Informed Consent: Delivering Information to Patients

Ways in which pretest information can be provided to patients include:

• One-on-one staff discussions with patients based on scripts and training
•  Fliers/posters posted throughout the emergency department with required information
• Pamphlets with required information handed out at registration or triage; these are appropriate to the patient's culture, language, sex, sexual orientation, age, developmental level, and literacy level
•  Rolling videos broadcast in waiting rooms and low urgency exam rooms
• Computer-aided, self-administered tutorials
•  Manufacturers' information pamphlets
• Handouts describing HIV transmission, the rapid test procedure, and methods to prevent transmission

Informational materials should be easily understood and made available in the languages of the ED's commonly encountered populations. The competence and availability of interpreters and bilingual staff to provide language assistance to patients with limited English proficiency must be ensured. Patients who do not read, or who do not read well (which may be a significant proportion of the ED clientele) should have the option of having information delivered orally.

See side bar for advice on delivering pretest information to patients.

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Sites using rapid HIV tests offer these practical suggestions for providing pretest information:

• Explain to patients that "rapid" refers to the time it takes the test to yield results. Patients may need to wait longer to account for time taken to obtain consent, explain rapid HIV testing, obtain a specimen, etc.
• Some patients mistakenly believe that "rapid" refers to the ability of the test to detect recent infection. Use the informed consent process to identify, respond to and correct any misinformation relating to the meaning of rapid HIV tests.
• Patients with a negative rapid HIV test can be told that they are not infected, unless they have a known or possible exposure within the three months prior to testing and should be retested.
• For patients with reactive test results, the CDC recommends this simple message, "Your preliminary test result is positive, but we won't know for sure if you are infected with HIV until we get results from your confirmatory test. In the meantime, you should take precautions to avoid transmitting the virus."