I come from an emergency department background and I don't think asking every person who presents to triage if they are HIV positive is a good idea.

As nurses, we need to treat every patient as if they are infected with HIV, Hepatitis or some other blood borne disease. This generally comes out in the past medical history section of the triage assessment form prior to entering the department regardless of their triage category.

From a patient's perspective, here are things you should look out for:

• If a nurse is not wearing gloves when taking your blood you can always demand they do.
• If they respond with an answer such as "I'm sure you're ok" which I have heard nurses say before, I answer with "I might be free from HIV but I personally don't know if you are. Please put your gloves on."

I suggest the following protocols for HIV testing:

• I think we have too many posters in ED's that are irrelevant and should be more on health prevention such as sexual health. ANYONE in an ED or clinic who is getting an HIV test MUST be seen by a counsellor or even a social worker first explaining the test, how they will cope if the test comes back positive and talk to them about the 3 month incubation period.
• I would actually refer them to a professional sexual health clinic rather than do the testing in an ED or unsupportive clinic. Send them to Albion Street Centre. They are fabulous. Or Sydney Sexual Health Clinic at Sydney Hospital or some other sexual health facility where these resources are available and the protocols are followed.
• If one of these are unavailable, an infection control nurse in your hospital is a great resource to refer patients to.
• I would also contact the IC nurse and tell them what expectations you have as the patients' advocate in receiving pre and post test counselling and telling the patient their sample is collected as a number and their names are not put on the vial.
• The patients also need to be aware that the DOH collects HIV data but names are not identified, just the collection numbers.
• All of this information MUST be relayed to the patient, and whilst doing this it is an excellent time to talk about safe sex, using condoms and dental dams.
• Nurses can be a bit lax sometimes due to the business of our jobs but HIV and AIDS needs to have time allocated to these patients in a quiet, isolated setting where the patient is free to talk. Gay or straight.

What about you? What are your thoughts on AIDS and HIV testing and protocols?

Contributed by a Nurse Uncut member: Nathan Brew in response to our request in our Forum for thoughts and opinions on AIDS in observance of World AIDS Day 2009.

If you want to contribute a blog post or an article to a Nurse Uncut that you think our community would be interested in, please drop me a note on admin@nurseuncut.com.au with your name and the topic you want to write about. Thanks, Christine.

Image credits: World Aids Day NSW and Photoxpress