Why Do We Need To Perform An Hiv Pretest Discussion

Primarily the function of performing an HIV pre-test discussion is to obtain informed consent. Patients have a right to information about the implications of HIV testing and they need to make the decision themselves about whether or not to test. The amount of information given to each patient will vary, according to factors such as risk behaviour, and the patient's own wishes. Patients may need more information to make an informed decision about an investigation for a condition, which, if present, could have serious implications for the patient's employment, and/or social or personal life.

Discussing other details, such as how long the test will take and the practicalities of the procedures involved, such as blood or finger-prick sampling, are also important. Where applicable, details of costs or charges that the patient may have to meet, particularly if he/she is not resident in the UK, may also be important to mention, depending on local clinic protocols. These could all be factors in the patient declining an HIV test.

It has also been suggested that a well-performed HIV pre-test discussion may help the patients prepare themselves appropriately for either a positive or a negative diagnosis. Patients may have misconceptions about risk behaviour, and may be mistaken in thinking that they are at either high or low risk.

When providing any information about HIV-testing in a pre-test discussion it is important to find out about patients' individual needs and priorities. For example, patients' beliefs, culture, or occupation may have a bearing on the information they need in order to reach a decision. You should not make assumptions about patients' views, but discuss these matters with them, and ask them whether they have any concerns about the test or the potential risks it may involve. You should provide patients with appropriate information, which should include an explanation of any risks to which they may attach particular significance. Always ask the patient whether they have understood the information and whether they would like more before making a decision.

You must abide by patients' decisions on these issues.

94 ADVANCED CLINICAL SKILLS FOR GU NURSES

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