HIV-1-2 test results: how to read them and what to do next

Getting HIV-1-2 test results can feel stressful. Knowing what the common terms mean and the right follow-up steps makes the process less scary and more useful. This page explains the main test types, what a negative, positive, or indeterminate result means, and practical next steps you can take right away.

How to read your HIV-1/2 test results

Most labs now use fourth-generation tests that detect both HIV antibodies and p24 antigen. If the test is nonreactive (negative) and you had no recent exposure, that usually means you don’t have HIV. If you had a recent high-risk exposure (sex without a condom, shared needles), remember there’s a window period — the time between infection and when a test can detect it. Fourth-generation tests usually catch infections 2–6 weeks after exposure, but some people may not test positive until 3 months.

A reactive (positive) screening test is not a final diagnosis. Labs run a confirmatory test next: an antibody differentiation test that tells HIV-1 vs HIV-2, or a nucleic acid test (NAT/PCR) that looks for viral RNA. If the confirmatory test is positive, your provider will talk about treatment options and send baseline labs like viral load and CD4 count. If confirmatory testing is negative but the screening was reactive, your result is often called indeterminate — this means repeat testing and possibly a NAT are needed.

What to do after a negative, positive, or indeterminate result

Negative: If you had recent exposure, repeat testing at 4–6 weeks and again at 3 months to be safe. If you’re frequently at risk, ask about regular screening and consider PrEP (pre-exposure prophylaxis), which greatly reduces HIV risk.

Positive: Start by getting linked to care quickly. Modern antiretroviral therapy (ART) is very effective: it suppresses the virus, protects your immune system, and prevents transmission to partners when viral load is undetectable. Your clinic will order HIV viral load, CD4 count, and baseline resistance testing. You may also get vaccinations and screening for other sexually transmitted infections.

Indeterminate or reactive-only: Ask for a NAT/PCR test. If you had recent exposure in the last 2–4 weeks, NAT is more likely to detect infection than antibody tests. Repeat the antibody/antigen test at intervals recommended by your clinic — commonly at 2–4 weeks and 3 months after exposure.

If you think you were exposed in the last 72 hours, ask about PEP (post-exposure prophylaxis). PEP can prevent infection if started quickly and taken for 28 days. For ongoing prevention, talk about PrEP.

Finally, keep documentation and ask for clear next-step instructions from your provider. If results are confusing or you feel anxious, reach out to a trusted clinic, local health department, or an HIV support organization. Quick action and clear follow-up are what matter most.