HIV testing for insurance purposes : a multi-faceted exploration of the clients' experience and aspects of current practice.

Abstract

HIV testing is required for life assurance applications. A written information document distributed at blood collection (venisection) serves as pre-test preparation. This study reviewed the adequacy of the document and explored possible alternative arrangements, by means of three research phases conducted at the point of venisection. Phase 1 used a specifically designed questionnaire which included a demographic section and questions assessing the applicant's appraisal of being adequately prepared, and their understanding and experience of testing. Constructed measures established their state of anxiety at testing and their range of information about HIV/AIDS. Phase 2 consisted of a counselling intervention, followed by the questionnaire used in Phase 1. Phase 3 consisted of semi-structured interviews with nursing personnel and insurance brokers. The phase 1 results indicated that the majority of applicants knew they were having an HIV test, did not feel coerced, had a moderate level of information about HIV and were not overly anxious at testing. The level of information about HIV/AIDS showed a significant correlation with their level of education, and the information document emerged as inadequate preparation. Answers given in Phase 2 differed qualitatively from those in Phase 1. Greater consideration of the impact of a positive result was shown, with increased concern about the implications for other people and anticipated acceptance of a positive result emerged in Phase 2. The personnel interviewed for Phase 3 indicated that they felt ill equipped to offer pre-test preparation.