What many people call the "AIDS test" is not really a test for AIDS itself. In fact, there are several tests, all of which detect the presence of antibodies to HIV.

Antibodies are proteins that your body produces in response to an infection --in this case infection with HIV. A window period exists between the time when an individual is infected with HIV, and the time when antibodies to the virus can actually be measured. This window period may be a few weeks or a few months; by six months at least 95% of infected individuals test positive. So it's important to remember that if you've recently contracted HIV, you may not show antibodies when tested. However, if you do have HIV, you are capable of transmitting the virus to others, whether or not you have developed antibodies.

Because of treatment advances, many public health experts strongly encourage anyone who thinks they may be at risk for HIV to seek counseling and testing as soon as possible. The NEA Health Information Network also emphasizes the benefits of early testing and treatment, but offers caution that many HIV-positive people have suffered discrimination in healthcare, employment, housing, and other aspects of their lives due to their diagnosis. It's because of these problems that counseling before the test is important. If you think your behaviors may have put you at risk for HIV, you should seek counseling from your physician or other qualified counselor or healthcare provider. If you need information on where to find testing and counseling sites, contact your local or state HIV program coordinator, or local AIDS hotline. You can also call the National AIDS Hotline: 1-800-342-AIDS.

There are many different types of HIV antibody tests. The most commonly used tests include the "ELISA'' (Enzyme-Linked Immunosorbent Assay), the "Western Blot,'' and the "IFA'' (Immunofluorescent Antibody) tests. Only a small amount of blood is needed for these tests.

What Is the Testing Procedure?

Because it is the most sensitive of available tests, the ELISA test is given first. The ELISA test is very accurate. As with any medical test, errors are possible. Because the ELISA was designed to be highly sensitive, the errors that can be made are those that give a false positive result, indicating that HIV antibodies are present when they are not. To minimize the possibilities of a false positive result, a single positive ELISA test result is not enough to accurately determine if you truly have HIV. One positive ELISA test should be followed by another to confirm the results.

If your blood test is repeatedly positive on the ELISA, then more specific testing is required to confirm results -- either the Western Blot or the IFA test. Two positive ELISA tests and a confirming Western Blot or IFA test indicate the presence of HIV antibodies.

What Do the Test Results Mean?

Positive HIV Antibody Results
A confirmed positive test result means that you have HIV and can transmit the virus to others:

	through anal, vaginal, or oral sex;
	by sharing needles;
	perinatally (to a baby before or at birth) or possibly through breastfeeding;
	by donating blood, plasma, semen, tissue, or body organs.

A positive test result does not mean that you have AIDS. Available data suggest, though, that the great majority of persons who have HIV will eventually develop AIDS in the absence of effective therapy to slow or halt the infection's progression. Nonetheless, many people who have tested positive, while still capable of infecting others, have remained healthy for years after contracting HIV.

When you decide to take the HIV antibody test, counseling is strongly recommended both before and after the test to help you sort out your feelings, maintain a healthy lifestyle, and get appropriate medical attention. Many options are available to persons who have a positive test. It's important that a person at risk for HIV seek testing early and get appropriate medical attention. Early detection and intervention have been proven to prolong the health and lives of persons with HIV.

Negative HIV Antibody Results
A negative test result means that you have not developed antibodies to HIV. It is important to remember the window period between the time when an individual is infected with HIV, and the time when antibodies to the virus can actually be measured. During the window period an individual is capable of transmitting the virus through unsafe sex or needle sharing. Therefore, if you have engaged in any risky behaviors in the six months to one year before being tested, a negative test result may not be accurate. You may want to consider getting re-tested in a few months.

A negative test result does not mean that you are immune to HIV or AIDS or that you cannot contract HIV in the future. It's necessary to continue avoiding those behaviors that transmit HIV regardless of your test result.

If you think your behaviors may have put you at risk for HIV, you should seek counseling to help you decide whether to get tested.

How Can Someone Get Tested?

HIV antibody testing is available through most public health departments, clinics, or private physicians. The National Education Association believes that HIV antibody testing should only be provided on a voluntary basis and with counseling both before and after the test.

Different states have varying policies on HIV antibody testing. Usually, it is offered at little or no cost on either a "confidential'' or "anonymous'' basis.

Confidential testing requires that you give your name, and your test results become part of your private medical records. While all states have taken steps to ensure the confidentiality of your test results, it is possible that your results may be disclosed by a court order, or accidentally by those persons who are permitted access to your private medical records. Most states require the reporting of positive test results to health officials.

With anonymous testing, you do not have to reveal your name or any identifying information; instead, a code number is often used which you must present in person at the test site to receive your results. This arrangement ensures that only you get the results. However, if you test positive and request treatment, you must give a name.

Anonymous testing is often available at clinics or alternative health sites, or through public health departments. At public testing locations, you may have to make an appointment, and there may be a wait. Confidential testing can also be accomplished through private physicians or some biomedical laboratories, however these results may become part of your medical records and may be disclosed without your permission as described above. Additionally, your test results may be disclosed if you sign a blanket release form. Blanket release forms are commonly used by hospitals and insurance companies. And anyone with whom you've discussed your test results may share that information with others.

For more information on the HIV antibody tests, you can contact the AIDS hotline for your state, or one of the national AIDS hotlines (listed in the Resources Section at the back of this handbook).

Whether you take the test or not, and whatever the results, you should avoid putting yourself at risk in the future. Do not engage in risky activities.

NOTE: Information for the above section is based on ``The HIV Antibody Test,'' American College Health Association. Used with permission.