HIV Testing

You may already know that standard HIV testing detects HIV antibodies (your body’s response to HIV), rather than the virus itself. We used to have to wait up to 3 months for antibodies to be at detectable levels to show up on an HIV test, testing in Ontario has improved and the guidelines have changed to reflect a new window period of 6 weeks as well as additional access points to testing in priority communities to try to ensure that people know their HIV status sooner.

• Antibodies: your body’s immune response to HIV, what shows up on an HIV test (rather than the virus itself).
• Antigens: the p24 antigen is a specific part of HIV itself that some tests use to determine if HIV is present.
• Window Period: the period of time from when a person is infected with HIV to the time when an HIV test can detect the infection.

Many people will develop antibodies or have a detectable level of antigens with current testing technology within 3 weeks of exposure to HIV. [1] Your tester will ask you to return after 6 weeks, and possibly again after 3 months to get tested, depending on the type of test being used. They may use antibody testing which can take up 3 months to reach a high degree of accuracy; or a testing technology that uses both P24 antigen testing along with antibody testing to help detect infections with an equally high degree of accuracy as early as 6 weeks. [2] (Note: a tester might also ask you to get tested right away to set up a baseline test.)

Note: Taking PEP (post exposure prophylaxis) will affect these testing timelines. PEP is a medical intervention involving HIV medications taken within 72-hours after a possible exposure to HIV in order to reduce chances of infection.)

Types of HIV Tests

The two main kinds of HIV tests available in Canada are the standard HIV test and the rapid HIV test.

Rapid HIV Test (Point of Care Test, Self-Test)

With a rapid test, you get an initial result within a few minutes of doing the test. Rapid tests are screening tests involving a few drops of blood from your finger. This means that if the test shows a positive (“reactive”) result, you will need to get a confirmatory test to confirm the result. The Rapid HIV tests have 99.6% accuracy 3-months after exposure to HIV; your healthcare provider may ask you to get tested 3-weeks and 6-weeks after exposure using Rapid HIV tests as significant amounts of people develop antibodies at these time periods. [3] You might be able to get a rapid test from a healthcare provider or community worker, but this option isn’t available in every part of Canada. In regions where rapid tests are available, they are often provided at certain specialty clinics, such as sexual health clinics, or through HIV organizations. However, anyone in Canada can get a rapid self-test, which you can perform on yourself at home. Self-tests can be ordered online from the manufacture at low cost and may be available for free from community organizations or for purchase in some pharmacies. For more information on how to access free HIV self-testing, see the section below.

Note: At present one organization in Vancouver is mailing self test kits for free to men all over Canada – see the Self Testing section below about the Test@Home program from the Community Based Research Centre.

Standard HIV Test (Laboratory-based Serology Test)

Many people use what is known as a standard HIV test. A vial of blood is taken from a vein in your arm and sent to a laboratory for analysis. These tests will have 99% accuracy 6-weeks after exposure. [4] It can take up to two-weeks to get your result. Talk to the person who does your test about how you will get your test result. There are many places to get a standard HIV test, including family doctors’ offices, walk-in clinics, and sexual health clinics.

Anonymous Testing for HIV

This type of Rapid HIV testing does not involve a health card and doesn’t appear on any public record linked to you. In Ontario it is only offered for HIV and can only be done at designated site in Ontario. To find an Anonymous Rapid HIV test provider near you, contact:

Sexual Health Infoline Ontario (SHILO)

Website: SHILO
Toll-free: 1-800-668-2437
Local: 416-392-2437
TTY: 416-392-0658

Monday to Friday: 10 a.m. to 10:30 p.m.
Saturday & Sunday: 11 a.m. to 3 p.m.
Statutory holidays: Closed

The SHILO service is offered in many languages.

Find out more about HIV testing strategies at CATIE and at the Ontario HIV Treatment Network.

HIV Testing Locations in Toronto

This is not a complete list of testing sites.

Bay Centre for Birth Control
Target Community: Women
Accessibility: Wheelchair accessible, including barrier-free washrooms.
76 Grenville St. Floor 3 (map)
Toronto, ON M5S 1B2
Tel: 416-351-3700
Email: bcbc@wchospital.ca
Website: www.womenscollegehospital.ca/care-programs/the-bay-centre-sexual-health/
Hours: Monday/Friday (9am – 5pm), Wednesday/Thursday (9am – 8pm)
• Appointments are required.
• Rapid HIV testing is offered.
• Services are for women ONLY.

Centre Francophone de Toronto
Target Community: Primarily Francophones, but open to all.
Accessibility: Wheelchair accessible, including barrier-free washrooms.
555, Richmond St. West, (map)
Toronto, ON M5V 3B1
Tel: 416-922-2672
Fax: 416-922-6624
Email: servicesvihsida@centrefranco.org
Website: www.centrefranco.org
Hours: Monday/Tuesday/Wednesday/Friday (8:30am – 4:30pm), Thursday (8:30am – 8pm)
• Appointments are required.
• Standard HIV test (blood draw) only.
• Rapid HIV testing not available.

Hassle Free Clinic
Accessibility: Wheelchair accessible, including barrier-free washrooms.
66 Gerard Street East 2nd floor (map)
Toronto, ON M5B 1G3
Tel: 416-922-0566
Fax: 416-922-2018
E-mail: admin@hasslefreeclinic.org
Website: www.hasslefreeclinic.org
Women’s Clinic Hours: Monday/Wednesday/Friday (10am – 3pm), Tuesday/Thursday (4pm – 8pm)
Men’s Clinic Hours: Monday/Wednesday (4pm – 8pm), Tuesday/Thursday (10am – 3pm), Friday (4 – 7pm), Saturday (10am – 2pm)
• Appointments are required for HIV testing.
• Anonymous Testing available.
• Rapid HIV testing & Standard HIV testing available.

HQ Toronto
Target Community: gay, bi, and queer guys (cis and trans and non-binary)
Accessibility: Wheelchair accessible.
790 Bay Street, Suite 820 (map)
P.O Box 66, Toronto, ON M5G 1N8
Tel: 416-521-4445
Email: info@hqtoronto.ca
Website: www.HQtoronto.ca
Hours: Monday/Tuesday/Wednesday/Thursday (12pm – 7:30pm), Friday (12pm – 5:30pm)
• No appointment necessary.
• Rapid HIV testing & Standard test (blood draw) available.

Planned Parenthood of Toronto
Accessibility: Venue is not accessible.
Target Community: Youth (ages 13 – 29) only
36-B Prince Arthur Avenue (map)
Toronto ON M5R 1A9
Tel: (416) 961-0113
Fax: 416-961-2512/416-961-9856
E-mail: ppt@ppt.on.ca
Hours: Monday/Tuesday/Thursday (12:30 – 7:30pm), Wednesday (3:30 – 7:30pm), Friday (12:30 – 3:30pm), Saturday (9:30am – 2pm)
• No appointment necessary.
• Standard HIV test (blood draw) only.
• Rapid HIV testing not available.

Queen West Community Health Centre
Accessibility: Wheelchair accessible, including barrier-free washrooms. One designate disabled parking spot.
168 Bathurst Street (map)
Toronto, ON M5V 2R4
Tel: 416-703-8482 ext. 100 to book appointment
Fax: 416-703-6190
Website: www.ctchc.com
Hours: Thursday/Friday (9:30 – 11:50am)
• Appointments are required. Call 416-703-8482 ext. 100 to book an appointment.
• Anonymous Rapid HIV tests available on Tuesdays & Thursdays

St. Stephen’s Urban Health
Target Community: People who use Drugs & Homeless/ houseless
Address: 260 Augusta Ave, Toronto, ON M5T 2L9
Monthly Drop-in:
Every second last Thursday of the month 9 am – 12 pm
Contact the HIV Program Lead for more information:
Tel: (647) 463 5972
From 9am – 6pm via call & text message
• No appointment necessary.
• Rapid HIV testing is offered.

Women’s Health in Women’s Hands
Target Community: Racialized Women
Accessibility: Wheelchair accessible, including elevator & barrier-free washroom
2 Carlton Street, Suite 500
Toronto, ON M5B 1J3
Tel: 416-593-7655
E-mail: info@whiwh.com
Clinical Services: 416-593-7655, Ext. 7
Hours of Operation:
Monday, Thursday and Friday 9 am – 5 pm
Tuesdays and Wednesdays 9 am – 8 pm
Every 3rd Saturday 10 am – 4 pm
• Appointments are required.
• Rapid HIV testing is offered.

HIV Self-Testing

HIV Self-Testing Kits are Rapid HIV tests, meaning that the results will appear within a few minutes. These HIV Self-Tests are available for anonymous delivery right to your doorstep, or for pickup at ACT’s office.

I’m Ready
1. Download the “I’m Ready, Test” & set up a anonymous user ID. Answer survey questions to determine your demographic and level of risk.
2. Choose how you get your self-test kit: mail-out delivery OR pick-up. Mail out can take 1-2 weeks, and pickup at ACT is readily available.
3. Conduct the test wherever you are comfortable! Follow the instructions on the Test app to perform the test effectively. Answer the follow-up questions on the app after you get your results.
4. Download the “I’m Ready, Talk” to connect with a Peer Navigator for support. Answer survey questions to match you with the right Peer. Pick your preferred communications (i.e. video chat, text, voice call, etc.) Book an appointment to speak with your Peer: Monday – Friday from 12:00pm-10:00 pm
Recommended: Have your appointment with your Peer booked before you test yourself. A Peer can assist you during your test and counsel you before and after.

GetaKit
1. Go to GetaKit.ca/act/register.  Scan and sign the consent form. Create an account with your mailing address and contact info so GetaKit can send you a kit and contact you for follow-up purposes. Answer some survey questions to determine your demographics and level of risk.
2. Choose how you get your self-test kit: mail-out delivery OR pick-up. Mail out can take 1-2 weeks, and pickup at ACT is readily available.
3. Conduct the test wherever you are comfortable, using the instructions on the box.

Test@Home (Community Based Research Centre)
At the CBRC individuals can get up to four FREE HIV self-test kits through the Test@Home program.  https://www.cbrc.net/test_at_home . (With mirror sites in French and Spanish.)

Buying an HIV Self-Test

Self test kits are offered at pharmacies but can cost up to $60 each in some stores. Usually, these are local HIV and PrEP involved pharmacies who sell these kits. It is a convenient option if you do not want to wait for a self-test kit in the mail. The manufacturer of HIV self-test kits, Insti can sell and ship a pack of two test kits for a cheaper price.

When to Test

You should test for HIV if:

• you are not on PrEP, do not know the HIV status and viral load of your sexual partner(s), have had anal or vaginal/front hole sex with your partner and have not used a condom (or the condom broke or used only partially during sex); or
• you have shared a syringe with your partner and do not know their HIV status.

Note: If you do know your partner’s HIV status and they have a viral load above 200 copies/ml – you should consider testing if you have been in the above-described situations. Also, if you are within 72 hours of the potential exposure of HIV as described above, you should consider PEP (post-exposure prophylaxis) to reduce the risk of seroconverting (becoming HIV positive).

You should also test for HIV if:

• your sexual or substance-using partner(s) have recently tested positive for HIV;
• you have recently tested positive for other STIs or blood borne infections your medical provider has seen in association with HIV (eg. syphilis, chlamydia, gonnorhea);
• you have been sexually active / or shared syringes in the past and have acute HIV infection symptoms; (Over 70% of people with a recent HIV infection experience fever, joint and muscle pain, swelling lymph nodes, sore throats and rash. Night sweats, nausea, diarrhea, and headaches can also be experienced.); or
• you get a call from public health asking you to get tested.

Note: Starting and maintaining PrEP or PEP (medications taken to prevent HIV infection) will also require different HIV testing timelines.

The Queer Community has faced HIV Often – Routine Testing Makes Sense
If you are queer, routine testing makes sense. If you are queer and a member of another community that has also been affected by HIV disproportionately in Canada, testing becomes even more important. These other communities include: African, Caribbean and Black communities, Indigenous peoples, and people who use drugs. (Cis and trans women whose sexual or substance sharing partners belong to the above communities are also at increased risk – so routine testing makes sense for them too.)

This can range from getting tested once a year (even for men in monogamous relationships with other men) to getting tested every three-months or after every high-risk exposure for guys who experience a lot of condomless sex with partners whose HIV status is unknown or are living with HIV and have a viral load count above 200 copies/ml of blood. (PrEP should be considered as an option for people in this situation.)

It can also be a good idea to get an HIV test anytime a sexually transmitted infection happens, and when starting a new sexual relationship.

Travelling is often not seen as time to test for HIV, but if you have sex while travelling, even if its in your country of origin, you should consider getting tested upon your return to Canada. (Starting PrEP maybe a good thing to consider before travelling.)

If you are a newcomer to Canada and came here on a work or student visa, testing may not have been part of your entry experience, so getting an HIV test would be important if you have been here less than 5 years.

Having HIV for a while and not knowing It

HIV testing is important to consider when a queer guy is experiencing unexplained infections repeatedly.

This can look like unexplained weight loss, shingles before age 55, repeated yeast infection or thrush outbreaks in mouth or throat (a white crust, aka: candidiasis), vaginal/front hole yeast infection, repeated skin lesions, a decrease in white blood cells, pneumonia or infections affecting the heart (endocarditis), tuberculosis or any other infection a medical professional would associate with immune systems not working properly.

Receiving Health Care Can Involve Testing for HIV

HIV testing should happen in case of:
• pregnancy,
• immune-suppressing therapies,
• HIV associated cancers,
• high dose steroid and other treatments for rheumatoid arthritis,
• taking PrEP or PEP, and
• anxiety over being HIV positive, even without evidence of a high-risk exposure. [5]

Other STI Testing

It makes sense that if you are testing for HIV, then you should test for other STIs or blood borne infections such a as syphilis, rectal bacterial STIs such as chlamydia or gonorrhea, Hep C and B. [6]

What You Should Expect When You Test For HIV In Ontario

When you choose to test, you should be informed about the process and counselling should be offered in a non-judgmental way that looks at your needs. You should walk away from the experience knowing what future options are open to you as referrals.

This can look like assessing your risk for HIV and preparing you for a possible positive (“reactive”) test result. If the counsellor can see that you know a lot about HIV, they can be shorter in their time with you, but they should tailor the discussion to your experience with HIV testing. (Some examples: You may not be comfortable talking about sex explicitly. You may have a lot of questions. You may need more support.)

Many queer guys have had negative experiences with the health care system, especially when they encountered judgmental attitudes about sex, substances, sexual orientation, gender expression, gender identity, race or ethnicity. HIV testing services are mandated to be nonjudgmental, culturally responsive, anti-racist and safe care spaces. [7]

Foot notes:

[1] Ontario Guidelines for Providers Offering HIV Testing. 2023. P.10.

[2] Ontario Guidelines for Providers Offering HIV Testing. 2023. P.10.

[3] Ontario Guidelines for Providers Offering HIV Testing. 2023. P.10.

[4] Ontario Guidelines for Providers Offering HIV Testing. 2023. P.10.

[5] Ontario Guidelines for Providers Offering HIV Testing. 2023. P.18.

[6] Ontario Guidelines for Providers Offering HIV Testing. 2023. P.13.

[7] Ontario Guidelines for Providers Offering HIV Testing. 2023. P.21.