Our immune systems are beautiful things, refined through millions of years of evolution. The immune system’s complexity is testament to the “arms race” that has been taking place between our species and the harmful pathogens that surround us. Last century, a virus called human immunodeficiency virus (HIV) emerged, and it found a weak spot in our immune system’s armor. HIV has been exploiting this weakness ever since, and an HIV infection can eventually progress to a disease called AIDS, or acquired immune deficiency syndrome. AIDS is a condition that disables our immune system’s ability to function properly, rendering us vulnerable to a host of opportunistic infections and cancers.

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Even if you don’t think you’ve been exposed, HIV testing can be a good idea.

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HIV is transmitted via bodily fluids: blood, semen, pre-seminal fluid (which can be present without ejaculation), breast milk, vaginal fluids, and rectal mucus. (It can also be present in bodily fluids like amniotic fluid, cerebrospinal fluid, and synovial fluid, to which health-care workers might be exposed.) The virus is not transmitted by fluids like snot, saliva, sweat, tears, and urine — unless blood is present.

Activities that can bring you into contact with HIV-infected bodily fluids include injection drug use and sexual activities like anal, vaginal, or oral sex. It can also be transmitted to a fetus or baby during pregnancy, childbirth, or breastfeeding. In the early days of HIV, many infections occurred as a result of blood transfusions or organ transplants — though nowadays this is a rarity thanks to tissue screening. Lastly, health-care workers might be exposed to HIV through accidents involving needlesticks or cuts.

According to the National Institute of Allergy and Infectious Disease, the United States has experienced:

• 1,106,391 cases of AIDS by the end of 2008
• 597,499 deaths among people with AIDS by the end of 2007
• 40,000 new HIV infections each year, 70 percent of them affecting men
• 40 percent of new HIV infections arising from male-to-male contact, 30 percent from heterosexual contact, and 25 percent from injection drug use

Strategies to reduce your risk of HIV infection include:

• abstaining from sexual activity
• limiting your number of sexual partners
• using barrier methods such as condoms, female condoms, and dental dams (note: lambskin condoms are not effective in preventing HIV transmission)
• avoiding contact with blood, for example by abstaining from sharing needles when injecting drugs
• asking a doctor about post-exposure prophylaxis (PEP) immediately after you might have been exposed to HIV — as it is not 100 percent effective and comes with side effects, PEP is viewed as a last resort

In addition to taking steps to reduce your risk, it might be important for you to be regularly screened for HIV. After an HIV infection is initiated, it can take up to three months for antibodies to be detected by blood tests — this is called the “window period.” During those three months, it is possible to have a negative HIV test despite actually being infected and capable of passing the virus to other people. A more expensive kind of test, called an RNA test, can detect an HIV infection much earlier.

HIV tests entail having your blood drawn at a health center and returning later for the results. (At Planned Parenthood Arizona, results are available in 21 days.) For those who don’t want to wait that long for their results, rapid HIV testing is an option. This test involves an oral swab or blood from a finger prick, and the results take as little as 10 minutes. The state of Arizona allows anonymous HIV testing, meaning that an ID number will be used instead of your name. If you are interested in anonymous testing, ask if it’s available when you make your appointment. Arizona also allows minors to consent to STD-screening services without parental involvement, and physicians are not allowed to inform parents. Policies in other states may vary, and laws can change over time, so if you’re not sure, ask.

A major advantage of in-person HIV testing is that a health center like Planned Parenthood is staffed by people who can answer your questions and keep you informed. However, it’s also a good thing to have more options. To that end, earlier this year the FDA approved an at-home HIV test that can be purchased over the counter (Planned Parenthood Arizona does not carry home HIV tests in their health centers). Other types of home HIV tests allow users to mail a blood sample to a lab and call the company for their results.

The Centers for Disease Control and Prevention recommends HIV screening for anyone between the ages of 13 and 64, purely as part of their routine health care. Planned Parenthood especially encourages HIV testing for anyone who has:

• had unprotected vaginal or anal intercourse with someone who has HIV
• shared needles or syringes with someone who has HIV
• had a deep puncture with a needle or surgical instrument contaminated with HIV
• gotten HIV-infected blood, semen, or vaginal secretions into open wounds or sores

However, since we don’t always know other people’s HIV status, testing can still be important even if you don’t think you’ve been exposed. Planned Parenthood’s website has a tool called The Check that can help you determine if you should be screened for HIV. It’s also a good idea to get screened for HIV (and other sexually transmitted diseases) with your partner before initiating sexual activity — this can help you address difficult topics early in your relationship, and is a wonderful way to protect your and your partner’s health.

HIV tests are available from Planned Parenthood health centers and most physicians, hospitals, and health clinics. Local, state, and federal health departments may offer free testing. AIDS.gov also has a tool to locate a testing location near you.

Click here to check out other installments of our monthly STD Awareness series!