Voluntary Counselling and Testing for Diagnosis of HIV Infection

Voluntary Counselling and Testing for Diagnosis of HIV Infection

HE Code: 
HE1520
Language: 
Format: 
Card A6
Publication date: 
1 May 2008
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Information on pre- and post-test counselling and sexual health of patients being tested for HIV (not AIDS). For health professionals only.

Checklist for HIV testing and pre-test discussion

Specific consent to be tested for HIV must always be obtained.

It is recommended to consider addressing the following issues in the course of pre-test discussion, depending on their applicability or relevance to the individual. If not addressed in the pre-test discussion, they should be addressed during post-test counselling.

  1. The test is for HIV infection, not a test for AIDS.
  2. Significance of the ‘window period’ in relation to recent risk behaviour and the resulting accuracy of the test result.
  3. Significance of a positive test with respect to:
    • medical implications (prognosis, treatment)
    • psychological issues (coping, support, relationships)
    • social implications (who needs to know, employment, discrimination implications for insurance)
    • HIV status not being notifiable.
  4. Explain safeguards regarding preservation of confidentiality, ie, anonymous encryption of test form.
  5. Discuss future prevention measures.
  6. Safer sexual behaviour.
  7. Safe drug injection behaviour.
  8. How results of test are to be obtained (in person, face to face).
  9. Any costs that may be involved.

Post-test counselling

Providing the test result:

  1. If HIV positive:
    • Provide the result in person, face to face.
    • Schedule adequate time to give positive results.
    • Arrange initial psychological support arrangements and follow-up appointment.
    • Discuss need for further testing (repeat/confirmatory test, viral load, CD4 count).
    • Discuss with an infectious disease consultant including process for partner notification.
    • Referral for specialist counselling and support.
    • Provide information on HIV and community resources.
    • Reinforce safe sex and needle-using behaviours.
    • Explain partner notification and other implications of positive diagnosis.
  2. If HIV negative:
    • Results can be delivered by phone or other agreed means.
    • Discuss possible significance of ‘window period’ if recent high-risk behaviour and need for repeat test for final confirmation.
    • Reinforce behavioural changes needed to prevent HIV infection in future eg, prescription for condoms, information on needle exchange outlets/services.
    • Refer for specialist sexual health counselling, if required.