From the Guidelines
For individuals at high risk of HIV infection, repeat testing should be done every 3 months. This recommendation applies to people who engage in ongoing high-risk behaviors such as unprotected sex with multiple partners, men who have sex with men, injection drug users who share equipment, and sexual partners of HIV-positive individuals. The 3-month interval is optimal because it allows for detection of recent infections while providing regular opportunities for risk-reduction counseling, as recommended by the International Antiviral Society–USA HIV Prevention Recommendations Panel 1.
Key Considerations
- The window period for most modern HIV tests is about 2-4 weeks, but testing every 3 months ensures that any infection is caught relatively early, which is important both for starting treatment promptly and for preventing transmission to others.
- In addition to regular testing, high-risk individuals should consider pre-exposure prophylaxis (PrEP) with medications like Truvada (emtricitabine/tenofovir disoproxil fumarate) or Descovy (emtricitabine/tenofovir alafenamide), which can significantly reduce the risk of acquiring HIV when taken daily, as supported by the recommendations for PrEP in individuals at high risk of HIV infection 1.
- Anyone with a potential exposure should also be aware of post-exposure prophylaxis (PEP), which must be started within 72 hours of exposure, highlighting the importance of timely intervention in preventing HIV infection.
High-Risk Groups
- Men who have sex with men
- Injection drug users who share equipment
- Sexual partners of HIV-positive individuals
- Individuals with multiple sexual partners and unprotected sex
Importance of Regular Testing
Regular testing every 3 months for high-risk individuals is crucial for early detection of HIV infection, allowing for prompt initiation of antiretroviral therapy (ART) and reducing the risk of transmission to others, as emphasized by the International Antiviral Society–USA HIV Prevention Recommendations Panel 1.
From the Research
HIV Testing Frequency for High-Risk Individuals
- The Center for Disease Control and Prevention recommends that high-risk groups, such as sexually active men who have sex with men (MSM), receive HIV testing and counseling at least annually 2.
- A cohort study of 8,935 MSM found that repeat testers reported more male partners and more condomless receptive anal intercourse (CRAI) compared to single testers, and that the number of male partners, CRAI with high-risk persons, non-injection stimulant drug use, and sexually transmitted infections all increased between the first and last test 2.
- The study also found a linear increase of risk with the number of tests up to the 17th test, and that more HIV tests and younger age were associated with high Menza scores, a measure of risk behavior 2.
Repeat Testing and Risk Behavior
- The relationship between voluntary repeat HIV testing and sexual risk behavior in MSM was investigated in a cohort study, which found that repeat testers reported more risk behaviors than single testers 2.
- The study suggests that the highest risk individuals for acquiring HIV can be identified by their testing patterns, and that future studies should investigate causation versus association to improve prevention messages delivered to repeat testers during HIV testing and counseling sessions 2.
Other Considerations
- There is no direct evidence in the provided studies to support a specific timeframe for repeating HIV testing for high-risk individuals, beyond the CDC's recommendation of at least annual testing 2.
- Other studies focus on the effects of pre-exposure prophylaxis (PrEP) on kidney function 3, the role of tenofovir alafenamide in future HIV management 4, and the importance of third-trimester repeat HIV testing in pregnancy 5, but do not provide guidance on the frequency of HIV testing for high-risk individuals.