Pretest counselling

• Give information on the test (what it tells and does not tell).

• Explain about the false negative and 'window period'.

• Give appropriate information about HIV disease and other STDs.

• Dispel any myths about transmission of infection.

• Give preventive advice on safer practices (sex and IV drugs).

• Assess the possible coping mechanisms of the patient.

• Assess the patient's social support networks and interpersonal bonds.

• Reassure about confidentiality. This is a legal requirement.

• Discuss who to tell: informing sexual contacts.

• Offer tests other than STDs.

Finally

• Discuss how patient 'will cope with the test'.

• Discuss legal requirements (check with state laws).

• Advise of need for informed consent (not only for HIV test but other STDs).

• Make arrangements to discuss the test results.

Consider the useful question: 'How would your behaviour change, if at all, as a result of having this test today?'

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