HIV screening test: free and without a prescription in the lab

[Mis à jour le 7 février 2022 à 12h18] Nearly 6.2 million tests for the human immunodeficiency virus (HIV) are carried out in France each year (2019 figures from Health Insurance), with between 6,000 and 6,500 new discoveries of seropositivity per year since 2007. In this context, HIV testing must be strengthened. Since January 1, 2022, it is simplified and possible in the city laboratory: without advance payment, without an appointment and without a prescription. This system concerns all social security beneficiaries and their dependents (including beneficiaries of state medical aid (AME), we can read on the Health Insurance website, Ameli. In pharmacies, the screening test is not free. (about 5 euros) HIV testing lets you know if you are infected with the virus. responsible for AIDS. This disease sometimes starts several years after the contamination, the fact of being in good health, does not imply that you are seronegative. In addition, early detection makes it possible to benefit from treatment as soon as possible and thus to live much longer.

What are the indications for an HIV test?

Anyone can be screened whenever they want, regardless of the reason that leads them to this process. So you can do this test at any time.

• If you took a risk (unprotected sex, condom breakage, etc.). First to find out what’s going on and also to protect your future partners.
• If you want to have sex without a condom with your partner. Whatever he or she tells you, even if he or she has been tested before, both of you should be tested.
• It is mandatory in certain cases: for donors of blood or organs, for sperm donors, for milk donors. It is also systematically offered to pregnant women.

It is achievable for all those insured by social security and their dependents (including beneficiaries of state medical aid (AME). Anyone, without risk of exposure to a risk of contamination, should take an HIV screening test. at least once in his life between the ages of 15 and 70, insists the Health Insurance.

For whom is the HIV test recommended?

Some people are recommended to get tested regularly for HIV. Are concerned :

• men who have sex with men (recommended screening every 3 months);
• injection drug users (annual screening);
• people from areas where HIV infection is common, particularly sub-Saharan Africa and the Caribbean (annual screening).

Some people are recommended to get tested punctually for HIV, in the following circumstances:

• for a couple planning to have a child or during pregnancy;
• during a first prescription for contraception;
• in the event of a plan to stop using condoms;
• in the event of a request for voluntary termination of pregnancy;
• after a rape;
• while incarcerated;
• after exposure to a risk of HIV contamination (sexual, blood or occupational risk);
• when diagnosing a sexually transmitted infection (STI), hepatitis B or hepatitis C or tuberculosis;
• in the presence of a clinical picture suggestive of primary infection (first contact) with HIV.

What are the different HIV screening tests?

HIV testing is based on several techniques:

► A laboratory blood test. The HIV serology currently performed in the laboratory is the 4th generation Elisa test detecting anti-HIV-1 and anti-HIV-2 antibodies as well as a virus antigen called P24.

• If the test is negativethe person can be reassured as long as the last risk of exposure to the virus dates back 6 weeks or more.
• If the test is positive, another test called Western-Blot looking for different antibodies, is done to confirm the diagnosis. If the latter is negative, the screening must be repeated a little later.

► A rapid diagnostic orientation test (TROD HIV) which allows to have a result in 30 mins max. It is most often performed on a drop of blood taken from the fingertip (it can also be performed from the fluid present on the gums). It detects anti-HIV-1 and anti-HIV-2 antibodies.

• If the test is negativethe person can be reassured insofar as his last risk of exposure dates from 3 months or more.
• If the test is positivethe result must be confirmed by a 4th generation Elisa blood test in the laboratory.

► An HIV self-test, which is a TROD that can be used by anyone wishing to test themselves alone at home. Sampling and interpretation are carried out by the person concerned. The self-test can detect HIV antibodies in 30 minutes from a drop of blood or fluid secreted by the gum tissue.

• If the test is negativethe person can be reassured insofar as his last risk of exposure dates from 3 months or more.
• If the test is positivethe result must be confirmed by a 4th generation Elisa blood test in the laboratory.

>> Caution: the reliability of the tests is not perfect; there are false positives (positive test and absence of contamination) and false negatives (negative test and actual contamination).

Where to take an HIV test?

HIV and STI screening is possible in different places:

• In a public or private laboratory
• In a free information, screening and diagnosis center (CEGIDD) which brings together anonymous and free screening centers (CDAG) and STI information, screening and diagnosis centers (CIDDIST). They offer free screening for the AIDS virus (to anyone, including people without social security, as well as social security or AME beneficiaries who wish to remain anonymous), but also for hepatitis and sometimes other STIs.
• A family planning and education center (CPEF)
• A center for PMI (maternal and child protection)
• An association for the fight against AIDS
• A PASS (permanent access to health care)

Since January 1, 2022, the HIV screening test is simplified. It is possible in a city laboratory :

• without upfront costs
• without prescription
• without an appointment.

Do you have to be fasting?

The AIDS screening test consists of a simple blood test and that you can carry out in a classic analysis laboratory, in town, without the need to fast.

Can the test be anonymous?

Be aware that the traditional blood tests (blood tests) that your doctor may offer you do not include the HIV screening test. It is only with your agreement or because you have requested it that he will prescribe this test for you. The result will be indicated on the sheet sent by the laboratory (for this analysis, the results are not available online). Furthermore, your doctor being subject to medical secrecy, it will not communicate the result to anyone other than you. Also note that the laboratory test is covered at 100%, without advance of costs since January 1, 2022 for the insured and the beneficiaries.

Deadline: when to take an HIV screening test?

If you think you have been exposed to a risk of contamination within hours of exposure to risk : appointment as soon as possible and without exceeding 48 hours, either at the emergency department, or in a CDAG, or with your doctor. After having precisely assessed the risks to which you may have been exposed, preventive treatment for a period of one month may be prescribed to you, with your agreement, in order to try to avoid possible contamination by HIV.

• In the 6 weeks to 90 days after risk exposure : at this stage it is now possible to detect whether or not you have been infected with HIV. It is therefore strongly recommended to do a first screening test and repeat it after 3 months if the first result is negative.
• Within 3 months or more after exposure to risk : go to a CDAG, to a hospital department or to your doctor who will examine your situation in complete confidentiality; a screening test may be offered to you, with your agreement, or at your request in order to determine whether or not you are infected.