What is included in pretest and posttest counseling for rapid HIV testing?

Updated: Jul 27, 2020
  • Author: Jacob D Isserman, MD; Chief Editor: Steven C Dronen, MD, FAAEM  more...
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Pretest and posttest counseling can be done by nonmedical personnel. Pretest counseling can be completed in person, via prerecorded video, or pamphlet and takes less than 20 minutes. Counseling protocols and counselor prompt cards are available on the CDC website. A system for posttest referrals needs to be prearranged for patients with positive rapid test results to facilitate follow-up.

If HIV seropositivity is expected, patients whose test results are positive with rapid HIV tests should be told they likely have HIV and need further confirmatory testing. If HIV is not likely, a patient with a positive rapid test result should be counseled that he or she may have HIV but that a confirmatory test is necessary. Patients are expected to be anxious after learning rapid HIV test results.

Patients with a high suspicion for acute HIV infection and a probable false-negative rapid HIV test result should have HIV RNA viral load testing done and should be referred for follow-up HIV ELISA testing. Remember that during acute HIV infection, the antibody test ELISA, will usually be negative.

Protect patient confidentiality. Patients may not have informed family members or friends of their risk behaviors or diagnosis.

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