Physician use of the HIV antibody test. The need for consent, counseling, confidentiality, and caution

The author, a physician at the AIDS Service of Chicago's Cook County Hospital, examines some of the potential harms to patients of indiscriminate HIV antibody testing. He maintains that physicians have a responsibility to educate themselves about the meaning, appropriate use, and adverse consequences of the test and to encourage voluntary HIV antibody testing for persons at risk. Tests should be preceded by informed consent after full disclosure of risks and benefits, accompanied by counseling regarding HIV and AIDS transmission and prevention, and followed by post-test counseling. Strict confidentiality should be maintained at every step in the procedure. Sherer cautions physicians about confirming positive results and the occurrence of false negative tests and urges counseling concerning behavioral change for all at-risk persons irrespective of test results.