What If My HIV Test Is Positive?

What It Means and Doesn't Mean

Being told you tested positive on an HIV test may seem pretty straightforward and self-explanatory, but it's not necessarily so. While some people may respond by focusing on the immediate task on hand—accessing treatment—others will want a clearer sense of what a positive diagnosis means and doesn't mean.

Woman receiving news from doctor
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This article will walk you through what an HIV-positive diagnosis is and how your doctor reached it so that you can take the next step in dealing with what is today a chronic manageable condition.

How HIV Is Diagnosed

An HIV-positive diagnosis means that tests have confirmed the presence of the human immunodeficiency virus (HIV) in your body. It is a process in which a preliminary test is accompanied by one or more confirmatory tests to ensure an accurate diagnosis.

There are several tests commonly used to diagnose HIV:

  • Antibody tests, also known as enzyme-linked immunoassay (ELISA) tests, are blood- or saliva-based tests that detect antibodies produced by your body in response to HIV. These include traditional blood-based tests that can take several days to return results or rapid saliva-based tests that can return results within 30 minutes.
  • Combination antibody/antigen tests, recommended by the Centers for Disease Control and Prevention (CDC), are blood-based tests that detect both antibodies and a protein on the surface of the virus called p24 (known as the antigen).
  • In-home HIV tests are antibody tests that require either a finger-prick blood sample or a swab of saliva from your mouth. The finger-prick option is a mail-in test that are processed in a lab, while the saliva-based option can return results at home within 20 to 40 minutes.

A positive result with any of these tests would require confirmation using one or more blood-based lab tests recommended by the CDC (among them, the Western blot test, the HIV-1/2 antibody differentiation assay, or the HIV-1 Immunofluorescent assay).

When confirmed with the appropriate tests, a positive result can be considered definitive evidence of an HIV infection.

Recap

HIV is diagnosed with blood tests. If the initial test is positive, meaning that there is evidence of HIV, a confirmatory test will be performed to check for the virus in a different way. If the confirmatory test is also positive, the results can be considered definitive proof that you have HIV.

Inconclusive Results

If you have been diagnosed with HIV, this means that all the necessary tests have been performed to confirm the initial findings. With that said, some tests may not return an accurate result for several reasons:

  • Premature testing: Antibody tests can only diagnose HIV if there are enough antibodies produced by the body; this can take up to 90 days. Newer combination antibody/antigen tests may require up to 45 days. Testing prematurely during the so-called "window period" can return a false-negative result (meaning that you have HIV even if the test says otherwise).
  • User error: In addition to premature testing, in-home saliva-based tests can return a false-negative result if the swab is not performed improperly. While user errors in clinics and doctor's offices are far less common, they can occur due to improper storage or handling of a test.
  • Test limitations: When used as directed, in-office HIV tests are highly accurate. By contrast, home-based tests still have their limitations. The saliva-based Oraquick In-Home HIV Test has a one in 12 chance of a false-negative result. Similarly, finger-prick blood tests can take up to 90 days before enough antibodies are produced for a reliable result.

Despite these concerns and limitations, there are often ways to confirm an infection even if the test results are indeterminate (inconclusive).

There is a test called the nucleic acid amplification test (NAAT) that can detect the virus itself based on the presence of its genetic material. It is an expensive test that can return an accurate result in as early as 10 days of infection and is generally used when there has been a high-risk exposure to HIV but the initial test results are indeterminate.

In the past, doctors would often have to ask people to come back later if a test result was inconclusive, allowing these individuals to "slip between the cracks" if they forgot or were too afraid to return. NAAT testing has helped reduce the risk of this.

What HIV-Positive Means

Ultimately, an HIV-positive diagnosis means that you have been infected with HIV. And while the infection cannot be cured, you can receive treatment to control the virus and prevent it from doing damage to your immune system.

HIV vs. AIDS

An HIV-positive diagnosis does not mean you have AIDS. AIDS is a stage in infection where the immune system is compromised and unable to defend itself against opportunistic infections. This most often occurs when an infection is left untreated.


An HIV diagnosis also doesn't mean you are going to die early. Today, a person diagnosed and treated early can expect to live a normal to near-normal life expectancy. It is for this reason that HIV therapy is started as soon as you are diagnosed.

Moreover, if you are able to fully control the virus—defined as an undetectable viral load—your chances of infecting someone else are reduced to zero. This means you can plan to have a family and get pregnant if you want to.

An HIV test cannot tell you how you got infected, who may have infected you, or when precisely the infection took place.

HIV Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

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Emotions and Coping

If you are diagnosed with HIV, start by allowing yourself to feel exactly what you feel. This may be anger, sadness, regret, guilt, or any other number of emotions. Some people feel simply feel numb, while others express relief to finally know what they are dealing with and what they can do.

All of these emotions are fair and reasonable, although some may take time to sort out. What they hopefully do not do is keep you from seeking life-saving treatment. If you are unable to cope, it is important that you reach out to someone for help and not isolate yourself.

Even if you are not yet ready to share the diagnosis with family or friends, you can speak with a counselor at the testing site, get a referral to a local community health center, or contact doctors in your area who specialize in HIV.

For immediate assistance, you can call the 24-hour HIVInfo hotline at 1-800-HIV-0440 (1-800-448-0440) to access treatment advice or referrals.

Seeking Treatment

The aim of your first doctor's appointment is to find a specialist who is not only knowledgeable and experienced but is willing to forge a long-term partnership with you. This means that information is shared with you completely in a language you understand so that you can make a fully informed choice rather than being told what to do.

Once you find a doctor you can work with, you will be given a series of tests to determine both the status of your immune system and the characteristics of your specific virus. These include:

  • CD4 count, a blood test that measures the strength of your immune system based on the number of white blood cells (called CD4 T-cells) in a sample of blood
  • Viral load, a blood test that measures the number of viruses in a sample of blood
  • Genetic resistance testing, a blood test that identifies the types of genetic mutations your virus has in order to determine which antiretroviral drugs are most effective against it.

Once the right combination of antiretroviral drugs is selected, you will see your doctor regularly to assess your response to therapy, check for side effects, and overcome any barriers to adherence.

Once your viral load is fully suppressed, you may only need to see your doctor every four months to begin and eventually only every six months.

Recap

If you test positive for HIV, your doctor will order a CD4 count to measure how strong your immune system is, a viral load to tell how much virus you have your blood, and a genetic resistance test to determine which combination of drugs are best suited for you based on the genetic makeup of your virus.

Finding Support

Support means different things to different people. To some, it means reaching out for emotional support to better deal with fears and anxieties. To others, it may mean finding ways to cope with the cost of treatment or seeking legal recourse for workplace or housing discrimination.

Whatever the goals, building a support network helps you normalize the disease in your life so that your better ensure your physical and emotional well-being. This may include:

  • Finding the right support group for you as an individual
  • Working with a social worker who can help you access financial or housing assistance as well as legal aid and insurance subsidies
  • Finding a counselor or therapist who can help you deal with stress, depression, relationship issues, stigma, and other emotional concerns
  • Working with your HIV care team to ensure you get the vaccinations, nutritional support, substance abuse treatment, and dental care you may need

Summary

A positive HIV result means that you have been infected with HIV based on the results of a blood test. To ensure that the diagnosis is correct, the initial blood test will be confirmed with a second test that checks for the virus in a different way. If both tests are positive, the diagnosis of HIV infection can be considered definitive.

If an HIV test is inconclusive, you may be asked to come back later for testing when you are outside of the "window period." Or, you may be offered a test called NAAT that can detect the genetic material of HIV, particularly if your likelihood of infection is high.

If you are diagnosed HIV-positive, other tests will be ordered to select the best combination of drugs based on the genetic makeup of your virus. Other tests will be routinely performed to measure the strength of your immune system (CD4 count) and monitor the level of virus in your blood before and during treatment (viral load).

A Word From Verywell

Receiving an HIV-positive diagnosis will almost invariably be a life-changing event. Even so, make every effort not to presume the worst. HIV is a very different disease than it was even 10 years ago, and many of the concerns—from side effects to the cost of treatment—are nowhere near as impactful as they used to be.

Educating is key. By learning as much about HIV as you can and working with your doctor and care team, you can become a master of your disease rather than the other way around.

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7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Centers for Disease Control and Prevention. Laboratory testing for the diagnosis of HIV infection: updated recommendations. Updated June 27, 2014.

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  6. Rodger A., Cambiano V, Bruun T, et al. Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational studyLancet. 2019 Jun 15;393(10189):2428-38. doi:10.1016/S0140-6736(19)30418-0

  7. Department of Health and Human Services. Guidelines for the use of antiretroviral agents in HIV-1-Infected adults and adolescents. Updated August 16, 2021.