The process of conveying an HIV test result to the person tested is affected by the type of test performed, the setting of the consultation and testing, and the extent (if any) of additional testing to determine the true HIV status of the person. The result of an HIV test should also be used to determine the method of conveying a test result.
The person who requests the test is responsible for ensuring or confirming that appropriate mechanisms are in place for delivering test results and that contact details are confirmed at the time of the HIV test.
The window period will be determined by the type of test used – more advanced HIV tests can detect HIV sooner than others. It is essential to check the type of HIV test used. The way in which test results are conveyed should take account of the patient’s level of knowledge and capacity to deal with the test results. Occasionally, patients may be unconvinced by a positive or a negative test result. Assistance in dealing with such cases is available from specialist services (contact your local sexual health service, HIV specialist service, community peer-based organisation or the ASHM Health (ASHM)). Counselling may be required by some individuals and should be facilitated.
Negative test results #
The decision about how a negative HIV test result is provided (e.g. in person, by phone, email etc.) should be based on the clinical judgement of the person responsible for conveying the test result.
Discussion following an HIV-negative test result should include reinforcement of education, and information about transmission risk reduction practices appropriate to the patient.
For further information on conveying a negative HIV test result see 2020 National HIV Testing Policy.
Positive test results #
The 2020 National HIV Testing Policy outlines that:
‘[a] positive result should ideally be provided in person by asking the patient to return for the result as soon as possible. Some sexual health clinics have recently commenced delivering positive results over the phone where a patient has declined to re-attend the clinic quickly. Practitioners should use clinical discretion balancing the risk of not conveying test results when considering alternate communication methods.’
It is important to state the HIV test result very clearly to avoid a patient confusing a ‘positive’ result with a ‘good’ result.
The decision about how to convey a result should be based on the understanding of the person being tested. Counselling may be required by some individuals and should be offered to all who receive a positive diagnosis. Counselling should preferably be undertaken by an appropriately trained health professional, for example, psychologist, social worker or counsellor. The national Standards for psychological support for adults with HIV may be used as a guide. For more information on conveying a positive HIV test result, see 2020 National HIV Testing Policy.
For further information about discussing test results see chapter 9 ‘Conveying HIV test results’ in the ASHM HIV testing portal. Patients who do not return for a positive test result are not able to receive health and psychosocial supports, may place others at heightened risk of acquiring HIV, and risk contact with the criminal legal system or coercive public health powers.
All efforts should be made to contact these individuals as soon as possible by phone or in writing, and they should be asked to make contact with the clinic or relevant practitioner urgently.
Public health units can provide contact tracing assistance. Medical practitioners who fail to deliver test results risk legal liability (see, e.g. Kite v Malycha (1998) 71 SASR 321).
In PD v Harvey and Chen [2003] NSWSC 487, medical practitioners were found to have failed in the exercise of their duty of care by not confirming that the patient had attended post-test consultation. In a number of instances, medical practitioner–patient discussions during pre-test, post-test and subsequent discussions have been key evidence in criminal prosecutions of individuals accused of putting others at risk of HIV infection (see the case summary in Duty of care to third parties and civil liability). It is very important to take care in record keeping by ensuring documentation is accurate, and to ensure accurate communication of test results takes place without undue delay.
Resources #
2020 National HIV Testing Policy (last accessed March 2023)
Standards for psychological support for adults with HIV
The Australian STI Management Guidelines for Use in Primary Care
