24.7.2 Delivering the result and post-test counselling for HIV-negative people
An HIV-negative test result can produce a range of emotional responses, including relief, excitement, or optimism (the result may feel like a new opportunity). The person may also feel confused — they may have perceived themselves as HIV-positive, and they may have an HIV-infected current or former partner.
An important issue to consider when delivering a negative HIV test result is what is termed the window period. The window period refers to the time between HIV infection and the time at which HIV can be detected by available tests. Rapid HIV tests detect anti-HIV antibodies in the blood, but it usually takes about three months from the original HIV infection for the immune system to develop sufficient levels of antibodies against HIV to be detected by these tests. So individuals who are within this window period (i.e. who have been recently infected by HIV) may test negative in a rapid HIV test and yet still be able to transmit the virus. Therefore, you should advise people who may have recently been exposed to HIV (by unprotected sex and/or blood-contaminated products) to have another confirmatory HIV test at least three months after exposure to the virus.
Counselling for individuals with HIV-negative test results should include the following information:
- An explanation of the test result, including information about the window period for the appearance of HIV antibodies, and a recommendation to re-test in case of a recent exposure.
- Basic advice on methods to prevent HIV transmission.
- Provision of male and female condoms, and guidance on their use.
- The health worker and the tested person should then jointly assess whether there is a need for more extensive post-test counselling or additional prevention support, for example, through community-based services.