Definition: injection-drug users and their sex partners, persons who exchange sex for money or drugs, sex partners of HIV-infected persons, men who have sex with men (MSM), and heterosexual persons who themselves or whose sex partners have had more than one sex partner since their most recent HIV test.
They should have an HIV test at least once a year.
Advise patients that if they suspect they have been exposed to HIV in the past three months, it may be too soon to detect it. Providers should refer patients to their primary care provider or a community-based testing site for retesting in three months.
PrEP: PrEP stands for Pre-exposure prophylaxis. PrEP is a once a day pill that can keep you HIV negative. Condoms should be used for STD protection. Learn more at prepforsex.org
PEP: PEP stands for post-exposure prophylaxis. PEP is a medicine that you take if you are HIV-negative and you believe you have just been exposed to HIV. PEP is most effective in preventing HIV when taken correctly and as soon as possible. Learn more at https://www.cdc.gov/hiv/basics/pep.html
Definition: all other individuals not listed as higher risk.
Patients may be given their result and informed that no further testing is required at that time.
Reactive Screening Test
Patients should be advised that additional testing will be performed to confirm their reactive HIV test result. Patients should be told how they will be informed about the results of the confirmatory testing (e.g., at their first follow-up appointment, via telephone, or some other way).
Confirmed HIV Positive Results
Provide or Arrange for in-person post-test Counseling:
- Coping with the consequences of learning the result;
- The potential for discrimination;
- Preventing transmission of HIV to others;
- HIV information is confidential and how to authorize or revoke the release of HIV information;
- HIV reporting is required by law;
- How to access prevention and supportive services. Outside of New York City, the New York State Department of Health Partner Services staff can also assist in providing post-test counseling.
Provide or schedule an appointment for follow-up HIV medical care
The medical professional who receives a patient’s confirmed positive HIV test result must provide an appointment or schedule an appointment for follow-up HIV medical care. If the provider does not provide HIV medical care, the patient’s medical record should reflect the name of the medical provider/facility where the appointment was made.
Discuss options for notifying partners, contacts, and spouses, including screening for risk of domestic violence; or refer to a Partner Services.
- Partner Services is a free program offered by the New York State Department of Health, the New York City Department of Health and Mental Hygiene, and many county health departments. Partner Services helps people and their partners recently diagnosed with Chlamydia, gonorrhea, syphilis, and HIV plan how to best notify their sexual and/or needle-sharing partners of an exposure to an STD/HIV, and link them to testing. Partner Services is voluntary and confidential.
- Partner Services staff can assist providers with techniques on how to quickly and effectively communicate the importance of Partner Services referral to your patients. Partner Services will work with each patient to identify sexual partners and/or needle-sharing partners (as appropriate), and will develop a plan to notify each partner while protecting the patient's identity. Staff can also help patients who choose to notify their partners themselves.
- When a new confirmed case of HIV, Chlamydia, gonorrhea or syphilis is reported to the Department of Health, Partner Services can work with the patient to create a plan to inform any sexual and/or needle-sharing partners about an exposure to the STD/HIV. Health care providers are integral to quickly connecting patients to Partner Services. A Partner Services Specialist will interview the patient in a private, confidential setting. The Specialist will ask the patient to share information about recent behaviors, including places where they meet partners (including the Internet) and other contact information about their partners.
- The sexual and/or needle-sharing partners are then contacted by phone, mail or e-mail to arrange a meeting with the Partner Services Specialist to inform them confidentially about their STD/HIV exposure.
- Throughout the notification process, names or identifiers (including the dates of exposure) are never revealed to the partners. The anonymity and privacy of the original patient is the highest priority.
- All partners are offered free STD and HIV counseling and testing services. Additionally, referrals to substance abuse, mental health and other social services are offered as appropriate. Subsequent HIV care services and STD screenings are also available.