Testing for HIV infection has several potential benefits, from promoting prevention to improving access to care and prevention of mother-to-child-transmission (see Chapter 7). HIV testing should always be voluntary, conducted by trained staff with respect for privacy and confidentiality, and include pre- and post-test counselling.

Indications for screening

In most communities, voluntary HIV counselling and testing services should be available:

• as part of routine antenatal care or linked to those services;
• for anyone who wants to know their HIV status (including partners of pregnant women).

Available screening tools

There are many kinds of HIV tests available. WHO recommends confirmatory testing with a second test of a different type before the client is notified of a positive result.

Implementing screening

Counselling and testing for HIV should be available to reproductive health clients on-site or through referral. Counselling and testing for HIV includes:

• pre-test counselling;
• HIV test with confirmatory test;
• post-test counselling and referral if indicated.

Counselling and testing for HIV should be voluntary and the consent of the patient is always required. HIV testing should never be done on the request of another person, and results should only be given in person to the client.