Pre- & Post-Test Counseling for HIV

Treatment advances since the mid-1990s have improved the length and quality of life for people living with Human Immunodeficiency Virus (HIV), but as of May 2010 there is no cure. Counseling before and after HIV testing will help you understand what behaviors put you at risk and teach you how to decrease the chance of becoming infected. If you do test positive, counseling will address your immediate needs for support and information, and teach you what you need to know to decrease the chance of infecting others.

Importance

• According to the Centers for Disease Control (CDC), between 800,000 and 900,000 people were infected with HIV in the United States by 2007. The CDC estimates that 25 percent of people who have HIV don't know they are infected. Its guidelines recommend routine, voluntary HIV tests because those who learn they have an HIV infection early are less likely to transmit it to others and with treatment can have fewer symptoms. They may delay the progression of their illness to Acquired Immune Deficiency Syndrome (AIDS).

Pre-Test Counseling

• The CDC emphasizes that HIV testing should be voluntary. Your counselor will tell you what you need to know to give informed consent before you are tested. He or she will ask you about your sexual partners and activities and about drug use. This information is not reported to law enforcement; it is needed to assess your risk of having HIV and to determine what information you'll need to reduce your risk. You will learn about your choices to have confidential or (at many test sites) anonymous testing. There are testing options that are less invasive than an intravenous blood test including oral fluid, urine or a finger-stick.

Test Results

• Several types of rapid HIV tests provide results in 10 to 40 minutes. If a rapid test result is negative and it has been three months or longer since you have had a potential exposure to HIV, you will be considered to be free of the disease. If the test result is reactive, it means that HIV antibodies have been detected. You will need to have a confirmatory blood test, which takes one to two weeks to return results. You will be counseled about the importance of returning for your results and on how to protect yourself and others from exposure to HIV while you wait for your results.

Post-Test Counseling

• Whatever your immediate results, after testing you will receive information about risk-free and safer sex options and learn about other sexually transmitted and blood-borne diseases. You may also learn about the effectiveness of using clean needles and other drug paraphernalia and get information about drug treatment programs in your area. You may receive referrals to programs that will provide emotional support and help you address any barriers you have to reducing your HIV risk in the future.

Misconceptions

• Some people mistakenly believe that only men who have sex with men are at risk of getting HIV. Through counseling you'll learn that any unprotected vaginal, anal or oral sexual contact with a person who has HIV can transmit the disease if there is enough of the virus present. HIV-positive mothers may transmit the virus to their babies before or during birth or through breast milk. Another misconception that leads some to risk contact with HIV through unprotected sex is that if they get it, they can use antiretroviral medicines and be fine. Post-test counseling will discuss how these medicines have extended and improved the lives of many with HIV, but stress that it is still a serious, incurable disease.