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 person’s true HIV status. Examples are provided for reference in Appendixes A and B. The site director and the person who requests the test are 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. Nevertheless, even for those familiar with HIV, a positive diagnosis of a lifelong condition is a significant psychosocial event, in which some people display symptoms consistent with post-traumatic stress disorder (PTSD).26,27,28 For people visiting Australia and potentially returning to regions with poor access to treatment, a positive result may understandably be received as a traumatic and life-threatening diagnosis. Aboriginal and Torres Strait Islander people and those from culturally and linguistically diverse backgrounds may experience heightened difficulty in adjustment and linkage to services. [29,30,31,32]These populations continue to climb as a proportion of those diagnosed in Australia.15
Preferably a positive HIV test result should be given in person. However, current practice includes the provision of test results over the phone, by email or phone text message (SMS), or via apps such as Facetime, when it is considered appropriate. It is important for those performing the test to use professional judgment in deciding how results will be delivered. The decision should be based on the understanding of the person being tested. Counselling may be required by some individuals and should be offered to all receiving a positive diagnosis. Counselling should preferably be undertaken by doctors or nurses experienced in this area, or a trained allied health professional e.g. psychologist, social worker or counsellor. The National Standards for Psychological Support for Adults with HIV may be used as a guide.[viii] Operational guidance on conveying positive HIV test results, negative HIV test result, and a decision-making flow chart, are provided for reference in Appendixes B, C and D. Arrangements can be made between services that are not experienced in delivering HIV positive results (e.g. Emergency Departments) and sexual health services so that the sexual health service provides the result to the newly diagnosed person; this facilitates testing within inexperienced services.