CERTAINTY CREATES SECURITY – FOR YOU AND OTHERS
It's always good to know what the status is - especially with regard to your own health. An HIV test gives you certainty and security. Of course, one hopes for a negative test result. But if the test result is positive, remember this: even with HIV, you can live a long and healthy life if you start HIV treatment as soon as possible after diagnosis.
By knowing your HIV status, you take responsibility not only for your own sexual health, but also for that of your sexual partners. You need to know that you are infected with HIV or another sexually transmitted disease in order to do something about it. Knowledge is power, and it's the best way to care for your own health and to ensure that you do not pass on the infection to others.
Getting an HIV test can give you peace of mind and a sense of relief. Because even if you consciously try to suppress your thoughts about HIV, the topic can still preoccupy your mind and create a permanent feeling of insecurity under the surface. It's much better to gain clarity by getting tested for HIV or other sexually transmitted diseases – regularly if necessary. By doing so, you are taking an important step in maintaining your sexual and mental health and that of your sexual partners!
WHEN SHOULD I GET TESTED?
SITUATIONS IN WHICH AN HIV TEST IS RECOMMENDED
Only a test can reliably rule out an HIV infection. Depending on how sexually active you are, it doesn't hurt to get tested multiple times, i.e. at regular intervals, of course always based on your own sense of risk. Knowing your HIV status automatically benefits your sexual health, and helps you have a more relaxed approach around your sexuality. It doesn't matter what kind of sex you have or how many partners you have.
An HIV test really makes sense in the following five cases:
if you are sexually active with multiple sexual partners. The larger the circle of people you have sexual contact with, the higher the probability that someone among them is HIV positive. Therefore, it may be a good idea to get tested for HIV and other sexually transmitted diseases at regular intervals (for example, every six months or once a year).
if you have recently had high-risk exposure. A high-risk contact could mean a broken condom during sex with a person whose HIV status you do not know. In the next section, you will learn about the different time windows that must be observed between a high-risk contact and a test in order for the test to provide a meaningful result. Types of tests.
If you notice changes in your body that don't seem normal. You should be extra cautious if, for example, you notice unexplained weight loss, have frequent diarrhoea or suffer from fungal infections in the mouth and throat. These symptoms could mean that your immune system is weakened by an HIV infection. Symptoms like this that can indicate HIV are called "indicator conditions". If you notice any of these changes, you should see a doctor to have them checked. You can read more about the link between HIV infection and the immune system in the section “Phases of HIV infection“.
Sometimes an HIV infection is initially confused with the flu because the symptoms in the acute phase can be similar. The most common signs of acute HIV infection, listed in order of severity, are:
Image: Description of the most common symptoms of acute HIV infection (modified according to Hecht1)
If you are unsure about your HIV status or are worried that you may have aquired HIV. Gaining clarity is always better than worrying.
If you are pregnant, you should also get an HIV test. It is best to speak to your gynaecologist about this.
There are different types of tests: some can detect a possible infection as early as two weeks after a high-risk exposure, while others can only rule out HIV infection after six or twelve weeks. The time at which a specific test delivers a reliable result depends, among other things, on when you experienced a high-risk situation. For more information on the different tests available, how they work and what you need to consider, you will find an overview of the individual test types in the next section.
HOW DO THE TESTS WORK?
The types of tests
An HIV test is often an antibody screening test. This means that the test does not look for the HIV virus directly, but for antibodies that the human body has produced as a defence against the HIV viruses. The antibody screening test is often referred to as a reactivity test and means: if this initial test is reactive (i.e. the test result is positive and therefore indicates that there is a high probability of an HIV infection), a second test, known as a confirmation test, is always carried out to be on the safe side. The confirmation test, which is always carried out using a different method, is intended to rule out any false positive results.
Image: Schematic representation of the HIV testing process
The five most common testing methods are:
HIV laboratory test: Here, at a testing site (for example in a doctor's office, at the health department, at a checkpoint or at a regional German AIDS Foundation contact point), blood is taken from the vein in the crook of the arm and sent to a laboratory. You usually get the results after a few days. If the test is positive, a second laboratory test must be done to confirm the result. The HIV laboratory test can be performed at the earliest two weeks after a possible high-risk contact to identify whether you are HIV positive. However, a reliable negative result, i.e. a certain confirmation that one is NOT infected, is only possible six weeks after a high-risk contact. This time window between risky contact and testing should be kept in mind.
Rapid HIV test: This test is also performed at a testing site. With a little drop of blood froma fingertip prick, you will have a result in just a few minutes. If the rapid test is positive, the result must also be confirmed to be absolutely sure. For this purpose, a second blood sample is sent to the laboratory. It will then take a few days for the result of this confirmatory test to be available. The rapid HIV test can only detect an HIV infection three weeks after possible infection. However, the rapid test can only give a reliable statement that you are NOT infected at least twelve weeks after a high-risk situation.
HIV self-test: The HIV self-test is basically a rapid HIV test, with the difference being that you can do it yourself at home and do not need to go to a testing site. You can get an HIV self-test kit from a HIV community support group, in pharmacies and chemist’s or online. To perform the test, you prick a fingertip, take a small amount of blood and place it onto a test strip. After a few minutes you can read the result. Please follow the instructions exactly. If the self-test is positive, this result must also be confirmed by a laboratory test. You can then contact one of the testing sites. Like the HIV rapid test, the self-test cannot be reliably performed until at least twelve weeks after a high-risk contact to confirm with certainty that you are NOT infected with HIV.
Mail-in HIV test: The mail-in test (e.g. the test from s.a.m health) is carried out at home but with some differences compared to the HIV self-test described above:
- The test offer includes competent advice.
- With the mail-in test, you can test not only for HIV, but also for other sexually transmitted diseases (gonorrhoea, also known as "the clap", syphilis and chlamydia).
- The test result is not read immediately at home directly from the test kit; instead, you take the samples yourself and then send them to a laboratory. There, the samples are examined in detail. This means that the mail-in test provides a more reliable result than the self-test kits that you can get from a HIV community support group, pharmacies, chemist's or on the Internet.
- With the test service, you have the option of being reminded of a test on a regular basis and testing yourself again.
This is how it works: after registering in the s.a.m health online portal and completing a short telephone or personal consultation with an s.a.m health advisor, you will receive a test set discreetly by post. You use this to take samples (blood from the fingertip, urine and swabs) at home and then send them in a prepared envelope to the professional partner laboratory. If the results are negative (i.e. if the tests show no evidence of the presence of any of the infections tested), you will receive an SMS with this information. If the result is positive (i.e. if one of the tests sent in shows that an infection is present), you will be asked to call back. This gives you a direct point of contact who can tell you the right people to contact for treatment of the detected infection. After either three, six or twelve months, you will be asked again via SMS whether you would like to have another test set sent to you. This way you can take care of your sexual health discreetly, conveniently and regularly.
HIV PCR test: unlike the four tests described above, this test does not detect HIV antibodies, but the HIV viruses themselves. The PCR test is usually used as a confirmatory test after an HIV antibody test has shown a positive result. It can also be used to monitor the extent to which HIV treatment that has already been started is successful. As a further option, the PCR test can also be used directly as an initial HIV test (instead of an antibody test) - although this is often too expensive and therefore not possible. The advantage of this test is that an infection with the HIV virus can be detected just two weeks after high-risk contact. If there is a reasonable suspicion of exposure, the costs of a PCR test are usually covered by the health insurance company. So if you speak openly with your doctor about a possible risk or HIV infection, you do not have to bear the costs of the PCR test yourself.
Other STD tests
STD (sexually transmitted diseases), also known in this context as STI (sexually transmitted infections, both mean the same as the older term "venereal disease"). In addition to HIV infection, sexually transmitted diseases include hepatitis, gonorrhoea, syphilis, chlamydia and herpes.
Typical symptoms of a sexually transmitted disease are:
- discharge from the vagina, urethra or rectum (intestine)
- burning or pain when urinating, itching
- ulcers, blisters, nodules or warts on the genitals, on or in the mouth, in the anal region or on other parts of the body
- redness or whitish to yellowish deposits in the mouth, on the genitals or in the anal region
- pain and swelling on the genitals
- swollen lymph nodes in the groin or in the area around ulcers
- unusual skin changes, for example weeping spots, rashes, redness
All of these infections can be detected by a test performed by your family doctor, gynaecologist or urologist and then treated accordingly. Many of the contact points where HIV tests can be carried out—checkpoints, HIV community support group, health authorities—also offer tests for other sexually transmitted infections. Another possibility is the mail-in test, which includes an HIV antibody test as well as testing for gonorrhoea, syphilis and chlamydia.
More detailed information on sexually transmitted diseases is available in this brochure from the German AIDS Foundation:
If you suspect that you have been infected with a sexually transmitted disease other than those listed above (for example, fungal infections or genital warts), talk to your doctor about it. Depending on the infection, there are different methods to detect it. Sometimes a simple visual diagnosis is enough, but often a swab is taken, a urine sample is tested or blood is taken from a vein and examined in the laboratory.
Fortunately, most sexually transmitted diseases are quite easy to treat and usually curable. The prerequisite, of course, is that they are detected early. Therefore, regular testing is recommended not only for HIV, but also for other sexually transmitted diseases. Being well informed can help you protect your health and the health of your sexual partners, and help you enjoy a healthy sex life.
There are also different ways to prevent sexually transmitted diseases. The condom or female condom doesn't just protect against HIV, but also against infection with other sexually transmitted diseases such as gonorrhoea, syphilis or chlamydia. There is also a vaccination against human papillomaviruses (HPV for short). It is best to speak to your gynaecologist about this.
At testing sites
If you want to do an HIV test locally, you can choose between different contact points, testing sites: At home or with a specialist, at the health department, at the regional offices of the German AIDS Foundation ("local AIDS assistance") or at checkpoints. The latter is a open access counselling and testing service offered by various organisations that you can find in many German cities.
Testing centres usually offer the opportunity to be tested for other sexually transmitted diseases (STDs) at the same time as the HIV test. For more information about testing for other sexually transmitted diseases, see the section “Other STD tests“.
At most testing sites—with the exception of doctors' surgeries—testing is anonymous. This means that you do not have to give your name to the facilities and the result will not be recorded in a file.
The tests are usually free of charge at the health authorities. In doctor’s offices they are only free if you have experienced a high-risk situation. At other testing sites it is different; sometimes there is a fee, sometimes not. When deciding where to get tested, you can simply base your decision on what is most important to you, be it accessibility, the lowest possible costs or even discretion and anonymity. If in doubt, you can visit the websites of the various testing sites to find out more or simply call them directly and ask in person.
Here you can find a list of HIV testing sites in Germany:
You can find a list of HIV specialists on the website of the Dagnä (German Association of General Practitioners in the Care of HIV-Infected People):
The HIV home test is a test that you can do on your own. There are two variants:
The HIV self-test, which you can buy at a local AIDS help centre, in pharmacies and chemist's or on the Internet. You carry out the test yourself at home and you'll have the result within a few minutes. If the self-test is positive, the result must be confirmed again by a laboratory test at a testing site. An HIV self-test can be performed at the earliest twelve weeks after a high-risk contact to reliably rule out an HIV infection.
There is also a mail-in test with laboratory analysis (e.g. the test from s.a.m health). This can be ordered online. You will then be sent a test kit and will take the samples yourself at home. You then send these to a laboratory. After the samples have been analysed in the laboratory, you will receive your results via SMS within a few days. If one of the tests detects an infection, you will be asked via SMS to call in to discuss the next steps. The following also applies to the HIV test: if this is positive, a further confirmation test must be carried out at a testing site to be on the safe side.
The advantage of the HIV self-test is that you have the result immediately. However, it should be noted that you can only get a reliable negative test result after the twelve-week window between the high-risk contact and test. The mail-in test, on the other hand, has the advantage that you can also carry out tests for other sexually transmitted infections at the same time and receive discreet advice. You can find more detailed explanations about the HIV self-test and the mail-in test in the subsection “The types of tests“.
WAITING FOR THE TEST RESULT
HOW TO DEAL WITH UNCERTAINTY
After the test, you usually have to wait. Waiting for the test result can seem endless - especially if you have to wait several weeks before you can even get tested. In order to obtain a reliable result, multiple weeks must pass between the high-risk situation and the test, depending on the type of test. Many people worry while they wait, or are afraid of receiving a positive test result. However, you don’t have to go through this alone.
You can get support from those around you to ensure that you do not have to face the insecurities, doubts and fears that may be bothering you alone. It often helps to talk about your worries with someone you trust in order to feel a little freer and more relaxed. Many people feel more comfortable if they have a trusted person with them when they do an HIV self-test or if they bring this person into the testing site with them when they collect their test results. The advantage is that a trusted person can encourage you and, if necessary, support you if the result is not what you had hoped for.
If you do not want to involve anyone in your circle—or if you generally prefer to seek professional help—you can also contact one of the many counselling centres who will assist you in such cases. In addition to the established advisory services of the German AIDS Foundation you can also receive support from Caritas – both in person near you and online. On the website of the awareness campaign “Liebesleben“ run by the German Federal Centre for Health Education, you will find a postcode search function and a map of the counselling services throughout Germany.
POSITIVE OR NEGATIVE?
THE TEST RESULT IS IN – WHAT HAPPENS NEXT?
If your HIV test is negative—meaning NO HIV infection was detected—that is of course very good news. A weight will certainly be lifted from your shoulders. The joy and relief you feel should encourage you to stay informed about HIV and to protect yourself effectively against the virus in the future. You now have the choice of three different prevention methods:
Using condoms during sex.
If you have a sex partner who is HIV positive and is receiving treatment with an undetectable viral load, they cannot pass on HIV to you and you are protected.2,3
Perhaps your positive experience will also motivate you to keep an eye on your sexual health in the future by following these tips:
- Remember to continue to get tested regularly for HIV if this seems necessary given your life circumstances and your individual risk of infection.
Ask your sexual partners to get tested too so they know their HIV status.
- Encourage your friends and family to get tested, especially if they don't yet know their HIV status.
Sure, if your HIV test was positive – that is, if the test (in a second test, known as a confirmation test) shows that an HIV infection has been confirmed – you certainly won't be happy. However, a positive HIV test does not have to be a reason for despair. Always remember: today's modern HIV treatments are so effective and well-tolerated that you can lead a long and healthy life even with HIV.
Take your time, focus on the future and take care of the necessary steps now. That means: inform yourself, get advice and start HIV treatment as soon as possible. You can find out how best to do this in the section “HIV POSITIVE” Test Result – What Now?”
References:
- Hecht FM et al. Use of laboratory tests and clinical symptoms for identification of primary HIV infection. AIDS 2002; 16(8): 1119–1129
- Eisinger RW et al. HIV Viral Load and Transmissibility of HIV Infection: Undetectable Equals Untransmittable. JAMA 2019 Feb 5; 321(5): 451452.
- Leitlinien der European AIDS Clinical Society (EACS), Version 12.0, last updated October 2023. https://www.eacsociety.org/guidelines/eacs-guidelines/eacs-guidelines.html.
NP-DE-HVU-WCNT-250003 – February 2025
