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Abstract
Objective: To provide physicians and other health care professionals with concise, easy-to-read counselling guidelines related to serologic testing for human immunodeficiency virus (HIV).
Options: Serologic testing for HIV without counselling has a psychological, medical and social impact on patients. Therefore, experts agree such testing must be preceded and followed by appropriate counselling by trained or experienced professionals. Kits for simple, rapid testing may mitigate against the recommended counselling process; these are not licensed for use in Canada.
Outcomes: When used appropriately, serologic testing for HIV with pre- and post-test counselling is an effective means by which physicians can diagnose disease, help patients manage their health and stop the spread of HIV infection.
Evidence: Recommendations presented in this document are based on the views of scientific experts and reports published to March 1995, as assessed by the Expert Working Group.
Benefits, harms and costs: Current tests for HIV are accurate and inexpensive. The potential benefits of testing and counselling outweigh the potential harm caused by uninformed and nonconsensual testing or refusal of testing.
Recommendations: Physicians should obtain a history of risk factors for their patients, and identify, when possible, the current reasons for testing. The purpose of testing for HIV must be to benefit patients, enable them to obtain care and counselling and make their behaviour safer for themselves and others. Testing should always be done with the patient's informed consent after a full discussion of the consequences of being tested, including if, when and under what circumstances test results might be disclosed to others. For those infected with HIV, counselling involves not only resolving the psychological and social consequences of this situation, but also continuing medical follow-up, promotion of safer behaviour and partner notification.
Validation: These guidelines were reviewed by a national advisory group composed of representatives from the Canadian AIDS Society, the Canadian Association of Nurses in AIDS Care, the Canadian Hemophilia Society, the Canadian Paediatric Society, the Canadian Public Health Association, the College of Family Physicians of Canada, and the Society of Obstetricians and Gynaecologists of Canada. They were then circulated to a broader range of physicians and other health care professionals. The comments of these professionals are reflected in this final report.
Sponsors: This project was funded by the AIDS Care, Treatment and Support Unit under the National AIDS Contribution Program of the National AIDS Strategy, Health Canada.
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