Question: I want to have an AIDS test but I'm told I have to be counselled before I can be tested. Is this necessary?
Answer: The law doesn't allow HIV testing to take place unless you are fully informed beforehand. The counselling is to provide you with adequate information so that you can decide whether you are ready for the test and its possible consequences. This enables you to give what is known as "informed consent."
Pre-test counselling is also necessary to make sure that the timing of the test is right in order to make certain you receive a reliable result.
If a test is conducted too soon after risk behaviour has taken place, the test may not give an accurate result. For example, if you had had unprotected sex within the previous thirteen weeks and were infected, with HIV on one of those occasions, testing now would be too soon to be sure of the test indicating that you have been infected. This is known as "being in the Window Period."
The object of the test is to find out whether "antibodies" to HIV are present in the blood. If the body has produced cells (known as antibodies) to fight the virus then this shows that the virus has entered the body. However, it takes up to thirteen weeks from the infection date for these antibodies to be detectable and so it is necessary to wait for this period to elapse in order to make sure that the test result is reliable.
In order for you to determine when you have been at risk, you first of all need to know what are the various ways in which you could become infected and what are the relevant degrees of risk. For example, some people think that 'dry' kissing is a risk, whereas it is not. By explaining what is and what is not risk behaviour we enable you to judge when you were last at risk and what is your overall degree of risk. In some cases it turns out that testing is probably not necessary. In other cases testing should be delayed, e.g. if you are in the Window Period.
Counselling does include talking about sexuality and your sexual behaviour but counsellors usually leave it up to you to decide just how much you feel comfortable to disclose about yourself, bearing in mind that the objective is to provide you with a result on which you can rely. We also make use of the counselling session to provide information about effective preventative measures. The tests themselves are very reliable. However, it is essential that they are conducted at the right time, so a great deal depends on whether the information you provide about the timing and nature of your risk behaviour is accurate. Holding back information can only undermine the reliability of the test.
If you are not in the Window Period and you test "Negative", the result is reliable and you are NOT infected with HIV. If, however, your test shows that you have been infected with HIV, a second, confirmatory test will be conducted to eliminate any possible error, even though our experience to date is that the second test invariably confirms the first test. Testing positive for the HIV does not necessarily mean that you have AIDS but it does mean that you can infect others. Obviously, many issues will be raised by receiving a Positive result. At ATICC we are able to offer up to six post-test sessions to support those who test positive and their partners. These sessions are provided by registered psychologists with considerable experience in this field. There is no charge and all counselling is conducted in the strictest confidence.