Opt-out approach to HIV testing
This approach expects you to provide information on HIV/AIDS and HIV testing in the form of group education. The opt-out approach is offered as a routine part of standard care. In this case, pregnant women are informed and routinely offered HIV testing and counselling. They are then given the opportunity to decline the test should they choose to do so or, in other words, to 'opt out' of a HIV test. The opt-out approach emphasises that HIV testing is a routine component of ANC.
However, you should stress to pregnant women that HIV testing is still voluntary under the opt-out approach, and that they have a right to refuse testing. You should identify and resolve issues that prevent a pregnant woman from accepting HIV testing. The Ethiopian FMOH recommends the opt-out approach and therefore you are expected to offer HIV testing and counselling to all pregnant mothers coming to your health post, or that you encounter in your community during house-to-house visits.
A pregnant mother who is HIV positive and two months pregnant comes to you with signs and symptoms of WHO HIV stage 4 disease. What will you do?
As you have learnt previously, WHO HIV stage 4 patients need ART, and you have to refer them to the health centre for thorough care and ART.