Have you had risky sex? Have you had unprotected sex, or did the condom rip or slip off? Used someone else's equipment to administer drugs? Or do you have symptoms that could indicate HIV? Go for an HIV test.
- There are several reasons for getting tested for HIV.
- You can get tested at your general practitioner, the GGD (Municipal Health Centre), an HIV rapid-test location, or you can do a self-test.
- If you were exposed to HIV less than 72 hours ago, taking PEP to prevent HIV infection is an option.
- The 3rd generation HIV test gives a reliable result 8 weeks after you were exposed. If the test comes up negative, repeat it 12 weeks after you were exposed.
- The 4th generation HIV test gives a reliable result 6 weeks after you were exposed. If the test comes up negative, repeat it 12 weeks after you were exposed.
- An RNA test can detect HIV as early as 1 to 2 weeks after you were exposed, but this test is not widely available.
- A rapid test gives you results within an hour, but it is not recommended if you are taking PrEP because the test is then less reliable.
Is an HIV test necessary?
HIV is mainly found in blood, semen, vaginal fluids and breastmilk. The virus can also be found in other bodily fluids, but in such low concentrations the risk of transmission is zero. Read more here about the risk of transmitting HIV.
You can get tested for HIV in the following cases:
- You’ve had sex with someone who has HIV but does not have a suppressed virus, and you didn’t use a condom.
- You’ve had sex with someone who you think might have HIV, and you didn’t use a condom.
- You’ve had an accident with an injection needle used by someone who has HIV but does not have a suppressed virus.
- Someone has told you that you are at risk.
- You have symptoms that indicate HIV infection (see acute infection for more info)
If you are not sure whether an HIV test is necessary, you can contact the Servicepunt (Service Desk) at the Hiv Vereniging (The Dutch Association of People with HIV) or the Soa Aids Nederland Infolijn (helpline).
Which test when?
Which test is appropriate, and when you can get tested, depends on how long ago you were exposed to HIV. When do you think you might have been exposed?
Less than 72 hours ago
Taking PEP (postexposure prophylaxis) for a month after you've been exposed, can prevent HIV infection. You should start taking PEP within 72 hours after you've been exposed, the sooner you start the better. Contact the GGD as soon as possible if you think you need PEP. If you don't manage to contact the GGD, you can contact Spoedeisende Hulp (Emergency room) at the hospital. After 72 hours there is no point in taking PEP.
3 months after you have finished the PEP cure (so 4 months after you were exposed) you have to do an HIV test to rule out HIV.
Where can you take an HIV test?
There are several ways to get an HIV test. The costs and type of test can differ from place to place. Check below for which place suits you best.
You can have an HIV test done at your general practitioner’s practice. You often get the results from the doctor’s as fast as from the GGD. Your own name has to be used in the test because of the health insurance, but your doctor has a duty of confidentiality. The costs are deducted from your eigen risico (the excess that has to be paid for health costs). Once you've used up your eigen risico, the other tests are free of charge. But you have to pay for HIV tests until your eigen risico has been used up.
If the test shows that you have HIV, you will be referred to an HIV treatment centre, where specialists will give you further assistance.
Various kinds of HIV tests
There are various ways of testing the blood to see if someone has HIV. Looking for antibodies and/or antigens is one of them. Click here to read more about what antibodies and antigens are. The same test is used for HIV-1 and HIV-2.
An HIV rapid test draws a drop of blood via a finger prick. The results of an HIV rapid test are usually available within 20 minutes to an hour. The results of a regular HIV test are usually given within a week. The rapid test is also called a point of care (POC) test.
Nowadays there are reliable rapid tests that can establish the presence of HIV after 6 weeks: the Alere HIV Combo and the Alere Determine HIV-1/2 test. These are 4th generation tests. But most rapid tests are 3rd generation tests. The 3rd generation rapid test is not reliable until 12 weeks after the infection. Check carefully which rapid test is being used, so that you know whether the result is reliable, and whether you may need to be tested again.
The rapid tests have a sensitivity of at least 98.1% and a specificity of at least 98.9%. This means that at least 98.1% of people with HIV test positive, and at least 98.9% of people without HIV test negative. Don’t forget: the HIV rapid test is not recommended if you are taking PrEP. If you are taking PrEP it's better to get a regular HIV test.
Free HIV test
- You can do an HIV test free of charge at your general practitioner when your eigen risico has been used up. You will be liable to pay any costs for an HIV test until you eigen risico has been used up.
- HIV tests at the GGD (in Dutch) are free for young people under 25, men who have sex with men, sex workers, people who have been warned by someone with HIV, people who have symptoms. If you come from a country where there is a high incidence of STIs, you too can get tested at the GGD free of charge. Check on the website of a GGD near you if you can make an appointment.
- If you are a man who has sex with men, you can go to the Testlab for a free HIV test. You will need to be living in one of the following places: Amsterdam, Rotterdam-Rijnmond and Dordrecht; the Haaglanden region (The Hague, Delft and surrounding area); the Gelderland-Zuid region (Nijmegen and Tiel); or in Groningen, Drenthe or Friesland. Click here for conditions and more information.
- You can also have a free HIV test done at AHF Checkpoint in Amsterdam and Rotterdam. Click here for the opening times.
- From September 23, 2020 everyone can go to DC Klinieken Lairesse in Amsterdam for a free HIV rapid test. More information can be found here (in Dutch).
- Are you living in an asylum seeker centre (AZC)? Then you can get a free test at the AZC’s health centre.
HIV tests for people without a residence permit or health insurance
If you don't have a residence permit or health insurance, you can still get tested for HIV. If you test positive, you have the right to treatment, even without insurance.
HIV test for pregnant women
Pregnant women are routinely tested for HIV in the Netherlands. There is standard testing for pregnant women, because HIV treatment during pregnancy can ensure the baby will not contract HIV. So the test is not done for the mother, but for the unborn child.
HIV test and PrEP
Pre-exposure prophylaxis (PrEP) can influence the results of an HIV test. PrEP can cause the antibody production to be lower than normal, and for an HIV test not to be positive even though you have HIV. This occurs mainly with rapid HIV tests. So we advise you to take a regular HIV test when taking PrEP, and not an HIV rapid test.