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Viral STI

HIV/AIDS testing

HIV is manageable now — but only if you know your status. About 1.2 million Americans live with HIV, and roughly 13% don't know it. The science has caught up: with one pill a day, people with HIV reach an undetectable viral load and can expect a near-normal lifespan. <strong>U=U — Undetectable = Untransmittable</strong> — means a person on effective antiretroviral therapy cannot sexually transmit HIV to their partners. Testing is the first step. Compare private labs, at-home tests and free clinics below, or jump straight to testing near you.

Americans living with HIV
1.2M
~13% don't know their status
New diagnoses (2022)
~39,000
CDC estimate
Effective on ART
U=U
Undetectable = Untransmittable
Life expectancy on ART
Near-normal
when diagnosed and treated early

Where to get tested

Find HIV/AIDS testing near you

Choose your test and enter your city — we'll take you straight to local HIV/AIDS testing: nearby clinics and labs, prices, hours and county rates.

Test from home

At-home STD testing in the U.S.

if you'd rather skip the trip, an at-home kit ships to the U.S., you collect the sample privately, and mail it back to a CLIA-certified lab. Results come online in days, with a clinician available if anything is positive. Same labs as a clinic, no waiting room — and you can read how accurate at-home STD tests are before you order.

Want a free option first? The CDC-supported TakeMeHome program mails free at-home HIV self-test kits — and, in many areas, free STI kits — to your door, with no insurance or payment needed. The paid kits below add broader panels and faster turnaround.

  • Best range — couples & full panels

    myLAB Box

    $79 & up

    Screens for:
    Up to 14 infections — incl. HIV, syphilis, chlamydia, gonorrhea, hepatitis & herpes
    Sample:
    Self-collect: swab, urine, finger-prick
    Results:
    2–5 days, online
    • Free phone consult if positive
    • CLIA-certified labs
    • Couples & subscription options
    • Discreet packaging
    Order online myLAB Box review

  • Best for simplicity & support

    LetsGetChecked

    $89 & up

    Screens for:
    5–6 common STIs incl. chlamydia, gonorrhea, HIV, syphilis & trichomoniasis
    Sample:
    Finger-prick + urine/swab
    Results:
    2–5 days, online
    • 24/7 nurse support
    • Prescription for positives
    • CLIA-certified labs
    • Free shipping both ways
    Order online LetsGetChecked review

  • Best value — single tests

    Everlywell

    $49 & up

    Screens for:
    Chlamydia & gonorrhea, up to a 6-test panel adding HIV, syphilis, trichomoniasis & hep C
    Sample:
    Finger-prick + swab
    Results:
    Days, online
    • Telehealth visit if positive
    • CLIA-certified labs
    • HSA/FSA eligible
    • Subscription savings
    Order online Everlywell review

Every kit uses CLIA-certified labs. At-home testing is for screening; a reactive result should be confirmed and treated by a clinician. Prices and panels shown are illustrative and change often — confirm current details on the provider's site.

Understanding HIV/AIDS

What is HIV/AIDS?

HIV (Human Immunodeficiency Virus) is a virus that targets the immune system — specifically the CD4+ T cells that coordinate the body's defenses against infections and cancers. The virus hijacks those cells, replicates inside them and destroys them. Without treatment, CD4 counts fall by roughly 50–100 cells per microliter each year, gradually dismantling immunity until the body can no longer fight off organisms that a healthy immune system handles effortlessly. That endpoint — a CD4 count below 200 cells/µL or the appearance of an AIDS-defining illness — is what clinicians call AIDS (Acquired Immunodeficiency Syndrome). Untreated, the median time from infection to AIDS is about ten years; median survival after AIDS without treatment is two to three years.

Modern antiretroviral therapy (ART) has changed that trajectory completely. The first-line regimens today are a single tablet taken once daily. They don't cure HIV — the virus remains latent in reservoirs — but they suppress replication so thoroughly that the viral load becomes undetectable in the blood, the immune system reconstitutes, and the person can expect a lifespan approaching that of an HIV-negative peer. The landmark finding of the last decade is U=U: Undetectable = Untransmittable. A person on ART who sustains an undetectable viral load cannot sexually transmit HIV. That finding, backed by large multinational clinical trials (PARTNER, PARTNER2, Opposites Attract — zero transmissions across tens of thousands of condomless sex acts), has reframed HIV from a source of shame and fear into a manageable condition with powerful prevention tools.

In the United States, approximately 1.2 million people live with HIV. About 39,000 new diagnoses occur each year (2022 CDC data), with disproportionate impact on gay and bisexual men, Black and Latino communities, and young people aged 13–24. Roughly 13% of those infected don't know their status — and undiagnosed people account for a disproportionate share of ongoing transmission. Testing is the entry point to everything: to treatment, to U=U, to PrEP for partners, and to the epidemiological control the US has yet to achieve.

Screening guidance

Who should get tested for HIV/AIDS?

Because HIV/AIDS is usually silent, the CDC and U.S. Preventive Services Task Force recommend routine screening for the groups most likely to have it — not just people with symptoms.

  1. 1

    Everyone aged 13–64 — at least once in their lifetime

    The CDC and USPSTF recommend a routine HIV screen for every person aged 13–64 as part of standard healthcare, regardless of perceived risk. About 13% of people with HIV in the US don't know — routine testing is what closes that gap. You don't need to identify as high-risk to get tested; HIV testing is as routine as a blood pressure check.

  2. 2

    Gay, bisexual and other men who have sex with men (MSM)

    The CDC recommends testing at least once a year, and every 3–6 months for those with multiple or anonymous partners, partners of unknown status, or who use stimulant drugs during sex. MSM account for 68% of new HIV diagnoses in the US — not because gay sex transmits HIV more inherently, but because of network effects and structural inequities in access to care and prevention. PrEP is a game-changer for this group.

  3. 3

    People who inject drugs

    Sharing injection equipment is one of the most efficient HIV transmission routes. Test at least once a year, use sterile equipment (available at syringe services programs and most pharmacies without a prescription), and ask a clinician about PrEP. Naloxone access and medication-assisted treatment for opioid use disorder are also part of a comprehensive harm-reduction approach.

  4. 4

    People with HIV-positive partners or recent STIs

    An HIV-positive partner who is NOT yet on treatment or has a detectable viral load creates real transmission risk. If your partner has HIV, get on PrEP — it reduces your risk by more than 99%. A recent syphilis, gonorrhea, herpes or chlamydia diagnosis also warrants an HIV test: genital sores and inflammation are biological highways for HIV in both directions.

  5. 5

    Pregnant people

    HIV screening is recommended at the first prenatal visit and again in the third trimester in higher-prevalence settings. With ART throughout pregnancy, labor, and delivery — and infant prophylaxis after birth — the risk of transmitting HIV to the baby falls below 1%. A diagnosis during pregnancy is not a reason for panic; it's the start of highly effective management for two patients.

  6. 6

    Anyone with a potential recent exposure

    If you think you were exposed to HIV in the last 72 hours — a condom break with a partner of unknown status, a needlestick, or sexual assault — go to an emergency department or urgent care immediately for PEP (post-exposure prophylaxis) without waiting to test first. PEP must start within 72 hours to be effective, and sooner is always better. After completing PEP, test at 45 and 90 days to confirm it worked.

Symptoms

What are the symptoms of HIV/AIDS?

Most people with HIV have no symptoms during the chronic phase, which can last a decade or more without treatment. The only reliable way to know your status is to test — symptoms cannot tell you whether you have HIV. Acute HIV symptoms, when they appear, begin 2–4 weeks after exposure and typically last 1–4 weeks. They mimic a severe flu or mononucleosis and are often dismissed as such. After the acute phase, symptoms disappear and most people feel completely well for years while the virus continues destroying CD4 cells. That's exactly why testing matters — you can have it, pass it on, and never feel a thing.

Acute HIV infection (2–4 weeks after exposure)

  • High fever (often above 38°C / 100.4°F) — usually the dominant symptom
  • Severely swollen lymph nodes in the neck, armpits and groin
  • Debilitating fatigue described as the worst of one's life
  • Rash — flat, non-itchy reddish rash typically on the trunk, sometimes face and limbs
  • Sore throat, severe headache, muscle and joint aches
  • Painful ulcers in the mouth or on the genitals
  • Drenching night sweats
  • Many people have mild or no symptoms and never connect this phase to a possible HIV exposure

Chronic HIV / clinical latency (months to years)

  • Often completely asymptomatic — the person feels entirely well
  • Some develop persistent, painless lymph node enlargement (persistent generalized lymphadenopathy)
  • Without ART, CD4 counts decline gradually; below 500 cells/µL, some opportunistic infections begin
  • HIV is fully transmissible during this phase despite the absence of symptoms

Advanced HIV / AIDS (without treatment)

  • Dramatic, unexplained weight loss — more than 10% of body weight
  • Recurrent or prolonged fever and drenching night sweats
  • Chronic diarrhea lasting more than a week
  • Persistent, severe fatigue and extreme weakness
  • Thrush (oral candidiasis) — white coating or sores on the tongue and inside the mouth
  • Opportunistic infections: PCP pneumonia, toxoplasmosis of the brain, CMV retinitis, cryptococcal meningitis
  • AIDS-defining cancers: Kaposi's sarcoma (dark skin lesions), non-Hodgkin's lymphoma, invasive cervical cancer
  • Neurological symptoms: memory problems, confusion, coordination difficulties (HIV-associated neurocognitive disorder)

Acute HIV symptoms — if they appear — resolve without treatment and do not mean the infection has cleared. They mark the moment when the viral load is at its peak and the person is at their most infectious. Anyone who suspects acute HIV exposure, especially with these symptoms 2–4 weeks later, should seek immediate testing with an HIV RNA (NAT) test — standard antibody tests will be negative at this stage.

Disease progression

How does HIV/AIDS progress?

HIV/AIDS progresses through distinct stages — each with different symptoms, contagiousness, and consequences. Catching it early means a simpler cure; the later stages require more aggressive treatment and carry serious risks.

  1. 1

    Acute HIV Infection

    2–4 weeks after exposure Contagious

    Immediately after infection, the virus replicates explosively throughout the body, and the viral load in the blood reaches its highest level of the entire infection. The immune system mounts a furious response that drives the viral load down temporarily but cannot clear the virus. This is the most infectious period — the risk of transmitting HIV to a partner is dramatically elevated. Only an HIV RNA (NAT) test can detect the virus at this stage; antibody tests will still be negative. Many people experience acute retroviral syndrome (ARS), which resembles severe flu or mono. Even those who never recognize any symptoms are highly contagious.

    • High fever (>38°C)
    • Severe fatigue
    • Swollen lymph nodes (neck, armpits, groin)
    • Rash on trunk, face or limbs
    • Sore throat, headache
    • Muscle and joint aches
    • Oral or genital ulcers
    • Night sweats
  2. 2

    Chronic HIV Infection (Clinical Latency)

    Months to years after acute stage Contagious

    After the acute phase, the viral load stabilizes at a lower level (the 'set point'), and most people feel entirely well — sometimes for a decade or more. This is not a latent infection in the biological sense; the virus continues replicating actively, and CD4 counts decline at roughly 50–100 cells/µL per year without treatment. The person can transmit HIV to partners throughout this phase. With ART, this stage can last indefinitely — viral load drops to undetectable, CD4 counts stabilize or recover, and the person cannot transmit HIV sexually (U=U). Without ART, most people progress to AIDS within 10 years; a minority of 'long-term non-progressors' maintain CD4 counts without treatment for much longer.

    • Usually none
    • Persistent, painless lymph node swelling in some people
    • Mild, recurrent infections as CD4 count falls below 500 cells/µL
  3. 3

    AIDS (Acquired Immunodeficiency Syndrome)

    If CD4 count drops below 200 cells/µL or an AIDS-defining illness occurs Contagious

    AIDS is not a separate infection — it is the late stage of untreated HIV, defined by a CD4 count below 200 cells/µL or the diagnosis of an AIDS-defining condition. At this level of immune suppression, organisms that a healthy immune system ignores become life-threatening opportunistic infections. AIDS-defining conditions include PCP pneumonia (caused by Pneumocystis jirovecii), toxoplasmosis of the brain, CMV retinitis (causing blindness), Kaposi's sarcoma, cryptococcal meningitis, MAC (Mycobacterium avium complex) infection, and esophageal candidiasis. Without treatment, the median survival after an AIDS diagnosis is 2–3 years. AIDS is NOT a death sentence with modern ART — starting antiretroviral therapy even at this advanced stage initiates immune reconstitution, and many people recover substantially, though some complications can leave permanent damage.

    • Dramatic weight loss
    • Recurrent high fevers and night sweats
    • Chronic diarrhea
    • Extreme fatigue
    • Opportunistic infections (PCP pneumonia, toxoplasmosis, CMV retinitis, cryptococcal meningitis)
    • AIDS-defining cancers (Kaposi's sarcoma, lymphoma, invasive cervical cancer)
    • Neurological deterioration (HIV dementia, peripheral neuropathy)

Left untreated

Why HIV/AIDS is worth catching early

Treated early, HIV/AIDS clears with antibiotics and causes no lasting harm. Left untreated, it can climb into the reproductive tract and beyond:

AIDS and opportunistic infections

Untreated HIV progresses to AIDS, characterized by a CD4 count below 200 cells/µL and vulnerability to organisms that a healthy immune system handles effortlessly. PCP pneumonia, toxoplasmosis of the brain, CMV retinitis (which causes blindness), cryptococcal meningitis and Mycobacterium avium complex are the most feared — and they were the primary causes of HIV-related death before ART. Starting ART even after an AIDS diagnosis allows the immune system to reconstitute and reduces the risk of future opportunistic infections dramatically.

AIDS-defining cancers

Kaposi's sarcoma (caused by HHV-8, producing characteristic dark skin and mucosal lesions), non-Hodgkin's lymphoma, and invasive cervical cancer are AIDS-defining malignancies. People with HIV also have elevated risk for additional cancers — anal, liver, lung, and oropharyngeal — likely related to co-infections (HPV, HBV, HCV) that are less well controlled by an impaired immune system. ART and routine cancer screening reduce this risk substantially.

Cardiovascular and metabolic disease

Even with ART and undetectable viral load, people with HIV have modestly elevated risk of cardiovascular disease, kidney disease, osteoporosis and metabolic syndrome — likely from a combination of chronic low-level immune activation, some antiretroviral medications' effects, and social determinants (higher rates of smoking, stress) in affected communities. Modern ART regimens are designed to minimize metabolic side effects, and cardiovascular risk management is part of routine HIV care.

HIV-associated neurocognitive disorder (HAND)

HIV crosses the blood-brain barrier and can cause a spectrum of cognitive effects ranging from subtle processing-speed slowing (asymptomatic neurocognitive impairment) to, rarely, HIV-associated dementia. ART dramatically reduces the risk of severe HAND. Mild cognitive complaints are still reported in some people on fully suppressive ART — an active area of research into residual neuroinflammation.

Increased vulnerability to other STIs

HIV impairs the mucosal and systemic immune response, making people with HIV more susceptible to other sexually transmitted infections — and more likely to develop severe or atypical presentations. Reciprocally, an active STI (particularly ulcerative ones like syphilis and herpes) increases HIV RNA in genital secretions, making a person with HIV more likely to transmit to partners. Co-management of HIV and STIs is essential.

Perinatal transmission (without treatment)

Without ART, an HIV-positive pregnant person transmits HIV to their baby in 15–45% of cases (through pregnancy, delivery, and breastfeeding). With optimal ART throughout pregnancy and labor, plus infant antiretroviral prophylaxis after birth, the risk drops below 1%. A cesarean section is recommended when viral load is above 1,000 copies/mL near delivery. Breastfeeding is generally avoided in resource-rich settings where safe formula feeding is available, though guidelines differ for settings where safe water and food are not guaranteed.

Mental health and stigma

Depression, anxiety, and post-traumatic stress are significantly more common in people with HIV — driven both by direct neurological effects and by the profound social stigma the diagnosis still carries. Stigma delays testing, delays treatment initiation, and reduces adherence to ART. Addressing mental health is as clinically important as viral load monitoring; many HIV clinics now offer integrated behavioral health services.

U.S. data

How common is HIV/AIDS in the U.S.?

Gay, bisexual, and other men who have sex with men account for 68% of new HIV diagnoses. Black/African American individuals are disproportionately affected — 42% of new diagnoses while representing 13% of the population. With modern ART, people diagnosed with HIV and started on treatment early can expect near-normal lifespans.

39k
New HIV diagnoses (US) (2022)
1.2M
People living with HIV in the US

Where you test and what it costs vary by location — see the by-location links below for HIV/AIDS testing where you live. Source: CDC HIV Surveillance Report 2022.

How testing works

How a HIV/AIDS test works

HIV/AIDS is detected with a nucleic-acid amplification test (NAAT) — the most accurate method — on a urine sample or a swab. You can do it at a lab, a clinic, or at home.

When to test

For the most reliable result, test at least 45 days after potential exposure using a 4th-generation combo test — a negative at 45 days rules out infection from that exposure. If you used an older antibody-only test or an oral rapid test (OraQuick), wait 90 days for a definitive result. For any high-risk exposure within the last 72 hours, see a clinician or emergency department immediately for PEP — do not wait to test first. PEP must start within 72 hours and works best started within hours.

After treatment

If negative at 45 days with a 4th-gen test, no further testing is needed for that specific exposure. Continue routine annual testing (or every 3–6 months if you have ongoing risk factors such as multiple partners, recent STIs, or inject drugs). A reactive result on any test — including rapid or at-home tests — must always be confirmed with a follow-up lab test before starting treatment or making clinical decisions.

4th-generation antigen/antibody combo test Most accurate
Sample
Blood draw (venous or finger-prick)
Results
1–3 days

The current standard HIV test at virtually all labs and clinics. Detects both HIV p24 antigen (a viral protein present even before antibodies develop) and HIV-1/HIV-2 antibodies. Reliable at 45 days; detects about 80% of infections by day 23 and more than 99% by day 45. This is the CDC-preferred method for HIV diagnosis.

HIV RNA (NAT/NAAT) Earliest detection
Sample
Blood draw
Results
1–3 days

Detects the virus's genetic material directly — the earliest possible detection at 10–33 days post-exposure. Used when acute HIV is suspected (recent high-risk exposure + flu-like symptoms), for blood-supply screening, and in people who may have been exposed very recently. Not routine screening due to cost (~$150–300) and must be specifically ordered by a clinician. A negative at 33 days after a single exposure is highly reassuring.

Rapid antibody test (clinic/fingerstick)
Sample
Finger-prick blood or oral fluid
Results
20–30 minutes

Available at clinics, health departments and some pharmacies without an appointment. Results in about 20 minutes. These are antibody-only tests with a window period of 23–90 days — less sensitive than the 4th-gen lab test in the 23–45 day window. A reactive (positive) rapid test result must always be confirmed with a lab test before starting treatment.

At-home self-test (OraQuick) Most private
Sample
Oral swab (self-collected)
Results
~20 minutes

FDA-approved, available over-the-counter at pharmacies (~$40) or free through some health programs. Uses an oral fluid swab; results in about 20 minutes at home. Window period of 23–90 days. Sensitivity is slightly lower than lab tests (~92% vs 99%+) — a negative result in the 23–90 day window should be confirmed with a lab test if exposure was recent. A reactive result requires a confirmatory lab test.

Mail-in / at-home kit (lab-analyzed)
Sample
Finger-prick blood spot (self-collected, mailed to lab)
Results
2–5 days

Combines the privacy of at-home collection with the accuracy of a lab-analyzed 4th-generation test. You collect a dried blood spot at home and mail it to a CLIA-certified laboratory; results are returned online. More sensitive than oral-swab self-tests and has the same 45-day window as the standard 4th-gen test.

3rd-generation antibody-only test (older)
Sample
Blood draw
Results
1–3 days

An older test still used in some settings. Detects antibodies only (IgG and IgM), not p24 antigen — making it less sensitive in the 18–45 day window compared to 4th-gen tests. Reliable at 90 days. If you're told your test is 'antibody-only,' wait 90 days from your last potential exposure for a conclusive result.

What it costs: ~$24–$80 for a 4th-generation antigen/antibody test at a private lab (order online, walk in with no appointment); at-home oral-swab self-tests (OraQuick) ~$40 over the counter at pharmacies; mail-in lab-quality kits ~$79–$150. Free HIV testing is widely available at health departments, community health centers, Planned Parenthood, and CDC-funded community sites — find one at gettested.cdc.gov. The federal government provides free at-home tests to eligible individuals through programs like GetYoursAtHome.HealthCare.gov. ACA-compliant plans cover HIV screening at no out-of-pocket cost for all adults and adolescents. PrEP (the prevention medication) is covered with no cost-sharing under the ACA as preventive care; manufacturer patient assistance programs make PrEP available at $0 for uninsured individuals.

If your result is positive

How is HIV/AIDS treated?

There is no cure for HIV, but <strong>antiretroviral therapy (ART)</strong> has transformed it from a fatal illness into a manageable chronic condition. Modern first-line regimens are one pill taken once daily — typically an integrase strand transfer inhibitor (INSTI)-based combination such as bictegravir/emtricitabine/tenofovir alafenamide (Biktarvy) or dolutegravir-based regimens. For people who prefer non-daily dosing, long-acting injectable cabotegravir + rilpivirine (Cabenuva) is given every two months in a clinic. The goal of ART is to suppress the viral load below the level of detection (typically <20–50 copies/mL). At that threshold, the immune system reconstitutes — CD4 counts rise, opportunistic infection risk drops dramatically, and U=U applies: the person cannot sexually transmit HIV. ART is recommended as soon as HIV is diagnosed, regardless of CD4 count. Most people achieve viral suppression within 3–6 months of starting treatment. ART does not eliminate the virus from reservoirs — it must be taken lifelong.

Treat partners

Every sexual partner and needle-sharing partner should be tested for HIV. If an HIV-negative partner is in a relationship with someone who has HIV, PrEP (pre-exposure prophylaxis) reduces their risk by more than 99% when taken consistently — and if their partner is already undetectable on ART, U=U provides additional protection. Partner notification services through state and local health departments can help notify partners confidentially. Disclosure laws vary by state — some states criminalize HIV exposure even without transmission; knowing your local law and speaking with an HIV-knowledgeable clinician or legal advocate is worth doing.

In pregnancy

Pregnant people with HIV should be on ART throughout pregnancy, labor, and delivery. With optimal viral suppression, the risk of transmitting HIV to the baby falls below 1%. Infants born to HIV-positive parents receive a short course of antiretroviral prophylaxis after birth. Elective cesarean section is recommended if viral load is above 1,000 copies/mL near delivery. In resource-rich settings, formula feeding is generally recommended to eliminate breastfeeding transmission risk, though with well-controlled viral load on ART, some guidelines now permit breastfeeding with careful monitoring.

Re-test after treatment

Once on ART, viral load is measured at 2–8 weeks after starting treatment, then every 3–6 months until undetectable, then every 6–12 months once stable suppression is established. CD4 count is monitored less frequently once immune reconstitution is established — typically every 12 months when CD4 count is above 500 cells/µL. Routine STI screening (syphilis, gonorrhea, chlamydia, hepatitis) is done at least annually and more frequently in those with ongoing risk factors, as STIs increase HIV transmission risk even in people who are virally suppressed.

Treatment & online care

Resistance note: HIV can develop resistance to individual antiretrovirals, which is why taking every dose as prescribed is essential — missed doses allow the virus to replicate and select for resistant variants. Resistance testing is performed before starting treatment and whenever viral load rebounds on therapy. Modern regimens, particularly INSTI-based combinations, have very high genetic barriers to resistance: a single point mutation is generally not enough to confer resistance, unlike older regimens. If resistance is detected, treatment is adjusted based on genotyping results.

Prevention

How to prevent HIV/AIDS

  • PrEP — Pre-Exposure Prophylaxis

    PrEP is HIV prevention medication taken by HIV-negative people who are at risk. The daily oral option (Truvada — tenofovir disoproxil fumarate/emtricitabine — or Descovy for MSM and transgender women) reduces HIV risk by more than 99% when taken consistently. A bimonthly injectable option (Apretude — cabotegravir long-acting, injected every two months in a clinic) is available for those who prefer not to take a daily pill, with equivalent or superior efficacy. PrEP requires a prescription, HIV testing before starting, and follow-up every three months. With ACA insurance or manufacturer assistance programs, PrEP is often available at $0 cost. Talk to any primary care clinician or sexual health clinic about whether PrEP is right for you.

  • PEP — Post-Exposure Prophylaxis

    PEP is emergency HIV prevention — a 28-day course of antiretroviral medication taken as soon as possible after a potential HIV exposure. It must be started within 72 hours of exposure; the sooner the better, with the most benefit in the first hours. PEP is not 100% effective and is not a substitute for PrEP or ongoing prevention, but it provides a meaningful safety net after condom failure, sexual assault, a needlestick, or other discrete exposures. Go to an emergency department, urgent care, or HIV clinic immediately — don't wait. If you are repeatedly reaching for PEP, talk to a clinician about starting PrEP.

  • Condoms — used correctly and consistently

    Consistent, correct condom use reduces HIV transmission risk by approximately 80–90% for receptive anal sex. A new latex (or polyurethane) condom should be used every time, from start to finish, with an appropriate lubricant. Oil-based lubricants (lotion, petroleum jelly, coconut oil) degrade latex and increase breakage risk — always use water-based or silicone-based lubricant. Condoms also protect against gonorrhea, chlamydia, syphilis, and herpes, providing layered protection against the STI ecosystem that amplifies HIV transmission.

  • U=U — know your partner's viral load

    If your partner has HIV, the single most important question is whether they are on ART and maintaining an undetectable viral load. A partner who is undetectable cannot sexually transmit HIV — this is a scientific certainty, not a probability statement. Having that conversation, supporting a partner's treatment adherence, and combining U=U with other prevention tools (PrEP, condoms) creates an extremely low-risk environment.

  • Sterile injection equipment

    If you inject drugs, using a new, sterile syringe every time eliminates needle-sharing as an HIV transmission route. Syringe services programs (SSPs) provide free sterile equipment, HIV testing, naloxone, and linkage to treatment without judgment. Most US states now allow pharmacy purchase of syringes without a prescription. Never share needles, syringes, cookers, cotton filters, or water — HIV survives in used equipment.

  • Routine testing — knowing your status

    Testing regularly is foundational HIV prevention. The 2006 CDC guidelines recommend at least one HIV test for all Americans aged 13–64; people with ongoing risk factors should test annually or quarterly. Knowing your status lets you access treatment (and U=U), get on PrEP if you're negative, notify partners, and make informed decisions. The 13% of people with HIV who don't know their status are responsible for a disproportionate share of transmission — testing closes that gap.

Who is most at risk

Who is most at risk for HIV/AIDS?

Anyone who is sexually active can contract HIV/AIDS, but certain groups face significantly higher risk — and should test more frequently.

Gay, bisexual and other men who have sex with men (MSM)
MSM account for 68% of new HIV diagnoses in the US despite representing a small fraction of the population. This is driven by the higher per-act transmission probability of receptive anal sex, network effects (higher HIV prevalence within sexual networks), structural barriers to healthcare access, stigma, and criminalization. Routine quarterly testing, PrEP, and early treatment initiation are the primary tools to close this disparity.
68% of new US HIV diagnoses (2022 CDC data)
Black / African American individuals
Black Americans account for 42% of new HIV diagnoses while representing only 13% of the US population — the starkest racial disparity in HIV epidemiology. This is not driven by behavioral differences but by structural factors: less access to healthcare, higher rates of undiagnosed infection in sexual networks (increasing exposure risk), residential segregation concentrating HIV into high-prevalence communities, greater poverty, and medical mistrust rooted in historical abuses. Addressing structural racism is inseparable from addressing HIV disparities.
42% of new diagnoses; 13% of the US population
Hispanic / Latino individuals
Hispanic and Latino individuals represent 27% of new HIV diagnoses — the second most-affected racial/ethnic group. Language barriers, immigration status concerns, cultural stigma around HIV and sexuality, and healthcare access gaps all drive underdiagnosis and delays in treatment. Spanish-language outreach and culturally competent HIV services are essential components of prevention.
27% of new HIV diagnoses
People who inject drugs (PWID)
Sharing needles, syringes, cookers, and cotton exposes people to blood-borne HIV with high efficiency. Syringe services programs (SSPs), which provide sterile injection equipment, dramatically reduce HIV and hepatitis C transmission — and serve as vital connection points to testing, PrEP, naloxone, and drug treatment. Medication-assisted treatment for opioid use disorder also reduces injection frequency and HIV transmission risk.
9% of new HIV diagnoses; higher in certain rural and Appalachian areas
Transgender women
Transgender women face an HIV risk up to 49 times higher than the cisgender general population in some studies, driven by concentrated HIV prevalence in sexual networks, stigma and discrimination that limits healthcare access, economic marginalization that may contribute to sex work, and homelessness. Black and Latina trans women bear the greatest burden. Despite this, trans women remain critically underserved and understudied in HIV prevention research.
2% of new diagnoses; risk disproportionately high — up to 49× in some studies
Youth aged 13–24
Young people account for 20% of new HIV diagnoses, and the majority are unaware of their status — leading to delayed diagnosis, delayed treatment, and ongoing transmission. Adolescents and young adults often fall through gaps in routine testing recommendations, face unique barriers to confidential care (parental consent laws, insurance under parents), and may have less access to comprehensive sex education about HIV prevention.
20% of new diagnoses; many are undiagnosed

Why it matters

Why STD testing matters

Find HIV/AIDS testing
  • HIV is often completely silent — 13% of the 1.2 million Americans who have it don't know, and symptoms can't tell you your status. A test is the only way to find out.
  • Modern antiretroviral therapy (ART) suppresses HIV to undetectable levels: people on treatment live near-normal lifespans and — thanks to U=U — cannot sexually transmit the virus to their partners.
  • Prevention tools have never been more powerful: PrEP (a daily pill or bimonthly injection) is more than 99% effective against HIV in people who test negative; PEP can stop an infection if started within 72 hours of exposure.
  • Testing is fast, private and often free: a blood draw or oral swab, results in minutes to days at a clinic, lab or at home — and a positive result today means one pill once a day and a full life.

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HIV/AIDS testing by state & city

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Living with HIV/AIDS

Questions to ask your provider about HIV/AIDS

HIV/AIDS is common, treatable, and nothing to be ashamed of — millions of Americans are diagnosed every year. The most useful next step after a positive result (or before a first test) is a direct conversation with a clinician. Here are the questions that matter most:

  • Is my HIV/AIDS test result definitive, or do I need a confirmatory test?
  • What treatment options are available to me, and how long until I'm no longer contagious?
  • Should I notify my recent partners, and can your office help me do that confidentially?
  • How soon can I re-test to confirm the infection has cleared?
  • Are there other STIs I should test for at the same visit?
  • Can this affect my fertility, pregnancy, or long-term health if left untreated?

Good to Know

HIV/AIDS testing FAQs

Common questions about HIV/AIDS and HIV/AIDS testing, answered.

How do I get tested for HIV?

HIV testing is widely available and takes minutes. You can order a lab test online (Quest, LabCorp, and similar) and walk in with no appointment — a blood draw, results in 1–3 days. Clinics and health departments offer rapid tests with results in about 20 minutes, often free. You can buy an OraQuick oral-swab self-test at a pharmacy for around $40 and test at home immediately. Mail-in kits let you collect a blood spot at home and get lab-quality results online. Find a free testing site near you at gettested.cdc.gov. There is no reason to wait — testing is the first step to knowing.

What is the HIV window period and which test should I use?

The window period is the time between HIV infection and when a test can reliably detect it. The answer depends on the test type. An HIV RNA (NAT) test detects the virus itself and can turn positive 10–33 days after exposure — useful for very recent exposures or when acute symptoms are present. The standard 4th-generation antigen/antibody combo test (used by most labs) is reliable at 45 days — it detects more than 99% of infections by that point. Older antibody-only tests and oral-swab rapid tests (OraQuick) have a longer window of 23–90 days, so a negative result inside that range can miss a real infection. For most people, the 4th-gen lab test at 45 days is the right choice. If you test at 45 days with a 4th-gen test and it's negative, that exposure is definitively ruled out.

What's the difference between an HIV RNA test and a 4th-generation test?

An HIV RNA test (also called a NAT or NAAT) detects the virus's genetic material directly — the virus itself. It can turn positive 10–33 days after exposure, before the immune system has formed any antibodies. It's the only test that can catch HIV in the first few weeks. The 4th-generation antigen/antibody combo test detects two things simultaneously: the p24 antigen (a viral protein) and HIV antibodies. The antigen component gives it earlier detection than older antibody-only tests, making it reliable at 45 days. The RNA test is more expensive (~$150–300), must be ordered by a clinician, and is reserved for high-risk recent exposures or when acute HIV is suspected. The 4th-gen combo is the standard test used everywhere and is what you'll get at most labs and clinics.

Can I test for HIV at home?

Yes, and there are two types. The OraQuick In-Home HIV Test is an oral-swab test sold at pharmacies (~$40) that gives results in about 20 minutes — no lab involved. It's antibody-only with a 23–90 day window, and its sensitivity (~92%) is slightly lower than lab tests; a negative result in the first 90 days after exposure should ideally be confirmed with a lab test. Mail-in kits (such as those from myLAB Box, Everlywell, or similar services) use a dried blood spot you collect at home and send to a CLIA-certified lab; these use the same 4th-generation technology and give lab-quality results online within a few days, with the same 45-day window. A reactive result on any at-home test must be confirmed with a follow-up lab test before starting treatment.

What does a negative HIV test at 45 days mean?

A negative result on a 4th-generation antigen/antibody combo test at 45 days after a potential exposure means you do not have HIV from that exposure — with very high certainty. The 4th-gen test detects more than 99% of HIV infections by 45 days. You do not need to retest for that specific exposure unless you have had additional exposures since. This only applies to the 4th-generation lab test (or a lab-analyzed blood-spot mail-in kit) — not to oral-swab rapid tests (OraQuick) or older antibody-only tests, which need 90 days for a definitive result. Continue routine testing if you have ongoing risk factors.

What is U=U (Undetectable = Untransmittable)?

U=U means that a person living with HIV who is on antiretroviral therapy and has maintained an undetectable viral load for at least six months cannot sexually transmit HIV to their partners. This is not a probability reduction — it means zero transmissions. The evidence comes from three large multinational clinical trials: PARTNER (2016), PARTNER2 (2019), and Opposites Attract — together tracking over 75,000 condomless sex acts between HIV-serodiscordant couples where the HIV-positive partner was on ART with undetectable viral load. Transmissions: zero. U=U is endorsed by the CDC, WHO, and major HIV medical associations worldwide. It fundamentally changed what it means to live with and love someone with HIV.

Can HIV be transmitted through oral sex?

Yes, but the risk is extremely low — so low that most transmission probability tables list it as 'negligible' or present it as near-zero. The risk is highest for the person performing oral sex on a penis (fellatio) when the partner has HIV. Performing oral sex on a vulva (cunnilingus) or receiving oral sex are even lower risk. Factors that could marginally increase risk include active sores or inflammation in the mouth, bleeding gums, a high viral load in the HIV-positive partner, or an active STI. Condoms and dental dams eliminate the transmission risk. For most people in most contexts, oral sex is not a meaningful HIV transmission route — but it's not zero.

What is PrEP and who should take it?

PrEP (pre-exposure prophylaxis) is HIV prevention medication taken by HIV-negative people who are at risk of acquiring HIV. The daily oral option — Truvada or Descovy (both tenofovir-based) — reduces the risk of sexually acquired HIV by more than 99% when taken consistently. A bimonthly injectable option (Apretude — long-acting cabotegravir) is equally or more effective and suits people who'd rather visit a clinic every two months than take a daily pill. PrEP is recommended for: MSM with recent partners of unknown status, people with HIV-positive partners not confirmed undetectable, people who have had a recent STI or use condoms inconsistently, and people who inject drugs. PrEP requires an HIV test before starting and follow-up every three months. With ACA insurance or manufacturer programs, it's often $0. PrEP is one of the most effective public health interventions ever developed.

What is PEP and when should I use it?

PEP (post-exposure prophylaxis) is a 28-day course of antiretroviral medication taken after a potential HIV exposure to prevent the virus from establishing infection. It must be started within 72 hours of exposure — and the sooner the better, ideally within hours. PEP is for discrete exposures: a condom breaking with a partner of unknown HIV status, sharing injection equipment, sexual assault, or a medical needlestick. Go immediately to an emergency department, urgent care, or HIV clinic — do not wait to see if symptoms develop or for the clinic to open the next morning. PEP is about 80% effective when started promptly and taken consistently for the full 28 days. It is not a substitute for PrEP if you have ongoing risk; talk to a clinician about transitioning from PEP to PrEP after completing the course.

What happens if I test positive for HIV?

A reactive result on a rapid or at-home test must be confirmed with a follow-up lab test — a 4th-gen antigen/antibody test or NAT — before any clinical decisions are made. False positives occur, particularly on oral-swab rapid tests, so confirmation is essential. Once confirmed, the most important step is to connect with an HIV care provider and start antiretroviral therapy as soon as possible. Modern ART is a single pill once a day; most people achieve an undetectable viral load within 3–6 months. Testing positive today is not a crisis — it is information that opens the door to treatment, a near-normal lifespan, and the ability to protect your partners through U=U. HIV clinics typically offer integrated services including mental health support, partner notification assistance, and navigation of insurance and medication access programs.

How long does it take for HIV to become AIDS?

Without treatment, the median time from HIV infection to AIDS is approximately 10 years — though this varies significantly. A small percentage of people (called 'long-term non-progressors' or 'elite controllers') maintain CD4 counts without significant decline for many years without treatment. At the other end, some people progress to AIDS faster, particularly if infected with a more virulent strain or if they have other health conditions. AIDS is defined as a CD4 count below 200 cells/µL or the diagnosis of an AIDS-defining illness. With ART started early, this progression essentially never happens — people on effective treatment maintain their CD4 counts indefinitely and never develop AIDS.

Can I live a normal life with HIV?

Yes — for most people diagnosed with HIV today and started on treatment, the answer is an unequivocal yes. Modern antiretroviral therapy is one pill once a day with a side-effect profile vastly better than earlier regimens. People who start ART early and maintain viral suppression can expect a lifespan approaching that of HIV-negative peers, with essentially the same quality of life. The most important predictor of long-term health is how early ART is started — which is why testing matters. People with HIV live, travel, exercise, have children, and maintain relationships like anyone else. The persistent stigma surrounding HIV does not reflect the medical reality of 2026.

How does HIV affect pregnancy?

HIV can be transmitted from a pregnant person to their baby during pregnancy, labor, delivery, or breastfeeding — but with modern ART, this risk drops below 1%. Every pregnant person should be tested for HIV at the first prenatal visit (and again in the third trimester in higher-prevalence settings). If you are HIV-positive, you should be on ART throughout your pregnancy; the medication is safe in pregnancy and the benefit to the baby far outweighs any risk. Infants receive a short course of antiretroviral medication after birth as additional protection. A cesarean delivery is recommended if viral load is above 1,000 copies/mL near delivery. In the US, formula feeding is generally recommended to eliminate the breastfeeding transmission route, though guidelines differ in resource-limited settings. A parent with HIV can have a healthy baby.

Is there a cure for HIV?

Not yet for the general population — HIV establishes latent reservoirs in long-lived immune cells that current antiretrovirals cannot reach. A handful of patients have been 'cured' of HIV through stem-cell transplants from donors with the CCR5-delta32 mutation (which makes cells resistant to HIV entry), but this procedure is high-risk, complex, and not applicable as a broad strategy. Research into a functional cure — one that allows the immune system to control HIV without lifelong ART — is active and has shown promising early results in animal models and a few human cases. A vaccine against HIV has also proven exceptionally difficult to develop due to the virus's rapid mutation rate and immune evasion strategies. For now, ART is lifelong, but it is effective, tolerable, and provides a near-normal life.

Do I need to disclose my HIV status to partners?

The legal answer varies by state — some US states have criminal laws that require disclosure of HIV-positive status to sexual partners, with criminal penalties for non-disclosure even without transmission. These laws vary widely in their scope, and many were written before U=U was established — some criminalize activities where transmission is scientifically impossible if the person is undetectable. Know the law in your state. The ethical answer is more nuanced and personal; talking to an HIV-knowledgeable clinician, legal advocate, or support organization can help you navigate this. The practical reality for many people is that U=U and starting a conversation about prevention tools (PrEP, condoms) allows partners to make informed decisions without necessarily centering the diagnosis itself.

What is acute HIV infection and why does it matter?

Acute HIV infection is the 2–4 week period immediately after exposure when the virus replicates explosively throughout the body. The viral load peaks at millions of copies per milliliter — making this the single most infectious period of the entire infection. Many people experience flu-like symptoms: high fever, swollen lymph nodes, severe fatigue, rash, sore throat, and muscle aches. Because antibody-based tests (including rapid tests and self-tests) are negative during this phase, the only test that can detect acute HIV is an HIV RNA (NAT) test. Acute HIV matters because untested, unaware people transmit a disproportionate share of new HIV infections during this window. If you have these symptoms 2–4 weeks after a potential exposure, seek testing with an RNA test specifically — and tell the clinician about the timeline.

Editorial standards

Medically reviewed · Updated

Reviewed by Mark Riegel, MD · Sexual Health Physician · Chief Medical Reviewer

Physician focused on sexual health — STI testing, treatment and prevention — and EasySTD's chief medical reviewer. Owns the condition guides and is the clinical backstop for any page without a more specific specialist.

8 Sources

Data & references

  1. CDC HIV Surveillance Report 2022 https://www.cdc.gov/hiv/library/reports/hiv-surveillance.html
  2. CDC — HIV Statistics Overview https://www.cdc.gov/hiv/statistics/

Clinical guidance

  1. CDC — HIV Testing https://www.cdc.gov/hiv/testing/
  2. CDC 2021 STI Treatment Guidelines — HIV https://www.cdc.gov/std/treatment-guidelines/hiv.htm
  3. CDC — HIV PrEP Information https://www.cdc.gov/hiv/risk/prep/
  4. Prevention Access Campaign — U=U https://www.preventionaccess.org/
  5. USPSTF — HIV Infection Screening Recommendation https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/human-immunodeficiency-virus-hiv-infection-screening
  6. CDC — About HIV https://www.cdc.gov/hiv/about/index.html