Testing

Having sex with people who are of the same HIV status as you, whether positive or negative, can help reduce the risk of HIV transmission. This is sometimes called “serosorting”.

The only way to know whether you have HIV or not is to get tested.HIV testing will help you make decisions about your health care if you test HIV positive, and strategies for reducing your risk of infection, if you test negative.HIV testing is free in Ontario.  You will need an Ontario Health Insurance Plan (OHIP) card if you test at a physician’s office. However, it is possible to get an HIV test if you do not have an OHIP card. You can get an HIV test without an OHIP card at a local public health units’ sexual health clinic and through a community health centre.  Contact the clinic to confirm their requirements. Visit the Sexual Health Infoline Ontario for more information on the location of HIV testing clinics. Anonymous HIV testing is available in Ontario, and more information on anonymous testing is provided below. You can also get access to Rapid HIV Self Test Kits to do entirely at home or in a private location. In Ontario, health care is confidential under the Personal Health Information Act.  If you want to learn more about a provider’s privacy and confidentiality policies, do not be afraid to ask them directly.

There are a few different kinds of HIV tests to know about and you can also fund more information by visiting HIV Testing Ontario

• Standard testing is when a health care professional takes some blood from your arm and sends it to the Ontario Public Health laboratory (lab) to get tested. The lab uses a test that can detect HIV as early as three weeks after infection in some people. In most cases, you will get your results in three or four days.
• Rapid testing, also known as Point-of-care testing, is when a healthcare professional pricks your finger and tests your blood while you wait for a few minutes to get the results. Test results do not show “positive” (infected). Instead, they show either “reactive” or “non-reactive”. If your test is “reactive”, the healthcare professional will recommend standard testing to confirm the result. However, all “reactive” results should be treated as HIV positive results, as the majority of “reactive” results are confirmed positive by lab testing.
• Self Testing is done by the individual at home or in a private location and can produce results within minutes. To do the test, you prick your finger for a single drop of blood using materials that are in the kit, follow the kit’s instructions to mix and use the other materials included in the kit, and then read your results. The INSTI HIV Self Test kit is currently the only Health Canada approved home self test kit. The kits are available for free through two research projects I’m Ready to Know , GetaKit. Insti HIV Self Test (for purchase)

With rapid and self testing, if your test is “non-reactive”, and you are outside the “window period” ( the time it takes to develop HIV antibodies that the HIV test can detect) you are negative.  It can take as long as three months to develop HIV antibodies, but they can develop as early as three weeks after you have been exposed to HIV.  It is recommended to seek testing right after a high-risk exposure, as you may benefit from HIV post-exposure prophylaxis (PEP) – HIV medications that are effective at preventing HIV infection – these must be taken within 72 hours of an HIV exposure. Testing right away may also identify a previous HIV exposure you hadn’t tested for and permit you to seek treatment for that exposure. If you know you are outside the PEP window of 72 hours, then, testing three weeks after an HIV high-risk encounter, and if negative, again at six weeks, if negative, again at three months (3-6-3 testing) is recommended. See more on the window period below. Rapid/Point-of-Care testing is available at over 50 locations in Ontario and can be done anonymously.

• HIV tests can be nominal or anonymous. Most HIV testing is done nominally, such as at the doctor’s office. Nominal or name-based testing involves asking for personal identifying information, such as your full name and address.  A nominal test result can be linked back to you through the information you provide.
• Anonymous testing is available at over  50 locations in Ontario. With anonymous testing, the healthcare provider will not ask you for any personal information, so your test result cannot be linked back to you. You do not need an OHIP card. Only specifically designated clinics to provide anonymous testing. You cannot get this type of test at your doctor’s office or your average walk-in clinic.

There is a “window period” between the moment HIV transmission happens and when the virus can be detected on an HIV test. This is based on anti-bodies that your body produces to fight the virus. In many people, HIV anti-bodies can be detected at about 3 weeks after transmission. In others it can take up to three (3) months after somebody has been exposed to the HIV virus for tests to show a positive result, so talk about the window period with the person giving you the test.

To find out where to get tested for HIV, contact the Ontario AIDS and Sexual Health InfoLine for information in English and many other languages call: 416-392-2437 or 1-800-668-2437 (toll-free in Ontario), and for French call: 1-800-267-7432 (toll-free in Ontario). The InfoLine is free and anonymous.

HIV testing is part of the regular immigration or refugee claim process in Canada. If you have tested positive for HIV during your immigration process, please contact the InfoLine above for information on where to find care, treatment, and support services.