HIV pre-test information, discussion or counselling? A review of guidance relevant to the WHO European Region.
In the context of a shift from exceptionalism to normalisation, this study examines recommendations/evidence in current pan-European/global guidelines regarding pre-test HIV testing and counselling practices in health care settings. It also reviews new research not yet included in guidelines. There is consensus that verbal informed consent must be gained prior to testing, individually, in private, confidentially, in the presence of a health care provider. All guidelines recommend pre-test information/discussion delivered verbally or via other methods (information sheet). There is agreement about a minimum standard of information to be provided before a test, but guidelines differ regarding discussion about issues encouraging patients to think about implications of the result. There is heavy reliance on expert consultation in guideline development. Referenced scientific evidence is often more than ten years old and based on US/UK research. Eight new papers are reviewed. Current HIV testing and counselling guidelines have inconsistencies regarding the extent and type of information that is recommended during pre-test discussions. The lack of new research underscores a need for new evidence from a range of European settings to support the process of expert consultation in guideline development.
Centre for Social Research in Health, University of New South Wales, Sydney, NSW, Australia Stephen.bell@unsw.edu.au.
Stephen A
SA
Bell
Public Health England, London, UK.
Valerie
V
Delpech
CHIP, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Dorthe
D
Raben
Center for STI/HIV Epidemiological Studies of Catalonia (CEEISCAT/ASPCAT) and CIBERESP, Badalona, Catalonia, Spain.
Jordi
J
Casabona
Center for Information and Counseling on Reproductive Health - Tanadgoma, Tbilisi, Georgia.
Nino
N
Tsereteli
Centre for Social Research in Health, University of New South Wales, Sydney, NSW, Australia.
John
J
de Wit
D015492:AIDS Serodiagnosis; D019985:Benchmarking; D032921:Consensus; D003376:Counseling; D005060:Europe; D015658:HIV Infections / Q000175:diagnosis*; D006282:Health Personnel; D006801:Humans; D007258:Informed Consent; D008403:Mass Screening / Q000379:methods*; D017410:Practice Guidelines as Topic; D014944:World Health Organization
AIDS; Europe; HIV; diagnosis; guidelines; informed consent; pre-test counselling; testing