Pre- and post-test counselling

Pre-test counselling

These are the important elements of pre-test counselling:

  • Determining the level to which a person is aware and informed (or in denial) of their risk of HIV infection and facilitating an accurate self-perception of risk;
  • Ensuring the individual understands the nature of HIV infection;
  • Providing information about HIV transmission and risk reduction;
  • Discussing risk activities the individual may have been involved in with respect to HIV infection, including the date of the last risk activity engaged in, and the perception of a need for a test.
  • Exploring the reasons why a person wants a test;
  • Discussing whether the test is the way to get what the people want;
  • Discussing the benefits and difficulties a test brings to the individual, their family and associates, and knowing the result whether positive or negative
  • Discussing whether a person thinks they will be able to cope with a possible positive test result;
  • Providing details of the test and how the result will be provided, including information about post-test counselling.
  • Making a plan for when the actual test will be done;
  • Explaining the issue of the ‘window period’ (the period of time following infection before any antibodies can be reliably examined);
  • Obtaining an informed decision about whether to proceed with the test.

An additional element can be to negotiate and reinforce a plan to reduce or eliminate risk behaviour.

Post-test counselling

For those with a negative test result it is inevitable to give prevention advice and to discuss the impact of that result. A positive test result should be followed by post-test counselling to offer psychological support where needed and serve relevant information. In a session in which enough time is allowed to digest information and to ask questions, it is important to sort out and discuss possible emotional and psychological problems in case of a positive test result.

There are important elements of post-test counselling:

  • If necessary make a plan for and/or refer to ongoing psychological support.
  • Explain further tests (i.e. for hepatitis C - PCR, liver biopsy).
  • Help obtain referrals to receive additional medical care and treatment and other necessary services (such as drug treatment).
  • Allow such people to receive prevention counselling to help initiate behaviour change aimed at preventing the transmission or acquisition of HIV and hepatitis.
  • Provide prevention services and referrals for sex and needle sharing partners of HIV-infected people.
  • Provide information about the risk of infecting others and ways to prevent this.
  • Offer family planning information and referrals for women of childbearing age.
  • Suggest local support groups.
  • Give accurate literature to take away.