Transgender and gender nonconforming people experience some of the highest human immunodeficiency virus HIV rates in the United States, and experience many structural and behavioral barriers that may limit their engagement in HIV testing, prevention, and care. Evidence suggests that transgender and gender nonconforming youth TY are especially vulnerable to acquiring HIV, yet there is little research on TY and few services are targeted towards HIV testing, prevention, and care for this population. Telehealth presents an opportunity to mitigate some structural barriers that TY experience in accessing HIV testing, allowing TY to engage in HIV testing and counseling in a safe and nonjudgmental space of their choosing. Project Moxie is an HIV prevention intervention that pairs the use of HIV self-testing with remote video-based counseling and support from a trained, gender-affirming counselor. This study aims to offer a more positive HIV testing and counseling experience, with the goal of improving HIV testing frequency.
Hiv counseling protocols in virginia women of color and those under 25 years of age are disproportionately affected by the HIV epidemic [ 56 ]. Testing The decision to offer HIV testing in nontraditional settings should be based on several factors, including availability of resources and feasibility of providing test results and follow-up. Arch Intern Med ; Accepting or refusing testing must not have detrimental consequences to protodols quality coujseling care offered. Hunt Mary L. Results Project Moxie was launched in June and recruitment is ongoing.
Nude athletic women tgp. Introduction
If required, paperwork should be completed at Hiv counseling protocols in virginia end of the counseling session or by staff members who are not counseling. When follow-up prevention counseling sessions couneling be provided by a different counselor, careful record-keeping is recommended to ensure high-quality counseling. Lee Warner, M. Prevention case management can help coordinate diverse referral and follow-up concerns. Most infected persons will develop detectable HIV antibody within 3 months of exposure Am Rev Respir Dis ; Box 3 Return to top. One study indicated that telephone protocolz of positive results was associated with delay in linkage to care Figure 1 Return to top. Clients should receive help to identify the specific behaviors putting them at risk for acquiring or transmitting HIV and commit to steps to reduce this risk. Sensitivity: The probability that a test will be positive when infection or condition is present. Verified by Psychology Today. The relevance of any routinely collected data should be periodically assessed. Effective counseling models tended to use the same counselor for all sessions.
Methodology is explained in the Introduction page 5.
- More information about the panels can be found in each set of guidelines.
- Persons using assistive technology might not be able to fully access information in this file.
- Methodology is explained in the Introduction page 5.
- It identifies goals, objectives, and activities that needed to stop the spread of HIV in Virginia.
- Feel free to explain your need and to ask about our treatment programs and facilities.
Methodology is explained in the Introduction page 5. All HCWs must follow universal precautions. Individual cases may be referred to the Commissioner of Health and additional restrictions may be placed if necessary. Any such summary cannot capture the details and nuances of individuals state laws.
Although roughly a third of the states permit health care providers to inform a minor's parents that their child is seeking STI-related services, none require it. Also, the law is fluid, and these summaries may not reflect recent legislative change in a particular state. Every state in the country allows minors to consent to STI testing and care without parental approval, although a number of these set an age threshold for the right to consent without parental involvement. In these states, the minimum age ranges from 12 to 14 years of age.
As of the date of this posting, thirty-one states allow minors to also consent to HIV testing and treatment without parental approval. Unlike testing for most other infectious diseases, testing for HIV involves possible benefits as well as social, economic, and legal consequences that typically are not apparent or known to an individual considering testing.
HIV-related testing is the gateway to health-preserving treatment; it also can be the basis of criminal prosecution for those who are sexually active, or relied on to exclude individuals who test positive for HIV from programs, employment, or insurance. Although state and federal laws prohibit much of this discrimination against people with HIV, the ability to enforce those rights usually depends on access to free legal services, which are increasingly limited and not available at all in roughly half of the states in the United States.
Thus, the potential negative consequences of HIV testing at a particular time or location might inform an individual's decision of whether or when to get tested for HIV; or whether to test anonymously or through a "confidential" testing process that reports their test results and identifying information to the state but maintains the confidentiality of those results.
Although informed consent is a legal concept rather than a medical one, many states use definitions of "informed consent" for purposes of HIV testing and medical procedures that in fact are inconsistent with the accepted legal definition, e.
Prior to an HIV test, a medical care provider must inform the patient that the test is planned, provide information about the test, and advise the patient that he has the right to decline the test. If a patient declines the test, the medical care provider must note that fact in the patient's medical file. Persons who test positive must be afforded individual face-to-face disclosure and the opportunity for post-test counseling.
Skip to main content. Virginia Return to State List. While we have made an effort to ensure that this information is correct and current, the law is regularly changing, and we cannot guarantee the accuracy of the information provided.
This information may not be applicable to your specific situation and is not, and should not be relied upon, as a substitute for legal advice. Blood, Tissue, Organ, and Semen Donation:. Case-by-case decision by Commissioner of Health.
Physicians may, but are not required to, inform the parents of the HIV test result. Informed Consent Required:. Pre-Test Counseling:. Anonymous Testing Available:. Anonymous testing is available at designated anonymous testing sites. Partner Notification Required:. Published September, Published March,
Cohort studies have demonstrated that many infected persons decrease behaviors that transmit infection to sex or needle-sharing partners once they are aware of their positive HIV status After an occupational exposure, health-care workers should use measures to prevent transmission during the follow-up period However, although medical treatment has improved the quality and length of life for HIV-infected persons, it cannot cure HIV disease. However, these guidelines acknowledge public and private providers' needs for flexibility. Training and Education. Data should be collected with a standard collection instrument throughout the program. Your Phone.
Hiv counseling protocols in virginia. Contact Us
Persons using assistive technology might not be able to fully access information in this file. For assistance, please send e-mail to: mmwrq cdc. Type Accommodation and the title of the report in the subject line of e-mail. Terje J. David Atkins, M. Beadle de Palomo, M. Academy for Educational Development Washington, D. Gail A. Bolan, M. Browning, M. DeGroff, M. Douglas, M. Gandelman, M. Gostin, J. Georgetown University Washington, D.
Khurram S. Hassan, M. Hearn, M. Johnson, M. Kassler, M. Lindsay, M. Merson, M. Morin, M. Primm, M. Infectious Disease Solutions, P. Atlanta, Georgia Peter Salovey, Ph. Schable, M. Sikkema, Ph. Divine, M.
Stacie M. Greby, D. Kenneth V. Hunt Mary L. Kamb, M. Richard W. Steketee, M. Lee Warner, M. Randall, M. To develop these guidelines, CDC used an evidence-based approach advocated by the U. Preventive Services Task Force and public health practice guidelines. The recommendations are based on evidence from all available scientific sources; where evidence is lacking, opinion of "best practices" by specialists in the field has been used.
These advances include a demonstrated efficacy of HIV prevention counseling models aimed at behavioral risk reduction; b effective treatments for HIV infection and opportunistic infections; c effective treatment regimens for preventing perinatal transmission; and d new test technologies. Although the new guidelines include many aspects of the previous ones e. These guidelines were developed for policy makers and service providers in the many settings that offer voluntary human immunodeficiency virus HIV counseling, testing, and referral CTR public and private, urban and rural, and those with high and low HIV prevalence Box 1.
The guidelines are intended to be used to develop CTR services and policies in traditional clinical settings e. The Public Health Service is responsible for ensuring the quality of services in publicly funded programs, and many aspects of these guidelines focus on such programs.
The guidelines could also be useful for CTR in other settings e. Recommendations should be tailored to fit the needs of clients, communities, and programs within local, state, and federal rules and regulations. The first CDC guidelines, published in , highlighted the importance of offering voluntary testing and counseling and maintaining confidential records 1. In , new guidelines emphasized the need to decrease barriers to counseling and testing, especially disclosure of personal information 2.
In , an additional report described the model of HIV prevention counseling currently recommended an interactive rather than didactic model focusing on a personalized HIV risk-reduction plan 3. In , HIV Counseling, Testing and Referral Standards and Guidelines focused on standard counseling and testing procedures and reiterated the importance of the HIV prevention counseling model and the need for confidentiality of counseling 4. Where scientific findings were lacking, recommendations were guided by "best practices" from specialists in the field.
These guidelines were developed through the following five-step approach: Address user needs. Internal and external content specialists were consulted on key areas to address. Review scientific literature. Approximately 5, abstracts were screened and approximately relevant publications were reviewed and synthesized where appropriate.
Obtain technical opinion. A panel of technical specialists from public and private sectors; governmental and nongovernmental agencies; and legal, ethics, and policy fields was convened to review the recommendations. Obtain user input. Internal CDC comments, public and private provider assessments, key consultant interviews, broad external reviews, and public comments through the Federal Register were obtained.
Publish electronically and in hard copy. They will be updated and posted periodically. Differences in the new guidelines include giving guidance to all providers of voluntary HIV CTR in the public and private sectors; using an evidence-based approach to provide specific recommendations for CTR; underscoring the importance of early knowledge of HIV status and making HIV testing more accessible and available; acknowledging providers' need for flexibility in implementing the guidelines, given their particular client base, setting HIV prevalence level, and available resources; recommending that CTR be targeted efficiently through risk screening and other strategies; and addressing ways to improve the quality and provision of HIV CTR.
As of December 31, , a total of , persons were reported with AIDS, and , of these persons had died; the number of persons living with AIDS , was the highest ever reported Approximately ,, persons in the United States are infected with HIV, and approximately , of these persons might not know they are infected However, although medical treatment has improved the quality and length of life for HIV-infected persons, it cannot cure HIV disease. Furthermore, the successes of new medical therapies might have led to relaxed attitudes toward safer sex e.
Additional advances include improved understanding of HIV transmission; a wider array of HIV test technologies; effective prevention counseling approaches; and practical, beneficial referral strategies all of which could reduce the impact of the HIV epidemic in the United States. Early knowledge of HIV infection is now recognized as a critical component in controlling the spread of HIV infection Cohort studies have demonstrated that many infected persons decrease behaviors that transmit infection to sex or needle-sharing partners once they are aware of their positive HIV status HIV-infected persons who are unaware of their infection do not reduce risk behaviors 42, Persons tested for HIV who do not return for test results might even increase their risk for transmitting HIV to partners Because medical treatment that lowers HIV viral load might also reduce risk for transmission to others 51 , early referral to medical care could prevent HIV transmission in communities while reducing a person's risk for HIV-related illness and death.
The array of HIV test technologies available has expanded, possibly enhancing a person's willingness to be tested and learn his or her HIV status. HIV tests can use specimens collected by less-invasive methods e. Rapid HIV testing allows clients to receive results the same day, which is useful in urgent medical circumstances and settings where clients tend not to return for HIV test results e. HIV testing can also be conducted using commercially available home sample collection devices Also during the s, randomized controlled trials demonstrated that, for persons at increased HIV risk, certain prevention counseling approaches can be effective in reducing high-risk behaviors and new sexually transmitted infections 5, The counseling approach used is critical to effectiveness; interactive counseling approaches directed at a client's personal risk and the situations in which risk occurs are more effective than didactic, informational approaches 5.
Because personalized prevention counseling can require more provider time and training than traditional counseling approaches, providing it to everyone receiving HIV testing might not be feasible.
This recognition has led to a new area of health services research developing strategies that effectively target CTR services to persons most likely to benefit from them. The improved health of HIV-infected persons on antiretroviral therapy, along with new test technologies and effective counseling approaches, has contributed to an improved understanding of the importance of referral to needed services.
In addition, new guidelines for partner counseling and referral services PCRS 27 and prevention case management 28 were developed specifically for publicly funded clinics and could also be useful to providers in other settings. Specialists in the field have also identified situations in which additional counseling or psychosocial support services might benefit HIV prevention efforts. Finally, advances in several areas have led to new guidelines for preventing mother-to-child transmission see Revised Recommendations for HIV Screening of Pregnant Women , treating opportunistic infections 23 , 53 and other sexually transmitted 29 and bloodborne diseases 30 -- 32 , and managing occupational and nonoccupational exposure and prophylaxis 54 , These developments were considered in the formulation of the new CTR guidelines.
In private settings, a lower proportion of all clients are tested, and few receive prevention counseling and referrals In many potential testing settings e. Personal information should not be divulged to others in ways inconsistent with the client's original consent. Obtain informed consent before HIV testing. HIV testing should be voluntary and free of coercion.
Informed consent before HIV testing is essential. Information regarding consent may be presented orally or in writing and should use language the client can understand.
Accepting or refusing testing must not have detrimental consequences to the quality of care offered. Documentation of informed consent should be in writing, preferably with the client's signature. State or local laws and regulations governing HIV testing should be followed. Information regarding consent may be presented separately from or combined with other consent procedures for health services e.
However, if consent for HIV testing is combined with consent for other tests or procedures, the inclusion of HIV testing should be specifically discussed with the client.