HIV-testing

When is the result of an HIV test sufficiently reliable?

An HIV test (“Aids test”) can reliably exclude the possibility of infection with the HI virus only three months after potential exposure. This is the time it takes for the body to build up enough antibodies to the virus after being infected. After three months, the test result is considered to be sufficiently reliable: if the result is negative, no antibodies have been detected, which means that infection with the HI virus has not occurred; if the result is positive, antibodies have been identified, indicating that infection has taken place.  

If you carry out the test before the three-month waiting period has elapsed, it is possible that you have tested too early, which means that a (currently) negative result might turn out to be positive in a subsequent test.

 

Is it possible to carry out the test without having to wait three months?

The standard HIV test currently used in Switzerland is a combination test that looks for antibodies and virus components (p24 antigens) in the blood. After transmission of HIV, virus components appear in the blood relatively quickly, which means it is possible for the combination test to detect infection after just a few weeks.

If, during the first weeks following a definite risk situation, physical symptoms occur that confirm the suspicion that infection may have taken place, it is advisable to carry out a first HIV combination test (see “Symptoms”). Consequently, if infection is strongly suspected, a first HIV test can already be carried out between two and six weeks after a risk situation has occurred.

If the initial test is negative, this result is not absolutely definite. It is possible that infection has not occurred; however, it could also be that the HI virus has been transmitted, but that it is too early for the test to detect it, due to the fact that the body is either carrying too few virus components (p24 antigens) or has not yet built up enough antibodies. Whatever the case, if this first result is negative, a second test must be performed three months after potential exposure. Only this second test can provide sufficient proof that HIV infection has definitely not occurred.

If this initial test is positive or the result is unclear, a confirmation test is carried out, based on another blood test, in order to exclude the possibility of an incorrect diagnosis. If this confirmation test is also positive, infection with the virus has definitely occurred.

Should I get advice before being tested for HIV?

It is advisable to find out about the various aspects of the HIV test (risk of transmission, legal aspects, etc.) before you decide to go ahead with the test. If you have any questions or something is not clear, you should contact your regional Aids counselling service. This also applies to counselling after an HIV test. The staff will be pleased to answer your questions over the phone or arrange a personal talk. The Aids counselling services do not generally offer HIV tests themselves, but can accompany you through the testing procedure.
Generally speaking, the following applies: Every testing centre (university hospital, laboratory or doctor) should provide you with adequate advice before performing an HIV test. Be sure to insist on a counselling session!

Where can I go to be tested?

The regional Aids advisory services do not generally offer HIV tests themselves, but can advise you beforehand on the various aspects of the test and tell where you can go to be tested.

HIV tests are competently performed by the following institutions:

• Large (university) hospitals in Switzerland offer anonymous HIV testing (addresses and telephone numbers). Call one near you and ask about their testing schedules.
• In Geneva and Zurich, there are health centres where gay men can be tested for HIV. Ask about opening hours and consultations at Checkpoint Geneva or Checkpoint Zurich.

Once you have received counselling and have decided to test for HIV, the following options are also open to you:

Private medical laboratories also carry out anonymous HIV tests.

• Your GP can also carry out an HIV test on request. In this case, however, the issue of anonymity may pose a problem.

Can I carry out the test without anyone knowing?

Basically, you can be tested at hospitals and medical laboratories without having to reveal your identity. When you go for testing, inform the staff of your wish to remain anonymous and refrain from giving your name.  

Doctors who carry out HIV tests are subject to a professional obligation of confidentiality. However, this does not mean that the test is automatically anonymous; if you want your health insurance to pay for the test, they will know that a test has been carried out from the invoice they receive. The actual result of the test is not revealed on the invoice; it is, however, recorded in the doctor’s medical records, which may lead to insurance problems at a later date. If you wish to be tested anonymously by your doctor and do not want the results to be recorded in your medical notes, you should explicitly inform your doctor of your wishes. You should also consult your regional Aids advisory service before carrying out the test.

No matter whether you are tested at a hospital/clinic or by your GP, the same applies: all positive results must be reported to the Swiss Federal Office of Public Health in accordance with the Ordinance on Notification. Notification is important for monitoring the epidemic and also helps prevention work. Since 1 March 1999, in addition to your sex, date of birth and canton of residence, the first letter of and number of letters in your first name (e.g. S6) are required to be recorded on the notification form. This is to avoid duplicate reporting, i.e. recording multiple positive test results for the same person. This method also ensures that your data are forwarded to the notification authority in an anonymous form, without it being possible for anyone to find out your personal details.

Can I be tested for HIV anonymously even if I am still under age?

Yes, you can. No matter whether it is carried out anonymously or by your GP, an HIV test is a highly personal matter that requires the person concerned to be of sound judgement but not necessarily of age. In other words, you can test for HIV anonymously without having to obtain the consent of your legal guardian.

Will I automatically be tested for HIV when I have a medical check-up?

No, in all cases, a person is required to give their express consent before an HIV test can be carried out.  Consequently, no one can force you to have a test, nor can they secretly carry out a test without your consent. This also means that you have not been automatically tested for HIV in the course of past medical examinations or interventions without your knowledge.

How long do I have to wait for the result?

The result of the laboratory test will be available after anything between a few hours and one to three days, depending on where it was carried out.

Nowadays, hospitals and some doctor’s practices also offer a rapid HIV test, which is evaluated on the premises and delivers a result within 30 minutes. However, the same applies as with the laboratory test: the rapid HIV test only delivers a sufficiently reliable result if it is carried out at least three months after potential exposure.

How much do these tests cost?

An HIV test costs between approx. CHF 30 and 80. If you decide to be tested anonymously, you will have to pay for the test yourself; otherwise, it is covered by your health insurance.

How reliable are the test results?

The HIV detection tests that are currently offered by hospitals, laboratories and GPs are highly sensitive. Consequently:

If you carry out the test three months after potential exposure to the HI virus and the result is negative, it is certain that you have not been infected.

 A positive test result always needs to be verified by a second confirmation test, using a new blood sample. This confirmation test uses a different detection method and is also extremely accurate. At the same time, a third test is generally also carried out to determine the level of the viral infection or “viral load”. A positive confirmation test excludes the possibility of the original positive diagnosis being incorrect.

Is there an HIV test that I can do myself at home, and if so, how reliable is it?

HIV tests for self-testing at home do exist but they are not approved for use in Switzerland, other European countries or the USA. This ban on so-called home tests is not without good reason – they do not deliver sufficiently reliable results and they are very complicated to use. We therefore strongly recommend that you do not acquire such tests from abroad or via the Internet; they often concern dubious products that fail to meet our medical quality standards.