10.18.08.06

.06 Requirements for Pretest Counseling.

A. The health care practitioner who orders an HIV test to be performed by a laboratory shall ensure that pretest counseling is conducted and voluntary informed consent is obtained from the individual to be tested for HIV before:

(1) A specimen is obtained for the purpose of HIV testing; or

(2) An HIV test is performed on a specimen obtained for another purpose.

B. An individual performing pretest counseling shall:

(1) Provide HIV counseling:

(a) Verbally;

(b) In writing;

(c) By video; or

(d) By any combination of §B(1)(a)—(c) of this regulation based on the testing history and information needs of the individual to be tested;

(2) Conduct pretest counseling in a manner to protect the confidentiality of the individual to be tested;

(3) Include in the counseling, at a minimum, information:

(a) That an HIV test will be administered and that the individual has the right to refuse an HIV test without penalty;

(b) That a health care facility or laboratory may not use refusal to consent to an HIV test or a positive test result as the basis for denying services or treatment;

(c) On primary modes of HIV transmission and means of preventing transmission;

(d) On the advantages of knowing one's HIV status, including:

(i) If negative, the ability to protect oneself from future HIV infection; and

(ii) If positive, the ability to avoid transmission to others and to take advantage of available treatment to prevent or delay disease progression;

(e) That a negative HIV test result means either that:

(i) An individual is not infected with HIV; or

(ii) The test was unable to detect the presence of HIV because an individual is in the early stage of infection and has not yet developed detectable evidence of HIV infection;

(f) That an individual should be retested within 6 months if the HIV test result is negative and the individual has:

(i) Engaged in unprotected vaginal, anal, or oral sex or engaged in intravenous drug use; or

(ii) Had a potentially infectious exposure to blood;

(g) That a positive HIV test result means the individual:

(i) Is infected with HIV;

(ii) Will be linked with medical treatment and supportive services including case management; and

(iii) May need a confirmatory test if the preliminary positive was based on an HIV rapid test;

(h) That an individual with a positive HIV test result:

(i) Could have infected others since becoming infected and could infect others in the future; and

(ii) Has a responsibility to notify the individual's partners of the individual's HIV-positive status, or ask assistance of someone else in notifying those individuals;

(i) That an individual may choose to be tested on either a confidential or anonymous basis, and how a designated anonymous test site can be located; and

(j) For an individual being counseled in a designated anonymous HIV test site:

(i) That an assigned code will be used instead of a name;

(ii) That test results can be obtained by returning to the anonymous test site with the assigned code; and

(iii) That the individual may schedule a return appointment to obtain test results;

(4) Include an opportunity for the individual being counseled to:

(a) Ask questions about HIV infection and other topics described in §B of this regulation; and

(b) Have those questions answered; and

(5) Make necessary accommodation with respect to language or disability to ensure that the individual being counseled understands the information presented.