Voluntary Counselling and Testing (VCT) is about getting to know your HIV status by taking an HIV test, and does not test for Aids. This confidential test will tell you whether you are HIV positive or negative.
- Voluntarymeans that the decision to go for the test is entirely your own choice.
- Confidentialmeans that you have the right to absolute privacy.
1.1.1 IMPORTANCE OF VCT FOR HIV PREVENTION
- VCT provides the opportunity for people to know their HIV status with quality counseling support to help them cope with a positive or a negative test result. The majority of adult populations are HIV negative, even in high HIV prevalence settings. Knowing one is HIV negative can serve as a strong motivating factor to remain negative, particularly for those who may otherwise assume it is too late to adopt safer sexual practices. For people who test positive, while VCT services can link them to options for treatment if and where they exist, and to care and support, just as important, it allows for adoption of preventive measures. For some, self-protection is a stronger motivator for safer sex than the need to protect others; for others, the responsibility to avoid spreading the virus is itself the critical motivator. Both contribute to HIV prevention.
- By knowing one’s positive status, HIV positive individuals may become more motivated to adopt a more healthy lifestyle that improves their health status and slows the progression from HIV infection to symptomatic HIV disease and full blown AIDS – for example, avoiding further risks of infection with other viral strains and STIs, seeking early treatment for opportunistic and HIV/AIDS related infections, eating healthy food, avoiding tobacco and reducing stress.
- Knowing one is HIV positive also provides an opportunity to protect sexual partners and to plan for the future from an informed position – deciding on marriage and on child bearing, and preparing children and family for the progression of disease and death.
Today, there are many HIV positive people who are living healthy and positive lives. They serve as strong and effective HIV/AIDS advocates and also provide valuable support and motivation for others infected with HIV and affected by the epidemic.
- VOLUNTARY COUNSELLING AND TESTING STEPS
VCT is a three-step process that involves pre-test counselling, the test and post-test counselling.
Phase 1: Pre-test counselling
The pre-test counselling will prepare you for the test and will help you to anticipate the result – whether it turns out to be HIV positive or negative. A trained counsellor will explore your reason for attending and explain shared confidentiality. The counsellor will explain to you what HIV is, explore your level of risk of having the virus, correct any misconceptions you may have and explain what the HIV test is. The counsellor will also explain the importance and the benefits of knowing your HIV status. In addition, he/she will discuss the different options available to you and give you an opportunity to ask any questions you may have about HIV or the HIV test. You will be encouraged to talk freely about your fears and concerns. You then give informed consent/dissent freely.
Phase 2: The HIV test: How it is conducted
There are three common types of HIV antibody tests: the Elisa test, the Western blot test and the Rapid test. (All these tests are highly reliable and accurate).
- The Elisa and Western blot test will require that you have a sample of blood taken. This blood sample will be sent to a laboratory for testing and the results will be received a week later. The Rapid test requires that the health worker take a drop of your blood by pricking your finger. A drop of this blood will be placed on the test kit where a chemical agent will be added. Your results will be available within 15 minutes. If the test is positive, a second Rapid test will be done to confirm the result.
- Current HIV antibody tests can only detect the antibodies when sufficient quantities have been produced. With new technology the time it takes before antibodies can be detected is decreasing, but there is still a period during which the antibodies cannot be detected in the blood. This is called the window period and can last up to 42 days. During the window period, you may receive a negative HIV test result, but still have the virus in your body. It is recommended that if you have had unsafe sex in the past six weeks, you should have a second HIV test done six weeks later to confirm the result of a negative first test.
What kind of HIV antibody test will be used during VCT?
Some services use the ELISA HIV antibody test. A sample of blood will be taken from a vein in your arm. This sample will be sent to the nearest laboratory where the ELISA test will be conducted. The results take between one and three weeks.
· If the blood sample on which the ELISA test is conducted tests HIV antibody negative, then, during your post-test counselling session, the counsellor will tell you that you have tested HIV Antibody Negative. This means that you have no antibodies to HIV in your blood. However, you may still be in the window period so you will be advised to return for testing after a few months.
· If the blood sample tests HIV antibody positive, a second blood test will be done on the blood sample so that the result can be confirmed. If the second blood test tests HIV antibody positive, then, during your post-test counselling session, the counsellor will tell you that you have tested HIV Antibody Positive. This means that you have antibodies to HIV in your blood. You are therefore infected with HIV. You will be advised to return for another test in a few months time. If the first ELISA test is positive, but the second one is negative, you will be told that the result is Indeterminate or Discordant. This means that the test is not sure if you are HIV positive or negative.
· You will be advised to come back in a few months time to be tested again.
Rapid HIV Test
Some HIV/AIDS counselling and testing sites use the Rapid HIV Test. If the test is a blood one, the tip of your finger will be pricked with a special kind of needle and a drop of blood squeezed out. Using a thin glass tube, the drop of blood will be put into a small window in the test strip. Drops of special fluid will be added to this test window to help the blood move up the length of the strip. The test result will be ready in 15 minutes.
· If the test shows that you are HIV antibody Positive, a second HIV rapid test will be done. If the second test is also HIV antibody positive, the counsellor will tell you that you are HIV antibody positive. You are therefore infected with HIV.
· If you are HIV antibody Negative, no further test will be done. This means that you have no antibodies to HIV in your blood. Because you may still be in the ‘Window Period’ you will be advised to return for another test in a few weeks.
· Some HIV testing sites may use the Rapid Saliva Test. This test tells if there are any HIV antibodies in your saliva and is just as quick and reliable as the one that uses blood.
Phase 3: Post-test counselling
During the post-test counselling phase you will be given the results of your test simply and clearly. The counsellor will allow time for the results to sink in and to check your understanding. There are a number of basic issues that the counsellor can help you with, which includes dealing with your immediate emotional reactions, checking if you have immediate support available and identifying your options and/or resources.
- THE IMPORTANCE OF PRE AND POST TEST COUNSELLING AND THE IMPLICATIONS OF HIV TESTING FOR AN INDIVIDUAL
Counselling before and after an HIV test is important because it provides critical information about HIV itself and about the testing process. While counselling services may not be available in all health care settings, many testing sites do offer these services. If you would like access to pre-test and post-test counselling, be sure to inquire about the availability of these services at your chosen test site. If they do not have them readily available, the staff may be able to direct you to alternate service providers who do.
The purpose of pre-test counselling is to provide you with information on the technical aspects of testing and the possible personal, medical, social, psychological, legal and ethical implications of being diagnosed as either HIV positive or HIV negative. The purpose of pre-test counselling is further to find out why you want to be tested, the nature and extent of your previous and present high-risk behaviour, and the steps that need to be taken to prevent you from becoming infected or from transmitting HIV infection. The counsellor will usually follow the following guidelines in pre-test counselling:
- Reasons for testing
The counsellor will explore the reasons why you want to be tested:
Is it for insurance purposes, because of anxiety about lifestyle, or because you have been forced by somebody else to take the test? What particular behaviour or symptoms are causing concern to you? Have you been tested before, and, if so, when? For what reason and with what were the results?
These questions provide the counsellor with an opportunity to ascertain your perceptions of your own high-risk behaviour, and with allows you to assess whether you intend to be tested and whether your fears are realistic or if you are unnecessarily concerned. The following are some of the reasons that clients who want to be tested often give:
- Their partner has requested it.
- They want to determine their HIV status before starting a new relationship.
- They want to be tested prior to being married.
- They feel guilty and concerned about having multiple sex partners.
- They have had recent sexual encounters in which they did not use condoms.
- They are manifesting symptoms that are giving them cause for concern.
- They are been referred by a STI or TB clinic because the client has tuberculosis or a sexually transmitted infection.
- They have come to re-confirm a positive HIV test.
- Their current partner is HIV positive, or they were once involved with a partner who was HIV positive.
- They plan to become pregnant and want to check their HIV status before they do so.
- They have been raped or assaulted.
- They need to be tested after an occupational exposure (e.g. a needle stick).
- There are simply curious.
The reason why a client wants to be tested is important because it sets the scene for the rest of the pre-test counselling session.
- Assessment of risk
The counsellor will assess the likelihood of whether you have been exposed to HIV by considering how much and how frequently you have been exposed to the following risk factors and lifestyle indicators:
- What is your sexual risk history in terms of frequency and type of sexual behaviour? Have you been involved in high-risk sexual practices such as vaginal or anal intercourse with more than one sex partner without the use of condoms? In the case of anal sex, was it anal-receptive or anal-assertive sex? Did you have sex with a sex worker (or prostitute) without a condom? Or is your sex partner HIV positive?
- Are there any other risks involved? Are you an intravenous drug user, a prisoner who is exposed to rape or unprotected sex in prison, a migrant worker, a refugee or a sex worker? Have you been raped or coerced to have sex with another person? Do you have another sexually transmitted infection or tuberculosis?
- Did you receive a blood transfusion or body products in a developing country where testing blood for HIV is not standard practice? Note: All blood supplies in South Africa are tested for HIV, and are very safe.
- Have you been exposed to possibly non-sterile invasive procedures such as tattooing, piercing or traditional invasive procedures such as male or female circumcision and scarification for the application of medicines?
- Have you been exposed to HIV-infected blood in the work situation? (E.g. injuries with large volumes of blood involved, or needle stick injuries.)
- Beliefs and knowledge about HIV infection and safer sex
- The counsellor will determine exactly what you believe and know about HIV infection and Aids and he or she will correct errors or Myths by providing accurate information about transmission and prevention.
- The counsellor may also ask you about your past and present sexual behaviour and provide information about safer sex practices and a healthier lifestyle. He or she should find out if you know how to practise safer sex and how to use a condom correctly. They will also supply you with condoms. Sex is natural and nothing to be ashamed of. Allow the counsellor to ask these questions because that is the only way he or she can give you empowering information to enjoy sex safely.
- Information about the test
The counsellor will ensure that you know exactly what the HIV test entails. The counsellor will explain the following points to you, and if he or she does not, you now know what questions to ask:
- There is a difference between being sero-positive and having Aids. The HIV antibody test is not a “test for Aids”. It indicates that a person has HIV antibodies in the blood and that the person is infected with HIV. It does not say when or how the infection occurred, or in what phase of infection the person is.
- The presence of HIV antibodies in the blood does not mean that the person is now immune to HIV. It means that he or she has been infected with HIV and that he or she can pass the virus on to others.
- The meaning of a positive and a negative test results.
- The meaning of the concept of the “window period”. The need for further testing will be emphasised if the person practises high-risk sexual behaviour and tests negative.
- The reliability of the testing procedures. A positive HIV antibody test result is always confirmed with a second test and the reliability of test results is usually high. False-positive or false-negative results may, however, occasionally occur despite the general reliability of HIV tests (e.g. false negative tests result because the person is in the window period).
- The testing procedure. Many clinics in South Africa use HIV antibody rapid tests, which mean that the finger will be pricked to get a drop of blood. The results are available within 15 to 30 minutes. The counsellor will explain how blood is drawn for the Elisa test (if rapid testing is not available), where it is sent (if a rapid test is not used), when the results will be available and how the person will be informed of the outcome.
- The implications of an HIV test result
The counsellor will discuss the possible personal, medical, social, psychological, ethical and legal implications of a positive test result with you prior to testing. He/she will inform you about all the advantages and disadvantages of testing. The following advantages can accrue from taking the test:
- Knowing the result may reduce the stress associated with uncertainty.
- One may begin to make rational plans for preparing oneself emotionally and spiritually to live with HIV.
- Symptoms can be confirmed, alleviated or treated.
- Prophylactic (preventative) treatment can be considered, for example for tuberculosis.
- Anti-retroviral treatment can be considered.
- Adjustments to one’s lifestyle and sex life can protect oneself and one’s sex partners from infection.
- One can make decisions about family planning and new sexual relationships.
- One can plan for future care of one’s children.
The disadvantages that might accrue from taking an HIV test (especially if its result is positive) include:
- Possible limitations on life insurance and mortgages.
- Having to endure the social stigma associated with the disease.
- Possible problems in maintaining relationships and in making new friends.
- A possible refusal on the part of uninformed medical and dental personnel to treat an HIV-positive person. (A refusal to treat HIV-infected individuals of course goes against the provisions of the South African Constitution.)
- Possible dismissal from work (although it is illegal to dismiss people because they are HIV-positive).
- Possible rejection and discrimination by friends, family and colleagues.
- Emotional problems and a disintegration of one’s life.
- Increased stress levels and uncertainty about the future.
- The stress and negative effects of maintaining a secret if the person decides not to disclose his or her test results.
The counsellor will tell you about medical treatments that are available which can help to keep you healthier for longer.
- Anticipate the results
It is important to anticipate a positive HIV antibody result and to talk about how the client will deal with a positive test outcome. Anticipating a positive result helps the counsellor to ascertain the client’s ability to deal with, and adjust to, a positive result. The counsellor also gains insight into some of the potential problems associated with a positive test outcome. Preparation for the possibility of a positive test result, paves the way for more effective post-test counselling. In order to prepare you as client for the test result, the counsellor should ask the following questions:
- How would you feel if you tested negative? How would you feel if the test were to be negative but you were advised to be tested again because you may still be in the window period?
- What would your reactions and feelings be to a positive test? Would a positive test change your life? How? What negative changes would you anticipate? What positive changes can you imagine?
- Do you intend to tell others if you test positive? Who would you tell? Why that person? How would you tell them? Why would you tell them? Clients must be warned about people’s possible reactions. Often those closest to the client cannot cope with such news. The counsellor must help clients to think not only of themselves but also of those who are to be told. (For example, if the client says to you: “The news will surely kill my old and frail mother”, you may ask: “Why do you want your mother to know?”). Clients must also be warned that some people may not keep the information to themselves, and that this might have harmful effects for the client.
- How would you tell your sexual partner? If the test result is positive, the sexual partner also needs to be tested.
- How would a positive test result change the circumstances of your job, your family and your relationships? Would your relationships be improved or hindered by telling people you were HIV positive? What do you believe their reactions would be?
- Where would you seek medical help? How do you feel about a disease that requires a lot of care, lifestyle changes, commitment and discipline? Do you have members of your family or friends who could help you to be disciplined about your health? Could you take medication every four hours if necessary?
- Who could provide (and is currently providing) emotional and social support (family, friends, others)?
The choice to be tested remains the client’s prerogative. The advantages of testing can be explained to clients, but clients should not be forced to be tested if they feel that they will not be able to deal with the results. The mere knowledge of people’s HIV status will not necessarily protect them, or their loved ones, from infection. People who prefer not to be tested should, however, live as if they are infected and practise safer sex at all times. People who suspect they are HIV infected should also refrain from donating blood.
- Confidentiality of test results
The counsellor should stress the confidentiality of test results. The client’s right to confidentiality must be respected at all times. If individuals choose to remain anonymous, they must be reassured that no information will be communicated without their prior permission to anyone. The client’s consent must be obtained before anyone can pass on any information about his or her HIV status to any other health care professional who also treats the client. If the counsellor explains why other health care professionals need to know about the client’s HIV status, most clients will consent to this information being given out.
- Informed consent
The decision to be tested can only be made by the client and their informed consent must be obtained prior to testing. Consenting to medical testing or treatment has two elements: information and permission. Before an HIV test can be done, the client must understand the nature of the test, and he/she must also give verbal or written permission to be tested. A client may never be misled or deceived into consenting to an HIV test.
According to the law, health care professionals may not do an HIV test on a person unless he or she clearly understands what the purpose of the test is, what advantages or disadvantages testing may hold for him or her as client, why the health care professional wants this information, what influence the result of such a test will have on his or her treatment, and how his or her medical protocol will be altered by this information.
- Information about giving the results and ongoing support
The counsellor will explain to you when, how and by whom the results of the test will be given. The counsellor will assure you of personal attention, privacy, confidentiality and ongoing support and advice if needed.
- The waiting period
Waiting for the results of an HIV antibody test can be an extremely stressful period for the client. This waiting period (in cases where the rapid HIV antibody test is not being used) can last from two to 14 days, depending on where the test was done (whether by a private practice, a governmental health service or a rural clinic). The results of rapid HIV antibody tests are, of course, available within 30 minutes. However, if the client has to wait for the test results, the counsellor should anticipate this difficult waiting period by discussing the following points with the client:
- Find out the names of people whom the client might contact for moral support while he or she waits for the results.
- Encourage the client to contact you or a colleague if they have any questions.
- Counsel the client on how to protect sex partners (e.g. to use condoms) in the waiting period.
- Encourage the client to do something enjoyable to keep himself or herself occupied while waiting for the results (e.g. hiking, going to the movies or playing soccer with friends).
Pre-HIV test counselling is extremely important. It should not only be seen as a preparation for the HIV test, but as a golden opportunity to educate people about HIV/Aids and safer sex. Remember that this may be the one and only time that you will see the client because he or she might decide not to be tested, or not to come back for the test results after all.
Post HIV Counselling
Not many things in life could be as stressful as going back for HIV test results. For many clients it feels as if the counsellor holds the key to the future in his or her hands. Although the post-HIV test counselling interview is separate from the pre-test counselling interview, it is inextricably linked to it. The pre-test counselling interview should have given the client a glimpse of what to expect in post-test counselling. Pre- and post-test counselling should preferably be done by the same person because the established relationship between the client and counsellor provides a sense of continuity for the client. The counsellor will also have a better idea of how to approach the post-test counselling because of what he or she experienced in the pre-test counselling.
Counselling after testing will depend on the outcome of the test – which may be a negative result, a positive result or an inconclusive result. The counsellor should always ask the client if he or she is prepared to receive the results. In the case of the rapid HIV antibody test – where the results are available within minutes – ask the client if he/she is ready to receive the results immediately. Some clients need time to prepare for the results.
Counselling after a negative HIV test result
- For both the client and the counsellor, a negative HIV result is a tremendous relief.
- A negative test result could however give someone, who is frequently involved in high-risk behaviour, a false sense of security. It is therefore extremely important for the counsellor to counsel HIV-negative clients in order to reduce the chances of future infection. Advice about risk reduction and safer sex must therefore be emphasised.
- If you practise high risk sex behaviour and test negative, it does not mean that you are “immune” to HIV and that precautions are therefore unnecessary. Nobody is immune to HIV and everyone risks being infected if they do not change their behaviour.
- The possibility that the client is in the “window period” or that the negative test result may be a false negative should also be pointed out. If there is concern about the HIV status of the person, he or she should return for a repeat test after about three months and ensure that appropriate precautions are taken in the meanwhile.
Don’t underestimate the extreme importance of counselling a client who tested HIV negative. This may be your only chance to talk to this person about his or her sexual practices, potential drug abuse and other risk behaviours, and to educate him or her about safer sex practices. Free condoms can be given out at this session together with advice on how to use them and where to get more when needed. Use this counselling session to prevent a future situation where somebody else has to give the client a positive HIV test result!
Counselling after a positive HIV test result
To communicate a positive test result to a client is a huge responsibility. The way people react to test results depends to a large extent on how thoroughly the counsellor has educated and prepared them both before and after the test. When a test is positive, the following guidelines for counselling may prove useful for counsellors:
- Sharing the news with the client
- Positive (as well as negative) test results should be given to the client personally.
- Feedback should take place in a quiet, private environment and enough time should be allowed for discussion.
- The news of a positive result ought to be communicated openly, honestly and without fuss. Simple and straightforward language should be used. Do not give the individual false hopes and (alternatively) do not paint a hopeless scenario.
- Choose neutral words when conveying a positive HIV test result. Don’t attach value to the news by saying “I have bad news for you” – because such an attitude reflects hopelessness in the mind of the counsellor. Rather say: “Mr. Ritshela, the results of your HIV test came back, and you are HIV positive”.
- A positive result is NOT a death sentence and the counsellor’s task is to convey optimism and hope.
- There are a few Don’ts that we need to observe when sharing a positive HIV test result with a client.
- Don’t lie or dodge the issue.
- Don’t beat about the bush or use delaying tactics. Come to the point.
- Don’t break the news in a corridor or any other public place.
- Don’t give the impression of being rushed, distracted or distant.
- Don’t interrupt or argue.
- Don’t say that “nothing can be done” because something can always be done to ease suffering.
- Don’t react to anger with anger.
- Don’t say “I know how you feel” because you don’t.
- Don’t be afraid to admit ignorance if you don’t know something.
- Client reaction to a positive HIV test result
- Clients’ responses to the news usually vary from one person to another, and may include shock, crying, agitation, stress, guilt, withdrawal, anger and outrage – some clients may even respond with relief.
- The counsellor should allow clients to deal with the news in their own way and give them the opportunity to express their feelings.
- The counsellor should show empathy, warmth and caring.
- Maintain neutrality and respond professionally to outbursts. Don’t show surprise or make value-laden comments such as “There is no need to be upset with me!” Because the loss of health is bereavement, it manifests with all the components of denial, anger, bargaining, depression and acceptance. The counsellor must respect the personal nature of an individual’s feelings.
- Responding to client needs
- People’s needs, when they receive an HIV positive test result, vary, and the counsellor has to determine what those needs are and deal with them accordingly.
- Fear of pain and death are often the most serious and immediate problems and these can be dealt with in various ways. Talking to clients about their fears for the future is one of the most important therapeutic interventions that the counsellor can make.
- Often it is enough for the counsellor just to be “there” for the client and to listen to him or her.
- One of the major concerns for HIV positive people is whom to tell about their condition and how to break the news. It is often helpful to use role-play situations in which the client can practise communicating the news to others.
- In responding to a client’s needs, an attitude of non-judgmental empathic attentiveness is more important than doing or saying specific things. Listening is more important than talking; being with more important than doing.
- Crisis intervention
- Crisis intervention is often necessary after an HIV positive test result is given
- Make sure that the person has support after he or she leaves your office. A person in crisis should never be left alone: he or she should have somebody with whom to share the burden.
- Ask the client where he or she is going after leaving your office. Let the person think about and verbalise his or her plans for the next few hours. Although it is better for the client not to be alone, personal needs should be taken into consideration: Some people prefer to be alone and work through a crisis all by themselves.
- Be sensitive to the possibility of suicide. If the client shows any suicidal tendencies, emergency hospitalization should be arranged if a friend or family member cannot be with the client.
- Make sure that your client does not leave your office without support to help him or her through the first few days.
- Don’t ever give an HIV-positive result on a Friday, because there are often no support systems available over weekends.
- Follow-up visits
- When people hear that they are HIV positive, they usually experience so much stress that they absorb very little information.
- Follow-up visits are therefore necessary to give clients the opportunity to ask questions, talk about their fears and the various problems they encounter.
- Significant others, such as a lover, spouse or other members of the family may be included in the session. During follow-up visits, clients should be offered a choice concerning their treatment.
- If health care professionals are not in a position to do follow-up counselling, information about relevant health services should be given. If there is a concern that the person might not return for follow-up counselling, information about available medical treatments such as anti-retroviral therapy, treatment of opportunistic infections, and social services for financial and ongoing emotional support should be given.
- Give the client a handout with whatever relevant information that he or she may need (such as the telephone numbers and addresses of Aids centres and other social services).
- Support systems
- Find out what support systems are available to clients.
- Refer clients to support systems where people meet on a regular basis to talk about their difficulties or simply to relax and enjoy each other’s company.
- Information about support systems such as the buddy system is usually available at the nearest Aids centre or from the offices of NGOs (non-governmental organisations) who work in the community.
- Advice about health and sexuality
- Convey information about safer sex, infection control, health care in general and measures to strengthen the immune system.
- Medical check-ups
- Encourage clients to go for regular medical check-ups to their family doctor or health clinic. Infections and opportunistic diseases can be prevented if treated in time.
Counselling after an indeterminate HIV test result
- In some cases an HIV test result can be “inconclusive”, meaning that the result is ambiguous or indeterminate, and it is not possible at that stage to say if a person is HIV positive or not. (A test result may be inconclusive because the test is cross-reacting with a non-HIV protein or because there has been insufficient time for full sero-conversion to occur since the person was exposed to HIV.)
- When a test result is inconclusive, other testing methods may be used to try to achieve a reliable result.
- The test can also be repeated after two weeks. If it is still inconclusive, it should be repeated at three, six and 12 months. If it is still inconclusive after one year, it should be accepted that the person is not infected with HIV.
Positive Test Result
A positive test result means that you have been infected with HIV. The counsellor will help you work through some of your feelings of shock, fear and anger. You will have the opportunity to talk about whether or not you are going to tell your family and your sexual partner. The counsellor will also discuss healthy and positive living with you. Being HIV positive does not mean that you have no future. Many people live happy, healthy and productive lives with HIV. But it does mean that you will have to learn about keeping your immune system healthy, lowering stress levels and building up a good support system. It is also important that you protect yourself and your partner from further infection. You will also be given information about your rights as someone living with HIV. Your counsellor will refer you to further supportive counselling and medical help whenever you need it.
Negative Test Result
The counsellor will explore with you the various ways of keeping yourself and your sexual partner(s) safe from contracting HIV. He/she will help you understand the window period and the possibility of needing to be retested. Even if you tested negative, your counsellor will share with you the importance of taking responsibility for avoiding future ‘risky’ behaviour and of using condoms. If you and your partner have come together for the test and one of you is HIV positive, you may need support as to how this affects your relationship.
Whether or not to take the test is a very personal decision best made after considering your own personal history and any possible risk factors for exposure to HIV/AIDS. It is illegal for your employer or anyone else to force you to be tested, and even your doctor may only test you with your written consent. If you are uncertain about testing, you can call any AIDS hotline numbers and receive free, confidential counselling over the phone to help you decide.