HIV testing for trans and non-binary people

Why should I test for HIV?

Many people feel nervous about taking an HIV test. It may feel nerve-wracking to visit a sexual health clinic and it can feel particularly difficult if you’re trans or non-binary. But having an HIV test is the only way to know for sure whether you have HIV.

If you do have HIV, it’s very important that it’s diagnosed. Only once you know you will be able to receive the treatment you need to stay well.

There’s not been much research into HIV in trans people, especially in the UK. But the little research we do have shows that rates of HIV are far higher among trans people than cisgender people. In particular, trans women have higher rates of HIV.

“Why I test regularly” A trans women at CliniQ – a holistic sexual health, mental health and wellbeing service for trans people in London – told us why she tests. She said that she’s on PrEP and always takes an HIV test when she gets a new PrEP prescription, just to make sure everything is fine. That’s because she’s meeting up with guys on online dating apps and testing regularly puts her mind at ease.

When should I test?

When and how often you test for HIV can depend on different factors:

• If you have a new partner or more than one partner, you should test for HIV at least every three months. And it’s good to test in between new partners if you can.
• If you are sexually active, for example have oral, vaginal / front hole / frontal or anal sex, it’s recommended that you test for HIV at least once a year – even if you use condoms or have sex with only one partner.
• Even if you’re not sexually active, it’s recommended to test for HIV at least once in your life.
• If you take PrEP, it’s recommended to do a HIV test every three months.

Where can I test for HIV?

There are many ways of taking an HIV test. If you choose to test through a private provider, you will likely have to pay for the test. If you’re testing through the NHS, your test will be free. Whichever option you chose, your test should always be voluntary and confidential. That means no one should force or pressure you to take a test and no one should share the results with someone else without your permission.

You can order a kit to take a test at home. You can find out more about where to get these by clicking here. There’s more information on testing at home below.

In the UK, you can also test for HIV at NHS sexual health clinics. There’s more information on this below. You can use our test finder to find HIV testing services near you.

Unfortunately, many trans people still experience discrimination and stigma in health care. That’s why some people prefer to go to clinics that specialise in care for people who are trans or non-binary, for example CliniQ – a holistic sexual health, mental health and wellbeing service for trans people in London. You can also find a list of sexual health clinics for trans and non-binary people in the UK on the Terrence Higgins Trust website.

“Why I go to a sexual health clinic for trans people” A non-binary person at CliniQ told us they’re often worried about STIs when hooking up with casual partners. In the past, when they went to other sexual health services, they often ended up having to educate staff about trans and non-binary people. That’s why they feel more comfortable going to CliniQ, as it’s a clinic run by trans people.

How do I test

Testing in a sexual health clinic

Some people prefer to test with the help of a medical professional, for example at a sexual health clinic. Sometimes, you may also be offered an HIV test as part of other medical care you are receiving.

There are different methods of testing. The healthcare professional may take blood from your arm to send it for analysis in a laboratory. These tests are the most accurate, but it usually takes a few days to get the results.

Or they might take a small drop of blood from your finger or rub an absorbent pad around your gums. With these methods, you will get the results within a few minutes.

A benefit of testing in a healthcare setting (like a sexual health clinic) is that you can ask questions and tell the healthcare professional if you have any concerns.

A lot of people also find it easier to have the help of a professional to draw blood rather than doing it themselves. This can be particularly helpful if you have low blood pressure or are fearful of needles.

Testing at home

You can also order a self-testing kit to use at home, or another private place. The test will usually arrive within a few days and will be packaged in neutral packing (so no one else can tell what it is).

There are different ways of testing at home. You will either collect a small sample of blood from the tip of your finger or rub an absorbent pad around your gums. Depending on the test, you will either send the sample to a laboratory via post or read the test result yourself after a few minutes.

Some people find at-home testing difficult. Even though the tests are designed to be easy to use, you have to follow the instructions carefully to get an accurate result.

However, many people prefer this because they find it convenient to test from home. Some trans people prefer this as you don’t have to directly interact with a healthcare professional and you don’t have to share your gender identity if you don’t want to.

“Why I test from home” A trans man at CliniQ told us that he prefers testing at home as it’s just more convenient. He works every day and there isn’t a sexual health clinic near his home.

 

Opt-out testing

Many A&E departments in the UK have now have adopted 'opt-out testing'. This may also be offered to you in other settings, for example at sexual health check-ups, during pregnancy appointments or at your GP.

It means that if you get any blood test, you will automatically be tested for HIV as well unless you explicitly decline. This is to make sure more people get an HIV test who are less likely do so otherwise.

In most cases it’s a good idea to say yes if a test is offered to you. But you should never feel pressured to have an HIV test.

How soon can a test detect HIV?

It’s important to note that HIV tests aren’t able to detect HIV immediately after you were infected. This is called a window period. The length of the window period depends on the type of test you take.

Laboratory tests are tests that require your blood to be analysed in a laboratory. Sexual health clinics and hospitals usually use these kinds of tests. They pick up most cases of HIV within four weeks of it being caught. But sometimes it can take up to eight weeks for HIV to be detected.

For a rapid test, your blood doesn’t need to be send to a laboratory. Instead, you receive a result within a few minutes after taking a drop from your blood or rubbing an absorbent pad around your gums. These types of tests pick up most cases of HIV within six to eight weeks of it being caught. However, it may take up to 12 weeks for HIV to be detected.

This information resource was developed in partnership with CliniQ, a holistic sexual health, mental health and wellbeing service for all trans people, partners and friends. CliniQ is a trans organisation by and for trans people in London, who offer a safe, confidential space for those who may not feel comfortable accessing mainstream services. Find out more.