Women may experience difficulties in assessing the risks they face. Most women will have engaged in risky behaviour (unprotected intercourse with men), but are often not in a position to easily assess their risk for HIV.

Women living with HIV/AIDS in this country come from a broad range of backgrounds. Increasingly HIV-positive women come from black African backgrounds and will have acquired their infection in Africa. A significant proportion were unaware of their male sexual partner's higher-risk behaviours, e.g. sex with men or injecting drug use. Just because a woman does not appear to have had partners who fit into either of these categories, it doesn't mean she hasn't been at risk. She may be unaware of past risk behaviour, or her partner may have denied risk behaviour. So it's important not to skimp on the discussion of the possibility of testing positive with women who appear to be least at risk.

Explore with the client strategies for safer sex. Does she currently have any? Does she have good or bad experiences in the past to draw on? Are there any additional difficulties, such as conflicts with contraceptive measures (such as oral contraception), or abusive and aggressive behaviour from male partners?

Check carefully the client's reasons for testing. Some women may seek testing because of known or suspected risk factors with her partner (e.g. infidelity). Will she find it easy to address the underlying issue if she tests negative, by adopting or maintaining safer sex?

Some women wish to have children. This may or may not be related to seeking an HIV test. All pre–menopausal women (of all sexual orientations) should be given information about HIV and pregnancy. This will need to include risks of transmission from mother to baby, options for managing conception and pregnancy to reduce the risks of transmission, and longer term considerations about childbearing.

If a woman seeks HIV antibody testing in order to know her health status before conceiving, it is important that the intended father also considers testing. All pregnant women are offered HIV testing as part of routine antenatal care. It is important that the needs of the woman are fully addressed at this time, and that women are not pressurised into taking the test. For further information see HIV testing, pregnancy and children later in this chapter.