HIV and STI prevention in the community: counselling, rapid testing, linkage and mother-to-child elimination
- Safe practice
The nurse offers voluntary, confidential testing, gives clear prevention advice, links people who test positive to care and helps protect babies from infection.
What it is
Most curable sexually transmitted infections cause no symptoms, so testing is offered rather than waiting for complaints. Rapid tests for HIV and syphilis give same-day results and can be used in homes, mobile units and outreach. WHO asks every testing service to follow the five Cs: consent, confidentiality, counselling, correct results and connection to prevention, care and treatment. A reactive result is confirmed according to the national algorithm, and people with HIV start treatment as early as possible: when the virus is undetectable, it is not transmitted sexually. Colombia works within PAHO's EMTCT Plus framework to eliminate mother-to-child transmission of HIV, syphilis, hepatitis B and Chagas disease.
What it requires
- Training in pre- and post-test counselling and in the national testing algorithm.
- A private space, even in outreach (a tent, a separate room).
- Rapid tests and materials for safe waste disposal, per institutional protocol.
- A referral route agreed with the HIV programme and prenatal services for same-day linkage.
Components
- Information and voluntary consent.
- Rapid testing and confirmation per national algorithm.
- Prevention package: condoms, information on pre- and post-exposure prophylaxis, hepatitis B and HPV vaccination.
- Linkage to care and treatment.
- Testing and treatment of sexual partners.
- Mother-to-child elimination actions in prenatal care and for the newborn.
How it is applied (and why)
- Explain the test, its benefits and its limits, and ask for free consent — testing is voluntary, never forced.
- Ensure privacy and confidentiality during the whole process — fear of disclosure keeps people from testing.
- Perform the rapid test following the institutional protocol — correct results are one of the 5 Cs.
- Give the result in person with clear counselling, whatever it is — a negative result is also a moment for prevention.
- If reactive, start confirmation per national algorithm and refer the same day — fast linkage means earlier treatment.
- If negative after a recent risk, explain the window period and when to retest — an early test can miss a new infection.
- Offer condoms and information on prophylaxis and vaccines — prevention is combined, not a single measure.
- Encourage testing and treatment of sexual partners per protocol — treating partners stops transmission and reinfection.
- In pregnant women, test in prenatal care and coordinate treatment of her and her partners — this prevents infection in the baby.
In nursing practice
- Adolescents need friendly, confidential services; see the adolescent-friendly services page.
- WHO recommends a dual HIV/syphilis rapid test as the first test in antenatal care.
- Self-tests can widen access; a reactive self-test still needs confirmation by trained staff.
- Use language without judgement about sexual practices, drug use or sex work.
Common mistakes
- Giving a diagnosis of HIV from a single reactive rapid test.
- Giving results in a corridor, by phone without identity check or in front of relatives.
- Testing without linkage: a positive result with no appointment is a lost person.
- Treating the pregnant woman with syphilis but not her partners, which allows reinfection.
Test yourself
Think of the answer, then tap the question to see it.
What are WHO's 5 Cs of HIV testing services?
Consent, confidentiality, counselling, correct test results and connection (linkage) to prevention, care and treatment.
Is a reactive HIV self-test a diagnosis?
No. A reactive self-test or rapid test must be confirmed by trained staff following the national testing algorithm.
What does an undetectable viral load mean for transmission?
A person on treatment with no virus detectable in the blood does not transmit HIV to sexual partners.
Which four infections does the EMTCT Plus framework aim to stop passing from mother to child?
HIV, syphilis, hepatitis B and Chagas disease.
Elsewhere in DurgiPedia
Connections
Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.
Sources: HIV and AIDS: fact sheet (World Health Organization, 2026); HIV testing services: approaches, the 5 Cs and self-testing (World Health Organization, 2024); Sexually transmitted infections (STIs): fact sheet (World Health Organization, 2025); ETMI Plus Colombia 2018-2021: marco para la eliminación de la transmisión materno infantil del VIH, la sífilis, la hepatitis B y la enfermedad de Chagas (Ministerio de Salud y Protección Social, Colombia, 2018).
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Representative model, for educational purposes only.