiv-testing/learn-about-hiv-testing/where-to-get-tested/
https://www.cdc.gov/hiv/basics/hiv-testing/hiv-self-tests.html
https://www.hiv.gov/federal-response/policies-issues/the-affordable-care-act-and-hiv-aids/