HIV test in Puerto Rico: get tested with a lab order

According to the CDC, post-exposure prophylaxis (PEP) must start within 72 hours (3 days) of a possible HIV exposure, and the sooner the better: every hour counts. If you had sex without a condom with someone who may have HIV, a condom broke, you shared needles or you were sexually assaulted, go to an emergency room today or call 911.

PEP is urgent in-person care; it is not prescribed in our video visits. Afterwards, we can help with your follow-up testing.

You see Dr. Diana Nieves Castro, MD, a Puerto Rico–licensed general practice physician with several years of emergency-department experience. No judgment, in English or Spanish. Join from a private place; visits are not recorded.

The doctor asks when the exposure might have happened and chooses the right test for your case. We give you a lab order for a lab near you. It often makes sense to test for other infections at the same time, such as syphilis, chlamydia, gonorrhea and hepatitis. Once your result is in, the doctor goes over it with you.

Doctor online 24/7: video doctor visits 24/7 — book online and choose your time right away. Every day, any time (Puerto Rico time).

A doctor visit has a published price, with no membership, and includes the lab order. You pay the lab for the tests. Reviewing the result is an online follow-up visit. You pay by card when you request the visit, and you get a full refund if the clinic can’t see you. See all prices.

The window period is the time between an exposure and when a test can detect HIV. Testing too early can give a negative result even if you have the virus. According to the CDC:

• Nucleic acid test (NAT), blood: 10 to 33 days after exposure.
• Lab antigen/antibody test: 18 to 45 days.
• Rapid antigen/antibody test: 18 to 90 days.
• Antibody test: 23 to 90 days.

If your test is negative but you took it inside the window period, the doctor tells you when to repeat it.

According to the CDC, everyone aged 13 to 64 should be tested at least once. Test at least once a year if you have sex with more than one partner, share needles or have other risks. Sexually active gay and bisexual men may benefit from testing every 3 to 6 months. In the same visit you can talk with the doctor about prevention and birth control online.

HIV symptoms. According to the CDC, most people have flu-like symptoms 2 to 4 weeks after infection, but many do not notice them. Symptoms do not confirm or rule out anything: the only way to know is to get tested.

If you are looking for free STD testing in Puerto Rico, or an HIV test at no cost, these are the options we could verify in official sources:

• CDC locator: gettested.cdc.gov (opens in a new tab) lists places for HIV, STI and hepatitis testing. According to the CDC, many clinics offer confidential free or low-cost testing, and most HIV tests are available free or at reduced cost.
• Puerto Rico Department of Health: its STI, HIV and hepatitis prevention program offers screening tests for syphilis, gonorrhea, chlamydia and HIV at its Centers for the Prevention and Treatment of Communicable Diseases (CPTET), plus counseling and testing for partners exposed to HIV. The Department publishes the CPTET directory on its program page (opens in a new tab) (in Spanish).
• Community organizations: the same program works with community-based organizations that offer HIV testing in the community and in clinical settings.
• Department of Health HIV and STI line: (787) 765-1010. Call to ask where to go and whether the test has a cost.
• Home testing: according to the CDC, there are FDA-approved self-tests and kits to collect a sample at home and mail it to a lab. Home HIV tests are sold at pharmacies and give a result in about 20 minutes.

If you would rather have a doctor pick the tests and go over the results with you, see STD testing and treatment: the visit has a published price and the lab bills the tests separately.

If your HIV test is negative and you are still at risk of exposure, PrEP is a medicine you take before an exposure to prevent HIV. Under the CDC’s 2021 guideline, you need a blood antigen/antibody HIV test done within 7 days before starting PrEP to confirm you do not have HIV. Rapid saliva tests and home tests are not enough to start PrEP, so the doctor gives you the order for that test at the lab; if you had a possible recent exposure, she may add an HIV RNA test. The doctor evaluates you by video for HIV PrEP, gives you the lab order for the other tests the CDC calls for and, if appropriate, prescribes it.

PrEP is not the same as PEP: PEP is for after a recent exposure and must start within 72 hours, at an emergency room.

A positive result is confirmed with another test. If it is confirmed, the doctor explains the result and refers you to an HIV clinic: HIV is treated by a specialized team, not in our visits. The Department of Health offers clinical and treatment services at its Centers for the Prevention and Treatment of Communicable Diseases (immunology clinics) in its eight regions.

According to the CDC, there is no cure yet, but treatment controls the virus: it can lower the viral load so far that a test cannot detect it, and people on treatment can live long, healthy lives.

If you are under 21, a parent or legal guardian must sign the consent, stay on camera for the whole visit and show photo ID.