The client has to be informed of the right to refuse to take the test and of the fact that declining an HIV test will not affect his access to services.
Informed consent is the authorization of the patient to undergo a medical examination, after having received all the information about risks, advantages and methods of this examination. The client has to be informed of the right to refuse to take the test and of the fact that declining an HIV test will not affect his access to services that do not depend upon knowledge of HIV/HCV status. Community-based organizations (CBOs) must have a consent form that carefully and clearly explains (in appropriate language) the CBO’s responsibility and the client’s rights. Client participation must always be voluntary, and documentation of this informed consent must be maintained in the CBO’s records. Clients offered HIV testing in non-clinical settings may be under the influence of alcohol or drugs or may have chronic mental health conditions, any of which may interfere with their ability to provide informed consent for voluntary HIV testing and to understand test results. Counsellors should be able to determine when clients are not competent to provide consent and understand the result.
Traditionally, in the pre-test counselling, the focus is on risk assessment, in order to make the person aware of the risks encountered that might eventuality lead to having a positive result; while strategies for risk reduction is done in the post-test counselling, when providing the client with test results. While speaking about the ways of transmission, the counsellor can check with the client what risks the client may have encountered since the last HIV/HCV test. An important aspect is also the risk behaviours of the client’s partner(s), which might affect HIV/HCV risk for the client.