Labor and Delivery Rapid HIV Test Counseling Counseling Flip Chart - Script to be used for Rapid HIV Test Counseling on Labor & Deliver

Important Information about Pregnancy and HIV Every pregnant women should know if she has HIV because she can pass HIV to her baby during . . . pregnancy . . . childbirth . . . or breastfeeding I would like to talk with you briefly about how HIV infection can affect a pregnancy. Every pregnant women should know if she has HIV because she can pass the virus on to their baby. This can happen during pregnancy, childbirth, and through breast feeding. But, we now have medicine we can give to protect babies from getting HIV.

Illinois Has an Important Law . . . The Illinois Perinatal HIV Prevention Act requires that all pregnant women in Illinois will be counseled and offered an HIV test. Since there is no HIV result in your medical record, the law states that we must offer you a rapid HIV test. If we do not know your HIV result when your baby is born, Illinois law requires that your baby be tested. Because of this, the Illinois Perinatal HIV Prevention Act requires every newborn to be tested with a rapid HIV test if the baby’s mother was not tested for HIV before delivery. We perform a rapid HIV test on every newborn baby whose mother does not have an HIV test result in their medical record. Since there is no HIV test documented in your medical records, we must run a rapid HIV screening test on your baby. Add documentation

Benefits of Doing a Rapid HIV Test The sooner we know your test result, the sooner we can give you medicine to protect your baby if it’s needed. The earlier medicine is started, the better it works to prevent HIV transmission. The preliminary results from a rapid HIV test can be ready before you leave the hospital. If the test is positive and you are near your date of delivery, you can choose to start medicine to keep you healthy and protect the baby from getting HIV during pregnancy. NOTE: The later in pregnancy a patient presents, the more urgent it would be to start HIV medicines as soon as possible. The earlier medicine is started, the better it works to prevent HIV transmission.

Risk of Transmitting HIV to a Newborn Without HIV medicine, there is about a 1 in 4 (25%) chance that a pregnant woman with HIV will pass it to her baby. If HIV medicine is given to a pregnant woman with HIV during labor and to the baby after delivery, it can cut the chances in half that the baby will get HIV (1 in 8). If HIV medicine is given to the mother during pregnancy and delivery and to the baby after delivery, it can reduce the chance that the baby will get HIV to much less than 1 in 8. 1 in 4 chance without HIV medicine 1 in 8 chance with HIV medicine during labor and to the newborn Less than1 in 8 chance with HIV medicine for the mother and baby

Rapid HIV Testing Procedures To do the rapid HIV test we need a small blood sample. You will be given the result as soon as possible. Your test result will be kept in your confidential medical record. To do the rapid HIV test we need a small sample of your baby’s blood. You will be given the result as soon as possible (usually within an hour or two after the blood is drawn). The test result will be kept in your baby’s confidential medical record. NOTE: HIV test results should be documented in the labor and delivery and newborn pediatric charts.

Understanding Rapid HIV Test Results The rapid screening test is very reliable, but it is not perfect. A negative test result means that there is no sign of HIV infection at this time. A positive test, however, is considered a preliminary result another test will need to be done to confirm the result before we can know for sure if it is correct. just to be safe, we will give you medicine to reduce the chance of passing HIV to your baby. and after delivery, we will also give your baby medicine to protect against HIV infection. The rapid screening test is very reliable, but it is not perfect. A negative test result means there is no sign of HIV infection at this time. A positive test, however ,is considered a preliminary result, which means: Another test will need to be done to confirm the result before we can know for sure if it is correct. It can take several days for the results of the confirmatory test to be ready. In the meantime, you may decide to start medicine to protect against HIV transmission, especially if it is late in pregnancy.

Consent for Rapid HIV Testing HIV testing is completely voluntary, so signing a general consent form means it is okay to test for HIV unless you say you don’t want a test. However, if you do not have an HIV test before the delivery, your baby will be tested for HIV. Let’s read through the form together and ask me any questions you have before you sign it. Consent Form HIV testing is completely voluntary, so signing a general consent form means it is okay to test for HIV unless you say you don’t want a test. However, if you do not have an HIV test before the delivery, your baby will be tested for HIV. Let’s read through the consent form together and ask me any questions you have before you sign it. NOTE:  STOP HERE UNTIL YOU HAVE THE RAPID TEST RESULT 

Your Rapid HIV Test was Negative Your HIV test came back negative, which means there is no sign of HIV infection at this time. Do you have any questions for me? Your HIV test came back negative, which means there is no sign of HIV infection at this time. Do you have any questions for me? NOTE: Consider recommending retesting if the patient has ongoing risk of HIV exposure.

For the Future . . . Would you like some information about how to prevent HIV and other STD’s? Prenatal visits are an important part of staying healthy in pregnancy and helping you have a healthy baby. Would you like some additional information about how to prevent HIV and other sexually transmitted diseases? NOTE: Provide HIV/STD risk reduction information and refer for additional counseling as needed. Prenatal visits are an important part of staying healthy in pregnancy and helping you have a healthy baby.

Your Rapid HIV Test was Preliminarily Positive Your HIV test was preliminarily positive, which means you could have HIV infection. Remember, this is a screening test. We need to send your blood to the lab for a confirmatory test before we know for sure if this preliminary result is correct. It will take a few days to get those results back. It is very important for you to return for care and get these results. NOTE: whenever possible, preliminary positive test results should be given by the patient’s physician. Your HIV test was preliminary positive, which means you could have HIV infection. Remember, this is a screening test. We need to send a sample of your blood to the lab for a confirmatory test (Western Blot) before we know for sure if this preliminary result is correct. It will take a few days to get those results back.

Starting Medicine to Protect Your Baby Right now we want to make sure that you and your baby are as safe and healthy as possible. We would like to give you some medicine to help protect your baby from HIV. The sooner we start the medicine, the better it works to prevent transmission. Right now we want to make sure that you and your baby are as safe and healthy as possible. We would like to give you some medicine to help protect your baby from HIV. The sooner we start the medicine, the better it works to prevent transmission. If it is very close to your delivery date, you may want to start taking medicine for HIV infection.

Until We Have Your Confirmatory Test Result We recommend that you do not breastfeed unless the confirmatory test result comes back negative. You and your baby will be given HIV medicine until the confirmatory test result is back. If that test is negative, you do not have HIV, but you will have taken HIV medicine for a few days. No serious side effects have been seen in people who have taken the medicines for a short time. We recommend that you do not breastfeed unless the confirmatory test result comes back negative. You and your baby will be given HIV medicine until the confirmatory test result is back. If that test is negative, you do not have HIV, but you will have taken HIV medicine for a few days. However, no serious side effects have been seen in people who have taken the medicines for a short time.

Coping with a Preliminary Test Result People often feel scared and overwhelmed when they hear this news. Can you tell me what you are feeling right now? What questions or concerns do you have? I know people often feel scared and overwhelmed when they hear this news. Can you tell me what you are feeling (thinking about) right now? What questions or concerns do you have?