This article assesses the performance of currently used tests for exposure to human immunodeficiency virus (HIV), the infectious agent associated with acquired immunodeficiency syndrome (AIDS); suggests, in view of that information, guidelines for counseling people seeking HIV antibody testing; and evaluates the claim that because antibody test results will effect behavior change in those who are infected, all members of high-risk groups should be tested.

HIV testing is likely to yield a high proportion of false-positive results in low-risk populations and infants born to infected mothers. A negative result may not establish freedom from infection in high-risk groups or the offspring of infected mothers. Counseling should relate these generalizations to a client 's motivation for and expectations from testing. In evaluating a client's risk of exposure, past and present, counseling should provide both information about and reinforcement for behavioral risk reduction.

The assertion that members of high-risk groups ought to learn their antibody status is questioned in view of concerns about test performance and even more serious questions about the psychological impact of test results — both short- and long-term — on people's adaptation to protective sex and modification of drug use patterns.



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