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Voluntary Counselling and Testing

By Sandra Olivier

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Published: 19Mar2010
Word count: 754
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Voluntary Counselling and Testing is the confidential procedure that is followed when you decide (on a voluntary basis) to take an HIV test. As the result of the test can be life changing, it is important that you are properly counselled before you take the test.

STEP ONE: Pre-test Counselling You will be assigned a code number- you will not be required to give your name. During the pre-test counselling session, which lasts between 20-45 minutes, you will be told about the test and HIV disease. Ways to cope with a positive diagnosis will be discussed. You will be able to ask questions.

STEP TWO: Testing If you agree to take the test, you will be asked to sign a consent form. You can also choose not to sign but to only give verbal consent. You must then supply a small sample of blood from a finger prick, or a saliva sample. Most hospitals and clinics use a rapid HIV test, which means that the results will be available within 20 minutes. If this test is not available an Elisa test will be done, which requires a larger blood sample from your arm. It also needs to be sent away to a laboratory. You will be told when to return for your results, which can take up to two weeks.

STEP THREE: Results and Post-test Counselling Your results will be given during a post-test counselling session. The health professionals and counsellors who conduct and discuss the test with you must, by law, keep the results strictly confidential. You decide whether to tell your family and friends if you are HIV-positive. Children over 14 years of age do not need permission from a parent or guardian to have an HIV test. Children under the age of 14 do require permission, although in emergency situations, such as after a rape when a HIV test is required, a doctor can authorise a test. What if your test is negative? • If your test is negative you will be given advice on how to prevent HIV infection in the future • If you have had unsafe sex in the three-month period before taking the test, you will be advised to come for a second test after another three months. This is because there is a time period after HIV infection, called the window period, when tests cannot accurately pick up the infection

What if your test is positive? • If your test is positive you will be given another different test to confirm the result • If the second test is negative a blood sample will be taken and sent to a laboratory for further testing to establish the correct diagnosis • If the second test is positive, counselling and advice on how to manage your health and delay the development of AIDS will be provided. You will also be advised on how to reduce the risk for your sexual partner(s) and how to deal with the issue of disclosure to your family and friends. The counsellor will refer you to a government HIV service point • The next important step is to find out how advanced your disease is. You will have to undergo more tests to measure your CD4 count (which indicates how strong your immune system is) and your viral load (which measures the number of viruses in your blood). You will be given appropriate advice on how to stay as healthy as possible, and treatment if necessary

What the HIV test cannot show • How a person was infected • Who the person got the infection from • When the person first became infected • If a person has AIDS – different kinds of blood tests need to be done Benefits of getting tested • If you test negative, you will be able to make sure that you do not put yourself at risk in future by adjusting your sexual lifestyle and practices. • If you are worried that you may be HIV-positive because you have practised unsafe sex it is important that you take a test. If you are negative you can put your mind at rest and start making sure you do not put yourself at risk in future. If you test positive you can start to actively manage your health and also make sure that you do not infect any of your future partners.

There is good evidence to support the fact that most people who test positive immediately modify their behaviour and therefore reduce the risk of infection for others. Testing negative also tends to encourage people to adopt safer sexual practices in the future.

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