Taking an Oral Swab Test
Don't eat, drink, or use oral hygiene products 30 minutes before taking the test. Set a timer on your phone for 30 minutes before you want to take the test and don't eat or drink anything during that time. It's also important to avoid brushing your teeth, flossing, or using mouthwash or whitening strips 30 minutes before the test because the chemicals can affect the accuracy of the test.Tip: Currently, the OraQuick In-Home HIV Test is the only at-home test kit approved by the CDC and the FDA. If you wear dentures, a retainer, or any other dental product that covers your gums, take it out before the test. Note that this test is not intended for people who are under 16 years of age, confirmed HIV positive, on HIV treatment, or taking part in an HIV clinical trial. Take some time for yourself to breathe deeply and recite positive affirmations to quell any anxiety or fear you may have about taking the test.
Check the expiration date and read the kit’s instruction manual. Before you break the tamper-proof seal to open the kit, look at the bottom to ensure the expiration date hasn’t passed. The first thing you see when you open the kit will be a detailed instruction booklet. It has important information about taking the test and interpreting the results, so be sure to give it your full attention. Oral swab kits typically include a test stick, vial, directions, and 2 information booklets about HIV. If the seal is broken or if the kit is expired, call the customer support number on the box or, if possible, take it back to the pharmacy where you bought it.
Take the test tube out of the sealed packet, keeping it upright. Slide open the drawer at the base of the kit and remove the packet containing the test tube. Use your fingers to carefully tear open the packet at the tear-crease located 1 inch (2.5 cm) from the top. Take the tube out and hold it upright to avoid jostling the liquid inside. If the kit doesn’t have a sliding drawer, look for the package containing the test tube (it may have the number “1” on it). The liquid in the tube blends with your saliva, allowing the compounds to travel up the testing stick to the pigments in the results window.
Pop off the cap of the tube and place it in the holder inside the lid of the kit. Grasp the tube between your fingers and palm and use your thumb to gently pop the cap off of the tube. Place the opened tube upright in the holder that has “test tube holder” printed on it. Don’t try to twist the cap open. Depending on which kit you have, the holder may be located in a different part of the kit. If some of the liquid spills out, discard the kit and use another one.
Remove the test stick from the packet. The packet holding the stick will be located in the same drawer where the test tube packet was stored. Tear off the top of the packet and take out the stick. The pad is exposed, so don't touch it with your fingers and don't let it touch anything else. If the test pad accidentally comes in contact with any surface, discard it and get another test kit.
Swipe your upper and lower gums once with the pad. Hold the testing stick like you would a toothbrush and swipe the pad along your top gums, moving it from your left molars to your right molars. Do the same on your bottom gums. Don't swipe more than once on each gum line because it could skew your results. It may be easier to use one side of the pad to swipe your top gums and the other side to swipe your bottom gums so you don’t have to flip the testing stick. It won’t affect the accuracy of the test.
Insert the test stick into the test tube and set a timer for 20 minutes. Place the stick pad first into the testing tube so it’s resting in the mold above the test tube holder in the lid of the kit. Set a timer on your phone for 20 minutes or record the time on a notepad. Make sure the test window is facing you so you can read the results. The window of the testing stick will turn pink for a few minutes after being inserted into the tube. If your kit has a fold-out cover to block the view of the test window, use that to cover the results. You don't have to do this, but it may help if you're tempted to anxiously stare at the results window. Use the 20 minutes to meditate, read, journal, stretch, or do anything that relaxes you.
Read your results after the timer goes off and within the next 20 minutes. After the timer goes off, you’ll have 20 minutes to read your reading. After that, the line on the test stick will overdevelop and skew the results. For instance, if you’ve started the timer at 3:05 PM, you can check your results any time between 3:25 PM and 3:45 PM. A single line next to the "C" (for “control”) and no line next to the “T” (for “test”) means your test is negative. If there are 2 lines next to the "C" and "T", your test is positive. Even a faint second line counts as a positive reading. The results window will show a line next to the letter “C” whether it’s positive or negative. If no lines appear on either marker, your test is defective and you’ll need to repeat the test with a new kit. Most kits come with an opaque disposable bag in the drawer so you can discreetly dispose of it in any trash can.
See your doctor to get a second test to confirm a positive result. If you got a positive reading from the at-home kit, there could be a slight chance that it was a false positive. To help you through it, talk to someone you trust about any emotions you might be feeling about the possibility of being HIV-positive. When you’re ready, schedule a doctor's appointment or go to an HIV testing clinic to get another test to make sure. To find a testing center, call 1-800-CDC-INFO (232-4636) or text your zip code to "KNOW IT" (566948). Getting a positive test result can often trigger depressive phases or psychological disorders like PTSD, so consider seeing a psychologist or doing group therapy to help you rise above any symptoms you might experience.
Using a Finger-Prick Test Kit
Place the test kit on a flat, clean surface. Since you'll be dealing with blood, it's important to place the testing kit on a sanitary surface. Use a disinfecting cleaner to wipe down a table or kitchen counter beforehand or lay out a layer of clean paper towels. Make sure no children or pets have access to the area for the 20 minutes it'll take to complete the test. The box will come with a sealed package, alcohol swab, lancet, and a dropper-bottle of buffer. Make sure all the parts are present, unopened, and undamaged. Currently, Home Access HIV-1 Test System is the only brand of finger-prick home testing that’s approved by the FDA and the CDC. Check the expiration date on the back of the sealed packet containing the test assay.Tip: Note that HIV tests can only pick up on HIV antibodies 45 to 90 days after exposure, so if you think you’ve been exposed more recently, see your doctor or visit a testing center to get an accurate result sooner.
Wash your hands with soap and warm water. Use a full pump of soap and rub your hands and fingers together to work up a good lather. Dry your hands with a clean paper towel. You’ll be puncturing your skin, so it’s important that your hands are free of germs and debris. Don’t use hand sanitizer because it won’t wash off grime and debris like soap and water will.
Wipe the tip of your middle or index finger with the sterile alcohol swab. Remove the alcohol swab from its package and wipe your chosen finger with it for a good 15 seconds. Wait at least 30 seconds for your skin to dry completely. It's best to use your index or middle finger on your non-dominant hand so you can use your dominant hand to collect the blood.
Puncture your finger with the lancet. Twist the protective cap off the lancet and hold the puncturing end firmly against your clean finger. Push down until you hear a pop and then set the lancet aside. You should see a small dot of blood developing on your skin. Don’t worry, finger pricks are nearly painless. If you can handle shots, you can definitely handle a tiny prick! If you're squeamish about blood, take a few deep breaths in and out before puncturing your finger. You can also think of a silly joke or cheerful moment to distract you for the half-second it will take.
Wipe away the first droplet of blood with the alcohol swab. Use the same alcohol swab to wipe away the first bubble of blood on your finger because this droplet contains tissue fluid from your skin that might skew the results. Place the soiled alcohol swab on top of its opened package until you can dispose of it in a biohazard disposal bag. Some kits come with small disposable bags for bio-waste. If not, use a small airtight plastic bag.
Use the pipette to drop blood onto the "S" window of the test assay. Squeeze the bulbous top of the pipette to expel any air and then hold the small tip to the bubble of blood on your finger. Release the pressure on the pipette's bulb to suck the blood into the barrel of the pipette. Then hold it over the “S” window of the test assay and squeeze it again to expel the blood. Squeeze your finger from the base to the tip to get a large droplet of blood. You’ll need at least 1 big drop to fill the “S” window, but some tests may require up to 3 or 4 drops. Refer to the instruction manual to see how many drops are necessary.
Squeeze 2 drops of buffer onto the "S" window on the assay. Open the small dropper bottle of buffer and squeeze out 2 drops onto the same window where you placed your blood. The buffer allows antibodies in your blood to flow along the testing pads inside the assay. Some tests may require more or fewer drops of buffer, so check the instructions that came with the kit. After you squeeze the droplets out, use a clean tissue or paper towel to blot away the blood before applying a sterile bandage. Most kits don't come with bandages so you'll need to have some handy.
Check the results on the test assay after 15 minutes and within 20 minutes. Use the stopwatch application on your phone to set a timer for 15 minutes. The results will appear in the center window of the test assay where you see the letters "C" and "T" (which stand for “control” and “test”). The pigment in the assay may distort after 20 minutes, so be sure to read the results 15 to 20 minutes after dropping your blood and the buffer onto the "S" window. You should see a line next to the "C" on the test assay—this means the test is in working order. If there's no line, contact the manufacturer to get a new test. A visible line next to the "T" denotes a positive result. No line next to the "T" means the test is negative. Place the kit and all its components into a biohazard waste bag. Some kits provide these, but if not, use a plastic zipper bag.
Go to a testing clinic for a confirmation test if you got a positive reading. Home tests are proven to be around 92% accurate, but it’s best to get a second test to confirm your HIV status. If you got a positive reading, take time to care for your mental health and tend to any anxiety or depression you might be feeling at the possibility of being HIV-positive. When you’re ready to find out for sure, ask your doctor where to get tested or search online for testing clinics in your area. For instance, type “HIV testing center Miami” into your browser’s search bar. You can also find test sites at https://gettested.cdc.gov. If you suffer from depression or other psychological disorders, ask your doctor if they can refer you to a mental health professional or therapy group for people going through a similar situation.
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