5.0 Conveying HIV test results

Posted in: HIV

The process of conveying an HIV test result to the person who has been tested, irrespective of the specific result, is affected by the type of test performed, the setting of the consultation and testing and the extent, if any, of additional testing required to determine the true HIV status of the person. Examples are provided for reference in appendices B & C. The site director and the person who requests the test is responsible for ensuring that appropriate mechanisms are in place for delivering the test result.

Community perceptions of HIV have changed over time as has the way people give and receive information. It is preferable that a positive HIV test result is given in person. However, current practice includes the provision of test results by phone, SMS, face-time, text message, email or other mechanism when it is considered appropriate. It will be important for those performing the test to use professional judgement in deciding how results will be delivered and these should be based on the understanding of the person being tested. Counselling may be required by some individuals and should be provided. Operational guidance on conveying positive HIV test results, negative HIV test results and a decision making flow chart are provided for reference in appendices B, C and D.

5.1 Contact tracing and partner notification

There is an onus on the person conveying a positive HIV test result to ensure that the patient is aware of the legal obligations relevant to their jurisdiction; to advise their subsequent partners of their HIV status and to inform former partners that they may have been at risk of exposure to HIV. Site specific approaches to contact tracing will need to be included in standard operating procedures.

Site directors are referred to the Australasian Contact Tracing Manual[i] and state and territory policies on contact tracing. Practical assistance can be provided to the health care provider and/or patients by ASHM, the local public health unit or sexual health clinics. Most facilities performing contact tracing should try and create an information wall between the person who gets information from the source patient and the person speaking to the contact. The details of the source patient must be treated confidentially and the contact must not be provided with the source patient’s name or details. Public health facilities, particularly sexual health clinics, are able to assist general practitioners and other private medical practitioners with contact tracing.

5.2 Confidentiality of HIV test results and testing data

HIV pathology results from a pathology laboratory will only be released to the requesting medical practitioner or to the clinical service team responsible for the patient’s care and management. Subject to the arrangement between the site and the reference laboratory, patient information may be shared between a specialist HIV, an s100 prescribing clinician or a sexual health service for the purpose of ensuring that a patient is informed of his or her test result. Part of the informed consent process should involve an explanation of how a patient can expect to receive their result.

Services are responsible for the security of HIV testing data and should develop mechanisms to restrict access to HIV pathology information. For example there must be security hierarchy within the information systems to restrict access to this information to those individuals directly involved with the treatment and care of the patient.

It is reasonable to expect that pathology test results are available on a patient’s record and that all staff with a legitimate clinical reason have access to the patient’s HIV test information including the range of non-HIV-related services that may be involved in the patient’s health care.

Any clinical, laboratory and non-clinical staff involved in HIV testing must not disclose any personal or medical information about a patient to any other person, in accordance with privacy provisions.

5.3 Assistance to doctors new to diagnosing HIV

Some jurisdictions and ASHM provide assistance to doctors who are unfamiliar with diagnosing HIV. This is most easily facilitated by the laboratory performing the HIV test. Services of this nature support the diagnosing doctor and improve the immediate management of the patient, including initiating contact tracing and assessment for treatment. They can also facilitate the collection of routine surveillance data and act to encourage the doctor to engage with the patient’s ongoing HIV management.

[i] Australian Contact Tracing Manual http://ctm.ashm.org.au/default.asp (Cited 5 May 2015)