When you get tested for a condition like human immunodeficiency virus (HIV), you likely understand the meaning of results that are positive (yes, you have it) or negative (no, you don’t). But what does a “nonreactive” HIV test result mean? It’s important to fully understand what the test measures and what your results mean.

An HIV test is used to find out if you’re infected with HIV, and a nonreactive result means that the test did not detect signs of HIV in the fluid sample you provided. A nonreactive result is reassuring, but if you tested too soon after exposure, the virus might not be detectable yet.

Understanding how HIV testing works is important to make sure you know whether you need treatment and if you could pass the infection on to others. It can be confusing if you’re told that your HIV test is nonreactive instead of negative, so read on to learn more about what a nonreactive test result means.

When Should You Get an HIV Test?

It’s important to time your HIV test properly in order to get the most accurate result. Avoid taking an HIV test too early, as HIV tests have limitations in terms of when they can detect the presence of the virus. The test won’t detect the infection during the eclipse period, which lasts about 10 days after the exposure.

The window period is the time between a possible HIV exposure and when an HIV test can accurately detect an HIV infection in your body. The length of the window period depends on the type of test you take and may fall somewhere within 10 days to 90 days after exposure. This means that a test might find an HIV infection as early as the 10-day mark, but it could take up to 90 days to accurately detect an infection. It’s best to get tested after the window period for the type of test you are taking.

Types of HIV Tests

There are three types of HIV tests available — antibody tests, antibody/antigen tests, and nucleic acid tests (NATs). Each test looks for a different indicator of HIV infection.

Talk to your healthcare provider about which test is right for you.

HIV Antibody Tests

An antibody test checks for HIV antibodies in a sample of body fluid. The sample is most commonly blood or saliva, depending on the type of test. Your doctor can use an antibody test to test you for HIV while you wait (a rapid test) or send a blood sample (taken from your vein) to a laboratory. You can also find at-home HIV antibody test kits.

Antibodies are proteins your immune system makes to help it recognize and fight foreign invaders, such as viruses. If you are infected with HIV, your body will make antibodies specific to parts of the virus called antigens. You won’t have HIV antibodies immediately after being infected because it takes time for your body to recognize HIV antigens and start producing antibodies. In general, antibody tests with a blood sample can detect HIV earlier than a saliva sample. The window period for an HIV antibody test is between 23 days and 90 days after infection.

If you have a nonreactive HIV antibody test, it means that the test did not detect HIV antibodies in your fluid sample. This test may not accurately diagnose HIV if you take it before your body begins making antibodies.

HIV Antibody/Antigen Tests

Antibody/antigen tests check for both HIV antibodies and antigens in your blood. These are the most commonly used types of HIV tests, and they’re available as rapid tests and laboratory tests.

This type of blood test may provide an accurate result earlier than antibody tests because HIV antigens can show up in your blood sooner than your body can make antibodies. The window period is 18 days to 90 days for a rapid antibody/antigen test and 18 days to 45 days for an antibody/antigen laboratory test.

A nonreactive antibody/antigen test means that the test did not detect HIV antibodies or HIV antigens in your blood sample.

Nucleic Acid Tests

Also known as viral load tests, NATs look directly for HIV and can tell how much of the virus is in your blood. This type of test is most often used to monitor HIV treatment. NATs require sending a blood sample taken from your vein to the laboratory for testing.

NATs can often detect an HIV infection earlier than other tests because they detect particles of the virus itself. The window period for NATs is between 10 days and 33 days after infection.

Although this test may be able to detect infection a few days earlier than others, it isn’t commonly used as a screening test. Your medical provider may order a NAT if you have had a nonreactive antibody or antibody/antigen test but are showing early symptoms of HIV, such as fever, chills, or swollen lymph nodes. If antigen/antibody testing shows initial reactive results, the lab may also run a NAT to confirm whether HIV can be detected.

Who Should Get Tested?

It’s generally recommended that all individuals aged 15 and older be tested for HIV at least once in their lifetime. If you have certain risk factors, you should get tested more often.

According to the World Health Organization (WHO), people who meet the following criteria are at greater risk:

• Having anal or vaginal sex without a condom
• Sharing drug injection equipment
• Receiving unsterile injections, blood transfusions, or other medical procedures that involve cutting, piercing, or needles
• Harmful drug or alcohol use before, during, or after sexual behavior
• Being diagnosed with another sexually transmitted infection (STI)
• Having sex with someone whose sexual history you don’t know

Depending on your lifestyle, you may benefit from getting tested every three to six months. Talk to your doctor about your risk factors and how often you should be tested.

What if You Have a Nonreactive HIV Test?

Your healthcare provider can explain your HIV test results and go over your risk factors for HIV infection. If you took the HIV test before the window period was over, you might need to test again. If you took the test three months or more after a possible HIV exposure, you can be confident you are not infected with HIV.

If you know or suspect you have been exposed to HIV, you should ask your doctor about starting post-exposure prophylaxis (PEP) to reduce your risk of an HIV infection. PEP should begin within 72 hours (three days) of exposure and can be started before an HIV test can detect an infection. Before you start PEP treatment, your doctor will administer a baseline rapid HIV test to make sure you’re not HIV-positive due to a previous exposure. This ensures the treatment is effective.

Is HIV Nonreactive the Same as HIV-Negative?

A nonreactive HIV test means that it didn’t find any evidence of HIV infection in your body. While this is technically a negative result, it’s important to be aware of the test’s limitations during the window period following exposure and to make sure your testing falls outside this window.

Can You Get HIV From a Nonreactive Person?

Yes, it’s possible to get HIV from a person with a nonreactive test result, because they may have taken the HIV test before the window period ended, before test results can accurately identify HIV infections. That’s why you should always practice safe sex and consider testing more frequently if you have a higher risk factor.

Other steps you may consider to prevent the spread of HIV include:

• Practicing abstinence (not having sex)
• Not sharing drug injection equipment
• Using condoms
• Taking PrEP

Find Your Team

On myHIVteam, the social network for people with HIV and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with HIV.

Have you received a nonreactive result for an HIV test? Did you discuss the result’s meaning with your healthcare provider? Share your experience in the comments below, or start a conversation by posting on your Activities page.