HIV testing at home

What HIV is

HIV (human immunodeficiency virus) is a virus that weakens the immune system over time. It passes between people through blood, semen, and vaginal and anal fluids – most often during anal or vaginal sex without a condom, or by sharing injecting equipment. It can also pass to a baby during pregnancy or breastfeeding.

Untreated, HIV can progress to AIDS, on average around 10 years after infection. Treated, the picture is very different: people with HIV who take their treatment as prescribed can expect a near-normal life expectancy, and once their viral load is undetectable they can’t pass the virus on through sex. That’s what undetectable = untransmissible (U=U) means.

Most people don’t notice it

About 70% of people get a short illness around 2 weeks after they acquire HIV – fever, rash, a sore throat, swollen glands, aching muscles or diarrhoea. It’s easy to mistake for the flu, and it passes on its own. After that, HIV can cause no symptoms at all for several years while it continues to affect the immune system. A test is the only way to know.

The 2 kinds of HIV test

A lab blood test looks for both the virus and your antibodies to it. A self-test looks for antibodies only, which take longer to appear – that’s why its window period is longer.

Two things to know about any HIV self-test: the test may not detect HIV acquired in the last 3 months, so consult a medical practitioner if exposure was possible during this time; and the test is a screening test and a positive test result requires confirmatory laboratory testing on the request of a medical practitioner.

If a recent exposure is what’s worrying you, a lab blood test at a sexual health clinic (opens in new tab), GP clinic (opens in new tab) or urgent care clinic (opens in new tab) gives you a reliable answer sooner.

About the HIV self-test

The self-test Prickly supplies is the Atomo HIV Self Test – a fingerprick screening test for HIV antibodies, included in the Australian Register of Therapeutic Goods (ARTG) for self-testing at home, with a result in 15 minutes. Always read the label and follow the directions for use (opens in new tab) – the test isn’t suitable if you’ve already been diagnosed with HIV, are taking antiretroviral treatment or have a bleeding disorder. For help performing or reading the test, call the manufacturer’s helpline on 1300 235 035. Free, confidential HIV support services are listed on the Care Card in the test box and on the manufacturer’s website (opens in new tab).

In laboratory testing, the Atomo HIV Self Test correctly identified 99.6% of HIV-positive samples (its sensitivity) and 99.6% of HIV-negative samples (its specificity). In field evaluations with first-time self-testers, those figures were 94.3% and 95.2%, so real-world results depend on the test being performed correctly.

When to test

After a recent exposure

If it’s been less than 72 hours and you’re not taking PrEP (opens in new tab) as prescribed, don’t wait for a test. Post-exposure prophylaxis (PEP) can prevent HIV, but it has to start as soon as possible – visit www.getpep.info (opens in new tab) or go to a sexual health clinic (opens in new tab), urgent care clinic (opens in new tab) or emergency department (opens in new tab) now. After that, a lab blood test is reliable from 6 weeks and a self-test from around 12 weeks.

As a routine

For many sexually active adults, a yearly test is a sensible baseline. Testing as often as every 3 months is recommended for people at higher risk, such as men who have sex with men with new or casual partners.

If your self-test is negative

A negative result means no HIV antibodies were detected. If any possible exposure was within the last 3 months, the test may not detect it yet – test again once you’re outside the window period, or see a clinic for a lab blood test.

If your self-test is positive, or doesn’t work

A positive at-home self-test isn’t a diagnosis – it’s a screening result, and a positive test result requires confirmatory laboratory testing on the request of a medical practitioner. If your self-test reads positive or doesn’t work, see a sexual health clinic (opens in new tab), GP clinic (opens in new tab) or urgent care clinic (opens in new tab) ASAP for confirmatory testing and, if HIV is confirmed, specialist care. You can always book your telehealth follow-up appointment if you want to talk things through – our doctor can explain the result and send a formal referral. Free, confidential HIV support is available in every state and territory: see the Care Card in your test box or the manufacturer’s support services list (opens in new tab), or call healthdirect on 1800 022 222, 24 hours a day.

If HIV is confirmed, the clinic arranges specialist care, and treatment usually starts as soon as possible. Notification to the health department is handled by the practitioner who orders your confirmatory lab testing.

Lowering your risk

• Condoms and lube. Used for anal and vaginal sex, they lower the chance of HIV passing between you and a partner.
• Undetectable = untransmissible. A partner with HIV who takes their treatment as prescribed and has an undetectable viral load can’t pass the virus on through sex.
• New injecting equipment, every time. Not sharing needles, syringes or other injecting equipment removes that route entirely.
• Testing as a routine. HIV can be silent for years, so regular testing is how it gets found early – yearly for many people, and as often as every 3 months at higher risk.
• Acting fast after an exposure. If you may have been exposed in the last 72 hours, visit www.getpep.info (opens in new tab) or go to a sexual health clinic (opens in new tab), urgent care clinic (opens in new tab) or emergency department (opens in new tab) now.
• A conversation with a clinic. If you’re at ongoing risk of HIV, a sexual health clinic (opens in new tab) or GP clinic (opens in new tab) can talk you through other ways to protect yourself, including options that involve medication.

How at-home testing works with Prickly

Prickly is an Australian at-home STI testing service for people without symptoms. It tests for chlamydia, gonorrhoea and HIV. The fingerprick HIV self-test comes with your collection equipment – you read it yourself at home, so that result isn’t emailed to you.

• Request online. Complete a five-minute online request. A doctor then reviews your answers and confirms that at-home STI testing is suitable for you.
• Receive your equipment. Collection equipment tailored to your exposures usually ships the next business day in an unmarked mailer box with Australia Post tracking.
• Collect at home. Follow the included STI testing self-collection guide – swabs and urine for the lab, and a fingerprick HIV self-test you read at home in 15 minutes.
• Post to the lab. Post your lab samples back the same day using the included prepaid return label – at any Australia Post Office, red street posting box or Parcel Locker.
• Get your results. A doctor reviews every lab test result and emails you privately. Telehealth follow-up included – with help accessing treatment and telling partners, if needed.

The same steps are on the home page under How it works, and fees are under Pricing.

When at-home testing isn’t right

See someone in person at a sexual health clinic (opens in new tab), GP clinic (opens in new tab) or urgent care clinic (opens in new tab) instead if you have symptoms or if you’re under 16. And if you may have been exposed to HIV in the last 72 hours, don’t wait for a test – visit www.getpep.info (opens in new tab) or go to a sexual health clinic (opens in new tab) or emergency department (opens in new tab) as soon as you can. If something happened without your consent, 1800RESPECT (opens in new tab) is also available 24/7 for free, confidential support.