1. Scenario:
You are working at a physician's of-
fice, and you have just taken C.Q., a
38-year-old woman, into the consulta-
tion
room. C.Q. has been divorced for 5 years,
has two daughters (ages 14 and 16), and
works full time
as a legal secretary. She is here for a rou-
tine physical examination and requested
that a human immunodeficiency
virus (HIV) test be performed. C.Q. stated
that she is in a serious relationship, is
contemplating
marriage, and just wants to make certain
she is "okay." No abnormalities were not-
ed during C.Q.'s physical
examination, and blood was drawn for
routine blood chemistries and hematol-
ogy studies. The physician
requests you perform a rapid HIV test,
which is an antibody test. Within 20 min-
utes, the results are available
and are positive.
2. Does a positive rapid HIV test mean that A rapid HIV test detects antibodies against the
C.Q. definitely has HIV? If it is negative, HIV virus. Anyone who has a positive rapid HIV
does it test
mean she definitely doesn't have HIV? needs to have additional testing with a West-
ern blot test to confirm or rule out the diagno-
sis of HIV.
False-positive results depend on the preva-
, Latest Case Study 83 Human Immunodeficiency Virus 2026
lence of HIV within a community and are higher
in areas
of lower HIV prevalence. False-positive results
can occur in pregnant women and women who
have
had children, recently vaccinated individuals,
injection drug users, people who have had
malaria,
patients with lymphomas, and other condi-
tions.
Because the test will be positive several weeks
to 3 months after exposure to the HIV virus, if
exposed to HIV within this time frame, the re-
sult might still be negative. Retesting would be
recommended,
particularly if the person was at risk for infec-
tion.
3. What counseling do you need to provide You need to explain the meaning of the rapid
to C.Q.? test result in simple terms, avoiding technical
jargon.
Emphasize the importance of having confirma-
tory testing and that you need to draw another
blood
sample. Go ahead and schedule a return visit
for the confirmatory test results. Underscore
the importance
of taking precautions to avoid the possibility of
transmitting infection to others while awaiting
results of confirmatory testing. A simple mes-
sage to convey this information could be, "Your
preliminary