Designated Medical Practitioner Handbook

Appendix V: HIV Post-Test Counselling

Post-test Counselling for HIV Infection

Counselling should be age appropriate and individualized to the patient being tested.

Non-reactive or negative results:

• Discuss and interpret the following issues for the applicant:
  • no infection, or
  • risks within the past three months dictate re-testing is necessary three months after last possible exposure.
• Use the opportunity to reinforce risk reduction strategies:
  • avoid high-risk activities
  • avoid needle and syringe sharing
  • use lubricated latex condoms with safer sex practices.

Reactive or positive results:

• Discuss and interpret the following issues for the applicant:
  • infected with HIV, not diagnostic of AIDS
  • explain that confirmation tests to rule out false positives have been performed.
• Matters of first priority:
  • deal with the issues important to the infected person
  • discuss coping and support systems
  • discuss benefits of early treatment and follow-up. Further medical support, immune testing, HIV viral load testing, and counselling are required.
• Other issues to deal with soon:
  • partner notification (by self or public health services)
  • infectivity (reinforce mechanisms of transmission, high- and low-risk behaviours)
  • specific guidance for HIV-transmission avoidance:
    • protection of others from blood, body fluids, sexual secretions
    • avoid donating blood, organs, tissue, sperm, breast milk
    • inform family physician and consider informing other health-care providers (e.g., dentist).
• For newly diagnosed HIV infection, DMPs should offer to arrange referral to appropriate local providers for recommended care and follow-up according to local guidelines and standards.
• DMPs should discuss issues of confidentiality regarding immigration medical information. If mandatory notification of local public health authorities is required, the applicants should be advised.
• HIV-positive applicants admitted to Canada will receive information from the visa or immigration office containing contact information and telephone numbers for public health and HIV services in their province of destination.

 

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