Saskatchewan HIV Testing Policy
Routine Testing Quick Guide
WHY? 26% of HIV positive people are unaware of their status.1
• In spite of The Joint United Nations Programme on HIV and AIDS (UNAIDS)/WHO 2004
recommendations, people who should be tested are still being missed.
• Missed testing opportunities when providers are required to determine need for testing
based on risk.
• Missed testing opportunities when testing is mainly client-initiated.
• Stigma and discrimination will lessen when testing is routine.
• To increase rate of testing, promote earlier diagnosis, improve treatment outcomes &
reduce transmission.
WHO?
• All patients aged 13 to 70 receiving primary or emergency health care who do not know
their HIV status.
• All persons who are sexually active with multiple/successive long-term partners and have
not had an HIV test in the last 12 months.
• All patients who have requested an HIV test.
• All pregnant women. HIV screening should be included in the routine panel of prenatal
screening tests for all pregnant women (Society of Obstetricians and Gynecologists of
Canada [SOGC] , 2006). Repeat screening in the third trimester may be indicated based on
clinical assessment and labor and delivery guidelines. (Morbidity and Mortality Weekly
Report [MMWR] Recommendations and Reports, 2006) (SOGC , 2006).
• All patients assessed in a sexually transmitted infection (STI) clinic or seen in any health
care setting for an STI or Hepatitis B or C.
• All persons with current or past history of illicit drug use.
• All persons from endemic 2 countries.
• All tuberculosis (TB) patients (active and latent) and contacts as indicated.
• All patients showing signs/symptoms that may be consistent with HIV-related disease. 3
WHEN?
• Consider at least once every 5 years in all adults.
• Part of an annual exam.
• Whenever a risk is discussed.
• On a regular basis or with other blood work. Refer to time frames in “Negative Result”
section.
1
Public Health Agency of Canada, HIV/AIDS Epi Updates - July 2010, [Link]/aids-sida/publication/epi/2010/[Link]
2
The Public Health Agency of Canada defines countries where HIV is endemic as those where the prevalence of HIV among people
ages 15 to 49 years is 1.0% or greater and one of the following:
• 50% or more of HIV cases are attributed to heterosexual transmission;
• a male to female ratio of 2:1 or less among prevalent infections; or
• HIV prevalence greater than or equal to 2% among women receiving prenatal care.
3
[Link]
Conditions_-_Guidance_for_Implementing_HIV_Testing_in_Adults_in_Health_Care_Settings_FINAL_version_2012-[Link]
March 2015
Page 1 of 2
HOW?
Confidentiality Counselling – dependent on setting Consent – informed and voluntary
Written, signed consent is not required; however verbal, informed consent must be obtained and
all care providers must document on patient record that verbal consent was/was not obtained.
Minimum information for consent:
• Benefits of testing.
• Right to refuse.
• Availability of support, assistance, care and effective treatment options.
• Information is kept strictly confidential throughout the testing process.
• HIV is reportable to the regional Medical Health Officer, who will assist with
partner/contact follow-up and with responsibilities under The Public Health Act
regarding disclosure to future partners.
The ability of a person (including a minor) to provide informed consent is determined by the extent
to which the person’s physical, mental, and emotional development will allow for a full
understanding of the test, including the right to refuse. Refer to the College of Physicians and
Surgeons of Saskatchewan’s Policy on Determining Capacity to Consent
at: [Link]
%20Determining%20Capacity%20to%[Link]
HIV Client Information Sheet may be used to provide the above information. The
practitioner simply confirms that the client understands the information, discusses any
client concerns, obtains verbal consent and documents.
“Did you have a chance to look over the Information Sheet? Unless you’d like to
discuss any questions first, I’m going to include a routine HIV test with your blood
work today. HIV testing is now recommended for people 13 years and older, so I ask
everyone.”
See In-depth HIV Pre- and Post-Test Counselling Guide for situations requiring more detailed
information.
Saskatchewan HIV Testing Policy March 2015
Routine Testing Quick Guide Page 2 of 3
ORDER HIV SCREENING TEST
NEGATIVE RESULT POSITIVE RESULT
• Discuss result. • Prepare before giving result (urgent but not emergent).
• Review need for further testing: • Protect the patient’s privacy and confidentiality.
– At 4 weeks and 3 months after a • Provide sufficient time to discuss the impact of the
known/suspected exposure. positive result and ask questions.
– Every 3-6 months for clients with on-going • Arrange for a follow-up appointment.
high-risk activities. • Provide risk reduction information to prevent
– Every 12 months for clients who are transmission of the virus.
sexually active. • Work with the patient to discuss when, how and with
• Reinforce prevention and risk reduction. whom to disclose the positive test result and develop
• Offer referrals for support services e.g. a partner notification strategy. Contact Public Health
prevention and risk reduction programs, to assist with partner/contact follow-up.
addiction services, mental health services. • Providers may also contact Population/Public Health
(or the Infectious Disease Clinic for In-Patients) to
assist with:
– Finding patient.
– Referral to Infectious Disease Clinic.
– Specific patient needs/situations e.g. pregnant,
addictions.
– Completion of HIV Case Report Form.
– Linkage to care, treatment and support services.
INDETERMINATE RESULT
Repeat test in 2-4 weeks, or consult with Infectious Disease Specialist or Microbiologist if client has
signs and symptoms consistent with HIV infection.
Saskatchewan HIV Testing Policy March 2015
Routine Testing Quick Guide Page 3 of 3