What Does a Non-Reactive Result Mean in HIV Testing?

A non-reactive result from an HIV test means that you tested negative for human immunodeficiency virus (HIV). In most cases, that means you don’t have a detectable infection.

In some cases, though, you may get a non-reactive result if you test too soon after HIV exposure. Retesting after some time—weeks or months—may be necessary to detect HIV more accurately.

Testing for HIV involves checking samples of your blood, saliva, or urine for HIV antigens (foreign proteins that trigger an immune response) or antibodies (proteins your body makes in response to viral infection).

A non-reactive result means that your sample did not show the presence of HIV antigens or antibodies at the time of testing. In other words, it was negative. This usually suggests one of two things:

• You do not have HIV.
• You tested too soon after exposure, before detectable HIV antigens or antibodies could develop.

On the other hand, a reactive result means that the test showed a reaction, suggesting the presence of HIV antigens or antibodies in your sample. This suggests a positive HIV infection.

HIV antibody test results are accurate more than 99.5% of the time.

Healthcare providers may test your sample two or more times to confirm the results before you receive them. The first test is called an enzyme immunoassay (EIA) or an enzyme-linked immunosorbent assay (ELISA) test. Lab technicians use another test called a Western blot to confirm positive results.

Inaccurate results may occur if you were tested during the window period.

The window period is the time between your exposure to the virus and when your body produces enough antibodies for the test to detect. In most cases, your immune system takes about three weeks to two months to produce detectable antibodies. Testing during the window period often leads to non-reactive (negative) results, even if you have HIV.

Due to the potential for a false negative result during the window period, retesting for HIV may be necessary, especially if you have certain risk factors. These may include:

• You had vaginal or anal sex with someone who has HIV.
• You had sex with more than one partner since your last HIV test.
• You have shared needles or syringes with other people.
• You have or had other sexually transmitted infections (STIs), such as hepatitis or tuberculosis.
• You’ve had sex for money or drugs.
• You had sex with someone who has done any of these things.
• You don’t know a sexual partner’s sexual history.

Avoiding sex and injection drug use can help you prevent and avoid HIV infection. If you have sex, though, you can help lower your risk of HIV infection by following certain habits. Try these strategies:

• Use condoms: Male and female condoms (sometimes called external and internal condoms) can help prevent HIV and other STIs. Make sure you use them correctly every time.
• Choose sexual activities mindfully: HIV mainly spreads through vaginal or anal sex, and there is little chance of getting HIV through oral sex.
• Take pre-exposure prophylaxis (PrEP): PrEP is a medication that can help reduce the risk of getting HIV from sex or injection drug use. PrEP is available as tablets or injections and is most effective when you take it as prescribed.
• Ask about post-exposure prophylaxis (PEP): You can talk to your healthcare provider about PEP if you are HIV-negative or don’t know your HIV status but think you have been exposed to HIV within the last 72 hours (three days). This is a medication you take for 28 days to prevent infection.
• Get tested and treated for other STIs: Having other STIs increases your chance of getting HIV. Getting tested and treated for these conditions can reduce your chances of getting HIV.
• Never share syringes or needles: If you inject drugs, use clean and new syringes, needles, and other injection equipment every time.
• Have fewer sexual partners: Having sex with fewer people means there’s less chance of having a partner who may transmit HIV to you.
• Encourage your partner to stay on treatment if they have HIV: HIV treatment can help reduce their viral load, which reduces their risk of transmitting the infection to HIV-negative partners.

A non-reactive HIV test result is a negative test result. It typically means that you do not have HIV. However, if you tested too soon after exposure—in the window period, before detectable HIV antibodies could develop—your test result may also be non-reactive.

If you have a non-reactive or negative test result, consider talking to a healthcare provider about your risk of HIV and whether you should retest to confirm the result.