HIV Testing

HIV testing can help women be empowered to take control of their health. Recently, Ontarians have more options for how they can test, including HIV Self-Testing.

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Why test for HIV?

Testing for HIV and other sexually transmitted and blood borne infections (STBBIs) is an important step, empowering women to connect with treatment and care, take control over their health, and prevent further transmissions.

HIV Testing: Quick Links

When is the best time to get tested for HIV?
What to Know Before Testing
Types of HIV Testing
HIV Self Testing & Women

When is the best time to get tested for HIV?

In Ontario, it’s recommended that you get tested for HIV as soon as possible after a potential exposure, at 3 weeks after the exposure, and at 6 weeks after the exposure.

For more information about Ontario’s newly released HIV Testing Guidelines, see Ontario Guidelines for Providers offering HIV Testing (2023).

It’s recommended to test multiple times after a potential exposure because HIV may not show up right away. A positive test at any of these time points indicates HIV infection. A negative result at all three of these time points rules out HIV infection from that exposure.

What to Know Before Testing

Before getting an HIV test, it is important to understand the different types of tests available, the possibility of a positive test result, and HIV treatment options.

How much personal identifying information is collected during an HIV test, and what happens with this information?

The amount of personal identifying information collected during HIV testing depends on the kind of test.

Nominally:
Your name and other personal identifying information is collected. If your test is positive, the testing laboratory will inform Public Health. Public Health will then contact you to provide support and refer you to HIV related services. Notifications to relevant partner(s) is done anonymously.

In Ontario, Public Health also requires any sexual or needle-sharing partners be notified that they may have been exposed to HIV. Depending on the circumstances, Public Health may do this, or may request you do this and provide proof. You can contact your local Public Health Unit for more information.

Non-nominally:
The test is ordered using a code instead of your name, but the test result may be linked back to your name.

Anonymous:
You can be tested without using your real name and no personal identifying information is collected (including your OHIP number). An anonymous file is set-up to keep your testing information separate from any other testing that may take place.

While the tester may know your name, your test result cannot be linked back to your identity. Anonymous tests are available at 50 sites across Ontario, primarily public health units and community health centres.

For more information on testing, public health and privacy related to HIV testing, contact your local Public Health Unit.

Self-Testing:
You can access self tests through Insti, GetaKit, and select pharmacies. These projects are research based so ask for some personal information; however, you can check in with your local ASO about ways to participate anonymously. See the section on Self Testing to learn more.

Find more HIV Services.

HIV Testing and Pregnancy

In Ontario, HIV testing is offered as part of pre-natal care. This testing is optional. For women who have repeated possible exposures to HIV, it is important to test regularly. Other STBBI testing can also be done at this time. For women living with HIV, early diagnoses and effective treatment is important. This is to prevent transmission during pregnancy, delivery and if breast / chest feeding.

Making a decision about breast / chest feed can be a difficult decision, and many women face judgement, stigma, and discrimination. It is important to speak to others, and consult with a health care provider with expertise in this area about what is best for you. The guidelines around pregnancy and breast / chest feeding were updated in 2023 and have helpful information to inform this decision. You can find them here.

In Ontario, there is a free formula for anyone living with HIV.

HIV Testing and Trans Women

Before 2018 the HIV test requisition form did not include information about Transgender or Non-Binary identities. When completing an HIV test, clinical staff were required to select “male” or “female” on the lab requisition form. The tester may have made that selection based on the gender presentation, health card, or assumed genitals of the person being tested. With recent updates to the testing requisition form, we will be able to have a better understanding of how many Trans women are living with HIV in Ontario.

Where to find HIV Testing Sites:

Contact Sexual Health Ontario
Call the Sexual Health InfoLine at:
- Toll-free: 1-800-668-2437
- Toronto: 416-392-2437
- eChat
Call Telehealth Ontario - a free 24/7 service where a registered nurse will answer your immediate health concerns:
- Toll-free: 1-866-797-0000
- TTY: 1-866-797-0007
Contact your local AIDS Service Organization

If you need a doctor, contact Health Care Connect

HIV Testing and Immigration

What does a positive test result mean?

A positive test result means that you have contracted HIV, unless you are using a Point of Care test or Self Test. With these tests, a confirmatory test (or Standard HIV Test) is required to confirm results.

With treatment, HIV is a chronic and manageable illness. Treatment can help to prevent the transmission of HIV to other sexual or needle sharing partners, or if you are pregnant, it can help prevent transmission to the fetus or infant. Treatment can help people live long, healthy lives. Ongoing health care and support are important to maintaining an undetectable viral load and positive health outcomes. An “undetectable viral load” is when antiretroviral HIV treatment lowers the level of virus in the body to undetectable levels on standard blood tests.

Types of HIV Testing

In Ontario, there are five types of tests available.

CATIE: HIV testing technologies

Self Test

Unlike the other tests, this type of test, which was approved by Health Canada in November 2020, is a do-it-yourself test. This means you follow instructions to collect your blood sample, conduct the test, and interpret the result. You can do this wherever you want with whomever you want. If the test indicates “positive”, the result needs to be confirmed by getting a standard HIV test.

More About Self-Testing.

Standard HIV Test

Anonymous Test

A sample of your blood is taken and sent to a public health laboratory with a code so that your personal information is kept anonymous. Anonymous testing is available at 50 locations across Ontario, mostly sexual health clinics and community health centres. Physicians and Walk-in clinics do not offer anonymous testing. To find the nearest anonymous site to you, contact Sexual Health InfoLine Ontario.

Point of Care Test

A sample of your blood is taken and tested while you wait. If your test is negative, you will learn the results immediately (about 30 minutes). If your test is reactive, your blood sample is sent to a public health laboratory for Standard HIV Testing to confirm the test results. Point of Care testing is available at over 40 locations across Ontario, mostly at sexual health clinics and community health centres. Many locations offer Point of Care testing anonymously.

Pre-Natal Test

HIV Self Testing & Women

The HIV Self Test was approved in Canada on November 3, 2020. Unlike other types of HIV testing, this test is a do-it-yourself test, much like a home pregnancy test. This means you follow instructions to collect your blood sample, conduct the test, and read the results yourself.

What is the self testing process?

The process is similar to that used in the Point of Care Test you may have done at an STBBI clinic, birth control clinic, or in an outreach testing setting. The test screens for HIV, and if the Self Test has a positive result, it needs to be confirmed through a standard HIV blood test. While the HIV Self Test results are private to you, the positive confirmatory test is reported to public health. If you test positive, it is important to seek treatment and care very soon after your positive result because starting HIV treatment right away is beneficial to your long-term health. If you choose, you can also get a confirmatory test at an anonymous HIV testing clinic, where your test results remain anonymous. Once you decide to seek treatment and care, your provider will request a name-based test for your medical file.

How do I access a self test?

Are there any concerns about HIV self testing for women?

While HIV Testing may be an exciting tool for many women, there are also concerns that are important to be aware of. Currently, the test has limited availability for free and requires people to purchase it from the manufacturer. The cost may be a barrier for some people to access it.

In some cases, there are concerns that women may face pressure to take an HIV Self Test. This concern has been raised by sex workers, and those facing gender-based violence or those who face situations where they can be coerced or forced to take the test by the use of physical violence or have their financial support, housing, or other supports taken away.

It can also be very emotionally difficult to take a HIV test. Pre- and post-test counselling, referrals for follow-up confirmatory testing, and linkages to care are an important part of the testing process. There have been concerns raised about the absence of those with the HIV Self Test.

There have been concerns about the reliability of the self-test. For more information, see “How reliable is the HIV Self Test?” below.

Whether you are a health-care or social support worker, or have a friend interested in taking an HIV Self Test, it is important for us to support each other and ensure we know all the information.

How reliable is the HIV Self Test?

Why is HIV self testing important for women?

HIV Self Testing is an exciting development; it makes HIV testing something you can do in a private setting or with the support of someone you trust. This can be an empowering tool for women to take control over their health, access care and support, or make choices to prevent HIV and ensure they live long and healthy lives. For women who have faced barriers to HIV testing due to gender-based discrimination or social, economic, and geographical barriers, this tool may mean increased access to testing and increased control over their health. It also may create opportunities for women to get connected to care earlier, while ensuring that they have the control to make decisions that impact their health care.

More resources on self testing

GetaKit

HIV Testing Ontario

Information about Accessing Support and Referrals

Sexual Health Info Line

Information on Where to Find Sexual Health Services

CATIE: Canadians Source for HIV and Hepatitis C Information

Rapid Response Free HIV Self-Testing: Basic Practices Positivity, Rates, and Associated Costs

Webinar: HIV Self-Testing National Survey Results: Knowledge, Access, Usability, Supports, and Barriers

HIV Testing and Reporting in Ontario

Self Testing How-To

More information on these programs will become available as they progress. To see how the HIV Self Test kit works, please check out this short video.

See Video Transcript

Your INSTI HIV self-test is simple to perform and very accurate. You may test positive with INSTI HIV self-test in as little as 21-22 days after infection. However, it can take as long as 3 months to produce a positive result. A negative result may not be accurate until 3 months after the infection. The test device will determine your result. The control dot and/or test dot will appear at the end of the test.

Remember, your INSTI HIV self-test will only work once. Once you have performed the test, it cannot be reused. Results should be read immediately. Before you start, read and follow the instructions carefully. Make sure that the testing area is clean and bright. Inside your self-testing kit, you will find the instructions, the test device pouch, bottle 1, 2, and 3, and lancet. When you are ready to start, open the test device pouch. Place the test device on a flat service.

Bottle 1: remove the cap and place the bottle on a flat surface. Place the cap nearby to recap the bottle after you add the blood. Twist and pull the blue tip out of the lancet and place aside. Rub your finger until warm. Place the lancet on the side of fingertip. Press hard until you hear a click. Rub the finger to get a larger round drop of blood. Let one drop fall into bottle 1. Twist on cap of bottle 1. Apply a bandage.

Bottle 1: shake bottle 4 times and pour all of the liquid into the test device. Wait until the liquid disappears.

Bottle 2: shake bottle 4 times and pour all of the liquid into the test device. You may need to gently tap bottle 2 to get the liquid out. Wait until the liquid disappears.

Bottle 3: shake bottle 4 times and pour all of the liquid into the test device. Wait until the liquid disappears. If your result is negative, test again in 3 months.

If your result is positive, go to a clinic to see a doctor. If your result is invalid, your test did not work. Go to a clinic to see a doctor. Countries may have their own disposal regulations. Please follow your country's regulations to dispose of the product. In France, you must dispose of the lancet in the yellow bins at a pharmacy. All other kit components can be disposed of in the regular household garbage. Throw away the self-testing kit into the waste bin. Frequently asked questions and troubleshooting guide are provided with your test. Additional resources are provided in the resources card.

INSTI by bioLytical Laboratories

Community Voices

Our work is always informed by the lived experiences of women.

Illustration of a green ivy plant with detailed leaves and a twisting vine on a white background.

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“Women don’t know what help is available and bridges are needed to connect more women to resources.”

- Woman’s Voice from Toronto

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“We need education for service providers about women and HIV. PrEP, PEP, PIP, U=U, testing. There is a lack of awareness, and it’s so important so women can find out more and so we can all work together.”

- Community Partner from Thunder Bay

Close-up of a blooming pink lotus flower with dark green leaves in the background.

“Healthcare should be designed based on women’s lived experiences. People should be listening to [women]. There isn’t enough of that.”