Informed Consent To Hiv Antibody Test


Connecticut Department of Public Health
TB, HIV, STD and Viral Hepatitis Programs
Informed Consent to HIV* Antibody Test
*HIV: Human Immunodeficiency Virus
Before you receive an HIV antibody test, you must give your consent. This form explains the test and how the test results can be used.
It should help you decide whether you want to take the test. Please read it carefully. Your doctor or HIV tester must go over this
information with you. If you have any questions, ask them. Please read all this information before you decide to be tested. If you want
to be tested, please sign the back of this form.
What is the HIV Antibody Test?
It is a test that shows if you have antibodies to HIV in your body. (HIV antibodies are a sign that HIV has entered your body.) A blood
(fingerstick/ venipuncture) or oral sample will be taken from you and be tested. If the first test shows that you have the antibodies, a
different test will be done to make sure the first test was right.
What does it mean if the test is negative?
A negative test means you're probably not infected with HIV. But it takes the body time to produce the HIV antibodies. It may just be
too soon for the antibodies to be seen in the test. If you recently had sex without a condom or shared needles with someone who may
be infected, you may want to be tested again in three to six months. Please talk to your doctor or HIV tester about this.
What does it mean if the confirmatory test is positive?
A positive confirmatory test result means you are infected with HIV. It doesn't necessarily mean you have AIDS, but HIV is the virus
that causes AIDS. It also means you could give the virus to other people. People who are infected can pass the virus during sex or by
sharing needles during drug use. A pregnant woman who is infected can pass the virus to her baby during pregnancy or childbirth.
How will the test help me?
If the test is negative:
Your doctor or HIV tester will tell you how to keep from getting HIV in the future.
If the test is positive:
Your doctor can take better care of you by knowing your test result.
You can learn about ways to stay healthy and new medicines that may help.
You can learn how to avoid passing HIV to others.
If you are pregnant, your doctor can give you and your baby special care and advice.
Your test result is reported to the state health department using your name.
Do I have to take the test?
No. Taking the test is up to you. In most cases, you can't be made to take the HIV antibody test. If you don't want the test, you can
still get medical care. But sometimes it may be harder for your doctor to give you the best care.
If you want to take the test, you don’t have to let anyone know your test result. You don’t even have to tell anyone you've taken the
test. You can find a testing site near you by calling
at 211 or 1-800-203-1234 within Connecticut.
Do I have to tell anyone my test result?
If you take the test, your result is private. Under Connecticut law, only the people listed on the back of this form may have the result.
(Please be sure to read the back of this form and ask your doctor or HIV tester if you have any questions.) If your test is positive, your
sex and needle-sharing partners need to know. This is true for past and present partners. There is a special program that can help you
tell your partners. If you are unable to tell partners yourself, they may be told, and your name won't be used.
What if I don't show up for my result?
By signing this consent form you give permission to the STD/HIV clinic to give your name to the Department of Public Health’s
Partner Services staff for the purpose of follow-up. Staff may follow-up with you for a period of up to thirty-six months for the
purpose of informing you of your HIV test result or to locate you to ask you to return for your test results.
Informed Consent-Eng (December 2014)


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