The Rapid Oral HIV Test

Did you know that you can find out your HIV status in less than 30 minutes? By choosing a rapid oral fluid test, you don't even need to have blood drawn. All you have to do is swab your gums and cheeks with an absorbent pad, and with the help of ELISA (enzyme-linked immunosorbent assay), you'll know in about 20-25 minutes.

Given that AIDS was not reported in the United States until 1981, and three more years were required to identify HIV as the cause, it is surprising that a reasonably accurate test was available as soon as 1985. It was a screening test designed to test donated blood (and potential donors) for the virus, since it had become evident that the blood supply was contaminated. Like the oral test, the ELISA method was used, but with blood instead of oral fluid.

ELISA checks for antibodies - proteins used by the immune system to attack foreign invaders such as bacteria or viruses. It takes from 2 weeks up to 6 months for a person exposed to HIV to start producing antibodies; this process is called seroconversion. Enzymes that will link to the specific HIV antibody are added to the sample (blood or oral fluid). Unbound particles are washed away, then a chemical is added to detect the presence of the enzyme. For example, some enzyme-antibody combinations will fluoresce under the right conditions.

Two years later, in 1987, an even more specific HIV test, the Western Blot, was approved by the FDA. The Western Blot is a more complicated procedure and results are not generally available for 1 to 2 weeks. It includes an enzyme-linking process similar to ELISA, but potentially infected cells are actually opened and examined for the presence of viral bands, evidence of the virus's genetic material. The Western Blot test is often used to confirm a positive ELISA result.

For almost 20 years, HIV testing required at least a finger prick to produce a blood sample. This was unpleasant for the many people who dislike needles, and also more dangerous for health care workers if the person turned out to be positive. Fortunately, the oral test became available in 2004. Since the results are quick, the client does not need to return later to get the results. According to the Centers for Disease Control, 30% of clients never returned to get the results of tests that required a week or two. Consequently, about a fourth of individuals in the United States who are infected with HIV do not know it.

The oral test is probably available from your local doctor or hospital, but if you wish to be anonymous, many cities offer free clinics where you can be tested for HIV without charge.

There are also many home testing kits on the market, but you should be careful with these. Several companies and individuals selling home test kits have been indicted by the Federal Government. Only one home test kit has been approved by the FDA - the Home Access HIV-1 Test System. You collect the sample at home, then send it to the company. Depending on which test you choose, your results will arrive in 3-7 days. You can buy the test at your local drugstore, or by mail order (see below).

Should you get tested? According to the CDC, all adults (especially pregnant women) and adolescents in health care settings should be tested, unless the patient opts out. No additional consent is required for this testing, so if you don't want to be tested, be sure to tell your doctor. Additionally, you should be tested if you have injected drugs with shared needles, had unprotected sex, received a blood or blood products transfusion before 1985, or have been diagnosed with hepatitis, tuberculosis, or a sexually-transmitted disease.

As part of my research for this article, I went to a local free clinic and had the oral HIV test. It was easy, quick, and completely anonymous. The counselor (pre- and post-test counseling are part of the process) was friendly and easy to talk to. I highly recommend having the rapid oral test, even if you have no risk factors. It's good to have peace of mind!