Voluntary Counselling and Testing for Diagnosis of HIV Infection
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.
- The test is for HIV infection, not a test for AIDS.
- Significance of the ‘window period’ in relation to recent risk behaviour and the resulting accuracy of the test result.
- 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.
- Explain safeguards regarding preservation of confidentiality, ie, anonymous encryption of test form.
- Discuss future prevention measures.
- Safer sexual behaviour.
- Safe drug injection behaviour.
- How results of test are to be obtained (in person, face to face).
- Any costs that may be involved.
Providing the test result:
- 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.
- 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.