“I got a ‘negative’ HIV test about a year after I last had risky sex, but I’m concerned about the incubation time. Could HIV be dormant and show up later, even if I haven’t had unprotected sex since the test?”
Questions like this are among the most common inquiries that About AIDS receives. The basic answer: No, your test was accurate; it doesn’t need repeating.
Knowledgeable test counselors usually will explain this. However, many private physicians do not understand that HIV doesn’t pop up years later after a properly done negative test.
The media also often cause confusion by using “dormant” and “incubation” without understanding what they mean. These terms have nothing to do with testing. They are about disease development.
The test is for HIV antibodies, the protein soldiers that an infected person’s body makes to fight HIV. Almost everyone, if infected, would make enough antibodies to trigger a test reaction by three months after the last exposure – the “window” for testing. (Cases taking longer than three months are too rare to consider, so forget “three to six months.”) No other time period applies to HIV testing.
The new “rapid” HIV test produces basic results in 20 minutes, on-site. However, it uses regular antibody testing technology, so the three-month window still applies. It’s just the no-lab-needed result that is quick.
“Incubation” is the time from infection to developing full AIDS, a period of slow immune destruction averaging 10-12 years.
HIV is seldom truly “dormant.” It becomes active immediately upon entering the body. The only dormant HIV is what’s inside inactive (resting) T4 cells in the lymph nodes. HIV can’t reproduce unless the cell is active; so more accurately, that virus is dormant only because its host
cell is dormant. These inaccessible “viral reservoirs” are the biggest challenge in fully eradicating HIV from someone’s body. However, that doesn’t affect antibody production – or testing.
Bottom line: If you waited three months after the last risk behavior before getting tested, then you got an accurate result. It isn’t necessary to repeat the test – unless there is further risk behavior.
For cheap ‘n’ easy HIV testing with good counseling, call A-TCHD at 972-5580 or ASA at 458-AIDS. As Martha says, “It’s a good thing.”
This article appears in July 15 • 2005.