Using an HIV Self-Test at Home: Timing, Steps, and Next Moves

HIV self-tests let you find out your status privately, in about half an hour, without a clinic visit or a lab. The test available over the counter in the US is the OraQuick In-Home HIV Test, an oral-fluid antibody test. It's a good screening tool, as long as you understand what it can and can't tell you. For how it compares with lab-based HIV tests, see HIV test types compared.

Step 1: Check your timing

Timing is the most important part of using a self-test well.

• The FDA describes the OraQuick window period as about three months. It notes that most people (97%) develop detectable antibodies within 3 months, though it can take up to 6 months (FDA).
• CDC lists an approximate window of 23 to 90 days for antibody tests, including most self-tests, compared with 18–45 days for a lab antigen/antibody test from a vein and 10–33 days for a nucleic acid test (CDC).
• CDC's STI guidelines add that home kits detect only antibodies, so they won't detect acute (very early) HIV infection (CDC).

If your last possible exposure was recent, a negative self-test is reassuring only for exposures from before the window period. Plan to retest, or choose a lab test with a shorter window. See window periods.

Step 2: Prepare

From the manufacturer's warnings and preparation page:

• Don't eat, drink, or use oral care products (mouthwash, toothpaste, whitening strips) for 30 minutes before the test.
• Remove dental products such as dentures or anything covering your gums.
• Have a timer that can track 20 to 40 minutes.
• The manufacturer says the test is indicated for ages 14 and older.

Step 3: Take the test

Always follow the instructions in your box. The general flow is:

1. Wash your hands and open the kit on a clean, flat surface. Check that nothing is damaged or expired.
2. Swab the test pad firmly along your upper gum once and your lower gum once, as shown in the instructions. Don't swab the inside of your cheeks or your tongue.
3. Put the pad into the tube of developer solution as directed and start your timer.
4. Leave the test alone. Don't take the stick out early.
5. Read the result between 20 and 40 minutes. Results read before or after that window may not be accurate.

Step 4: Read the result

Common mistakes that affect self-test results

• Reading too early or too late. Use a timer. A result read at 10 minutes or after an hour isn't reliable.
• Swabbing the wrong place. The pad goes along the outer gums, not the tongue, cheeks, or roof of your mouth.
• Testing right after eating, drinking, or brushing. Wait the full 30 minutes the manufacturer specifies.
• Touching the flat pad. Handle the device by the stick, not the collection pad.
• Using an expired or damaged kit. Check the date and the pouch before you start.
• Testing too soon after an exposure. This is the most common reason a negative result can mislead. Count back from your most recent possible exposure.

If you're unsure whether you did something correctly, the cautious approach is to retest with a new kit or get a lab test, rather than rely on a result you doubt. For a general look at false negatives and false positives, see can STI tests be wrong?

Self-test or lab test?

A self-test is a good fit for routine screening when you have no recent exposure, for privacy, or for testing more often between clinic visits. A lab test is usually better when:

• Your possible exposure was within the last few weeks, since lab antigen/antibody and RNA tests have shorter windows.
• You have symptoms that could be early HIV infection, such as a flu-like illness, rash, or swollen glands a few weeks after an exposure.
• You're on PrEP or PEP.
• You also need testing for other STIs, which a self-test doesn't cover.

How accurate is it?

FDA reports a sensitivity of about 92%, which means roughly one false negative for every 12 people with HIV who test. Specificity is 99.98%, about one false positive for every 5,000 people without HIV who test. Two things follow from that:

• A reactive result needs confirming, but it should always be taken seriously.
• A negative result is less certain than a lab test, especially after a recent exposure. If you have ongoing risk or symptoms, follow up with lab testing.

If your result is reactive

1. Take a breath. A reactive self-test isn't a diagnosis. CDC says every positive antibody test needs a follow-up test.
2. Get confirmatory testing soon at a clinic, health department, or your doctor's office. CDC recommends that anyone with a reactive rapid test be checked with a lab-based antigen/antibody test.
3. Use support if you want it. The FDA notes that OraQuick runs a consumer support center that's available around the clock.
4. If HIV is confirmed, treatment is highly effective. People on treatment who keep an undetectable viral load don't transmit HIV through sex.

Avoid sex that could transmit HIV until you have a confirmed result and medical advice.

If your result is negative

• No exposures in the last 3 months? A negative is reassuring for exposures before then.
• Exposure in the last 3 months? Retest after the window period, or get a lab test with a shorter window.
• Ongoing risk? Ask about PrEP, and set a regular testing schedule.
• Remember: an HIV test doesn't check for chlamydia, gonorrhea, syphilis, or other STIs.

Free self-tests may also be available through public health programs in some areas. See free STD testing.

Disclaimer: This article is for informational purposes only and does not diagnose, prescribe, or replace individualized medical care. Testing and treatment decisions should be made with a qualified healthcare provider. Some links on this page are affiliate links; we may earn a commission at no extra cost to you.