1. To provide a convenient opportunity for persons to learn their current serostatus;
2. Allow such persons to receive prevention counseling to help initiate behavior change to prevent the transmission or acquisition of HIV;
3. Help persons obtain referrals to receive additional medical care, preventive, psychosocial, and other needed services;
4. Provide prevention services and referrals for sex and needle sharing partners of HIV-infected persons.

Risk Assessment

Listen for and address information such as:

In order to reduce the further spread of infection, there are several behaviors that suggest one should be routinely counseled and tested for HIV. Those who should be tested include:

1. Persons who may have a sexually transmitted disease
2. Persons who have used IV-drugs
3. Persons undergoing medical evaluation or treatment
4. Persons admitted to hospitals
5. Persons in correctional systems
6. Persons who have engaged in prostitution
7. Persons who have had a sexual partner who was infected
8. Hemophiliacs
9. Persons who have or are currently living in communities or born in countries where there is a known or suspected high prevalence of infection
10. Persons who have received a blood transfusion before blood was being screened for HIV antibody but after HIV infection occurred in the United States (between 1978 and 1985)
11. Persons who choose to have a sexual partner of the same sex.

This information may be obtained by the clinician during the drug/sexual/medical history prior to or as a component of the counseling session. Document acknowledged risk behavior, decisions about testing, and negotiated risk reduction plans in the client’s record.

Guidelines for Informing Client of Results

Negative Results: (1) either the person is not affected, or  (2) so recently infected that the test could not detect the infection.
Ensure that the client understands what the test result means including Limitations of the test.
Periodic retesting if the client continues to participate in high risk behaviors.
Identify and encourage to continue any steps already taken by the client to reduce risk and provide positive reinforcement.
Assist the client in building skills to negotiate risk reduction activities with current or potential partners through discussion and role plays
Offer referral for further assistance in avoiding risk behaviors and maintaining low-risk behaviors.
Discuss his/her need and ability to help partners realize they are also at risk for HIV infection
Advise the client to refrain from donating blood, plasma, and organs

Some HIV positive clients may be better prepared to receive positive test results than others. Counseling of patients with positive test results must be directed to the client’s specific circumstances and may require more than one session. Counselors should recognize that the emotional impact of learning about HIV positive results often prevents clients from absorbing other information during this encounter.

Interpretation of HIV-Antibody Test Results

A test for HIV is considered positive when a sequence of tests, starting with a repeatedly reactive enzyme immunoassay (EIA) and including an additional, more specific assay, such as a Western Blot, are consistently reactive.

The sensitivity (the probability that a test will be positive when the infection is present) of the currently licensed EIA tests is 99% or greater when performed under optimal laboratory conditions. This makes the chance of a false-negative result remote, except during the first few weeks of infection before antibody is detectable.

Partner Notification/Contact Tracing

Sexual partners and those who share needles with HIV-infected persons are at risk for HIV infection and should be routinely counseled and tested for HIV antibody. Persons who are HIV-antibody positive should be instructed in how to notify their partners and to refer them for counseling and testing. If they are unwilling to notify their partners or if it cannot be assured that their partners will seek counseling, physicians or health department personnel can assist with confidential procedures to assure that the partners are notified.

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