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Best Practices for Routine HIV Testing in Health Care Settings

Offering Routine HIV Tests

  • Provide patients with information on the importance of knowing HIV status
  • Adopt policy of offering HIV testing routinely to all patients with undocumented HIV status
  • Develop written HIV testing and referral policies, procedures, and protocols
  • Ensure newly HIV diagnosed patients are linked to clinical care, counseling, support, and prevention services
  • Persons at high risk for HIV infection should be advised to be retested periodically and should be offered prevention counseling

 

AETC Script Requirements/Recommendations for Offering Routine HIV Tests:

  1. Inform patient that test is planned
  2. Provide information about test
  3. Inform patient about treatment options and need for more testing
  4. Advise patient of right to decline test

 

Sample Script/Language Suggestions:

  1. "We perform routine screening for HIV on all patients and we’ll be doing that as part of your visit today.”
  2. "We do this because of our desire to help keep our patients healthy and because there are excellent treatment options available for HIV.”
  3. "If your test is positive we will need to do more testing but you should know there are many effective treatments for HIV.”
  4. "You can decline the test and it will not affect the care you receive today."
  5. If using rapid test: “It’s a quick test and you will know the results before you leave today."

 

Delivering HIV Test Results

 

With NEGATIVE RAPID OR CONVENTIONAL TEST results:

  • No further testing is necessary unless patient may have been exposed during the last 3 months (“window period”).
  • If possible exposure during window period, patient should be re-tested in 3 months.
  • Provide counseling on risk reduction and resources for patients concerned about risk.

 

With PRELIMINARY POSITIVE RAPID TEST results:

  • Provide counseling, with focus on HIV as a manageable disease, risk reduction, psychosocial issues, and partner notification/disclosure.
  • The patient most likely has HIV, but the test needs to be confirmed with a Western Blot or IFA.

 

With POSITIVE CONVENTIONAL TEST results:

  • Clinicians should provide positive HIV test results in person.
  • Provide counseling, with focus on HIV as a manageable disease, risk reduction, psychosocial issues, and partner notification/disclosure.
  • Initiate appropriate screening and treatment and/or referrals for care and other services.
  • Report test result to local health department.

 

With INDETERMINATE TEST result:

  • Explain that results are unclear and the test needs to be repeated in a few weeks.
  • Explore possibilities of exposure during window period.

 

The information above was provided by the AIDS Education & Training Centers (AETC) HIV Testing Information and Resources for California Clinicians.

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