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Attachment III

Messages and Guidance About a Preliminary Positive HIV Test Result

Messages for a client with a positive preliminary HIV test are very similar to those appropriate for a client with a reactive screening result from a rapid HIV test. The following are examples of language that may be useful in conveying the results of a preliminary positive test result:

Because I think it is important for you to have information about your HIV status as soon as possible, I need to tell you that your preliminary HIV test result is positive. A preliminary positive test result indicates that you may be infected with HIV. We won't know for sure until the result is confirmed with a second test that will be done on the [blood, oral fluid] sample that is already in the laboratory. The second test will be available in [give time frame].

In the meantime, I need to make sure you understand how HIV is transmitted. Understanding your risk factors for HIV is important so you can protect yourself and others, especially until we know your confirmed HIV result. The main ways that HIV is passed to other people are through unprotected sex or sharing drug injection equipment with a person who has HIV. Precautions you can take during the period of time until you get your test result include using a condom during sexual activity and using clean needles and not sharing works when preparing or injecting drugs.

If the client identifies a risk, explain the meaning of the preliminary positive test result and clearly communicate the likelihood of HIV infection in relation to the client's reported risk. For clients who self-identify high-risk behavior, use phrases that convey a higher likelihood of infection (e.g., "likely to be infected."). For example,

Given what we've discussed about your [signs and symptoms/potential exposures to HIV] this result probably [does, does not] accurately reflect your HIV status. What does this test result mean to you? Do you understand the test result?

If the client is a woman who is breast-feeding, she should be advised to stop breast-feeding until her definitive HIV results are known.

The client should be given clear verbal and written instructions on the follow-up appointment, and the following should be stressed:

  • the importance of returning to receive the confirmatory test result
  • the importance of knowing one's HIV status
  • the importance of early access to medical care to help the person get treatment and stay healthy.

Clinical information, patient history, and assessment of the potential for follow-up should be used to determine if other actions or referrals are immediately appropriate. For example, contacting Partner Services may be warranted for a patient with recent high risk behavior that may have exposed others, or initiating referral to an HIV specialist may be appropriate if the patient already has clinical conditions suggestive of HIV infection.