'Have you ever had an HIV test?' Record yes/no, when and the result: this helps with the risk assessment if another test is to be done at this visit.
'Would you be interested in having an HIV test today, as it is now a routine part of the STI screen?' Record yes or no.
In many clinics at this point the history-taking would be terminated and the next phase of the process would be the examination. But increasingly the primary worker would continue and undertake the pre-HIV test discussion if the person is deemed to be low-risk and they are comfortable to continue. Most of the assessment questions have already been asked, so that now they need only cover the technical and legal aspects of the testing process.
You now perhaps have enough information to make a provisional diagnosis; however, until you complete the physical examination and collect the specimens you must keep your suspicions to yourself. It is important not to be drawn into making a diagnosis. If pressured you can use phrases such as 'It appears suggestive of X or Y; however, until the tests are done there is no definite answer.'
This process is obviously a comprehensive breakdown of a sexual history-taking process. Many people are worried just how long this will take. In an asymptomatic person and with an experienced healthcare worker you may be able to complete this in 5 to 10 minutes maximum. Obviously every person should be treated in an individual manner, and therefore the time will vary.
To break down the process into a simpler form the following questions are a useful assessment guide.
The nature and duration of any symptoms.
When was the last time they had sex - was it within the last three months? Describe the type of sex. Were condoms used?
Do they know if the partner has symptoms?
Have they tried any self-medication to alleviate the symptoms?
Relevant medical history.
For women - the last menstrual period.
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