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You shouldn't need to counsel for HIV testing out of hours, not least because you generally can't test for this out of hours. These cases do however need counselling regarding the risk-benefit analysis of triple therapy, and a serum save is taken for later analysis. Rarely the "donor" might be available for testing, and then a HIV test can be helpful, but I wouldn't consider such a test without professional counselling beforehand i.e. the next day. On the other hand, counselling the "recipient" prior to triple therapy is relatively straightforward.
 
Adrian Fogarty
----- Original Message -----
From: [log in to unmask] href="mailto:[log in to unmask]">Black, John
To: [log in to unmask] href="mailto:[log in to unmask]">[log in to unmask]
Sent: Monday, September 02, 2002 3:04 PM
Subject: Re: HIV and rape

Duncan,
 
Who provides the counselling for HIV testing etc out of hours in your set-up?
 
I trust you are keeping well!
 
John
-----Original Message-----
From: Duncan Peacock [mailto:[log in to unmask]]
Sent: 26 August 2002 08:20
To: [log in to unmask]
Subject: Re: HIV and rape

Where I work in Central London the virologists are telling us to give prophylaxis. If the patient requests it, and you refuse, and they subsequently sero-convert the law suit isnt worth thinking about. Its a risk benefit ratio, and after careful counseling, if the patient still insists you would be silly to refuse.
We have recently had gay males come in and state that their boyfriends HIV +ve and the condom has burst. You've guessed it the virologists recommend prophylaxis
 
Duncan
 
----- Original Message -----
From: Rowley Cottingham
Sent: 26 August 2002 06:14
To: [log in to unmask]
Subject: HIV and rape
 
If a patient presents after alleged rape, is HIV prophylaxis indicated?

Best wishes,


Rowley Cottingham

[log in to unmask]
http://www.emergencyunit.com

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