Module 5: Testing skills development - section 1

In this document:

Pre-test discussion and giving results

Activity: Lecture and group discussion
Section Time: Approximately 45 minutes

This activity introduces the main topics that should be discussed if someone is considering testing and when giving test results. Note that the term ‘discussion’ is used throughout, rather than ‘counselling’. This is to avoid any implication that someone with counselling training can only fulfil this role. Although some basic counselling skills are necessary, a counselling qualification is not.

Show Slide 5.2 (Group work) and ask participant to consider the question:

To facilitate the discussion::

  • Ask the group to debate ways in which the process of deciding whether to have an HCV test (and receiving the results) can be characterised as discussion or counselling
  • Distinguish a discussion using ’counselling skills’ from ‘counselling’ as a psychotherapeutic discipline


Show Slide 5.3 (Counselling skills) :

To facilitate the discussion:

  • Explore the extent to which participants consider that they already have these skills
  • Clarify any points that need explanation


Show Slide 5.4 (Pre-test discussion 1 – risk exposure) : 

Points to emphasise:

  • Clarify the nature of the confidentiality and any limits to it
  • The importance of understanding why the person wants testing as this can sometimes reveal important information about their understanding of risk.
  • Assessing risk behaviours provides an opportunity to clarify the transmission risks with them and discuss strategies for risk reduction in the future.
  • After evaluating the person’s risk exposure, testing may not always be necessary. Nevertheless, people will sometimes want and need testing for a) peace of mind or b) because they are unable or unwilling to talk about all their risk exposure.
  • HCV testing is also an opportunity to consider whether other tests or immunisations are needed.


Show Slide 5.5 (Pre-test discussion – Preparing for the result) :

Points to emphasise:

  • Knowing your HCV status can be beneficial because, for the majority of people, an effective HCV treatment now exists.
  • For best practice, the pre-test discussion requires a good understanding of the treatment options that are available locally and whether the person would be eligible to receive it.
  • Where access to treatment is limited or non-existent there is an important ethical question to consider about the merits of providing diagnostic information to people who are excluded from having effective treatment.
  • Even if treatment is not available, knowing their own HCV status can clarify and reinforce the person’s need for self-protective measures that avoid future infection (or re-infection with another genotype) and protect others.
  • Only when the information and advice is clearly understood and the person’s questions have all been answered, are they in a position to decide whether they want testing.
  • Consent should be obtained in line with local procedures.


Show Slide 5.6 (Giving negative results) :

Points to emphasise:

  • If antibody test results are negative, the opportunity should be used to clarify any questions that have arisen from the pre-test discussion and identify further ways that future risk behaviour can be minimised
  • Repeat testing is advised if the person is believed to have been recently exposed to the virus, sinceHCV antibodies can take up to six months to develop (but usually no more than 3 months)


Show Slide 5.7 (Giving positive results) :

Points to emphasise:

  • It is important to ensure that the person clearly understands the result and what to do next
  • The person may need support to come to terms with a positive test result and its potential implications
  • Ensure they understand who/where to ask further immediate questions as people are often unable to think of all the questions they have straight away
  • Consider support from a) their family and friends b) local peer support groups c) online support groups d) relevant professionals e) Liver/HCV charities
  • The person giving the test result should consider providing support while the person waits to see a specialist or support service
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