Positive results vary by clinical significance and can be classified as urgent or nonurgent, with others requiring no action.

The clinical significance of a test or result needs to be considered in the overall context of the patient’s history and presenting problems.

Systems will vary locally, but they should include processes for timely follow-up of positive results and cases where there is concern about the significance of a test result, e.g. persisting symptoms despite negative results.

Clinically accredited registered nurses within PFSHSs may be delegated management of test results including review, initialling (electronic equivalent) and actioned as outlined in the table below.

See RACGP Standards for general practices, System for follow up of tests and results.

Publicly Funded Sexual Health Services to have systems in place to ensure results are reviewed, documented, actioned and put in the patient’s medical record (paper or electronic).

Management of test results
Results requiring urgent action by clinician	Recommended action to be taken by clinician
HIV antigen or antibody positive (indeterminate or equivocal)	Recall patient on receipt of result The minimum follow-up is at least four attempts over two weeks, using two different notification methods (if available) and outside normal business hours If there is no response and a postal address is available, send a registered letter (person to person with a delivery receipt) Where the patient cannot be located or does not respond to contact efforts, seek advice from a senior clinician and consider HIV case conference with multidisciplinary team Additional measures may be possible through the SHIL partner notification service or local Public Health Unit. Document all attempts at contact
Syphilis serology reactive, rapid plasma reagin (RPR) raised Syphilis nucleic acid amplification test (NAAT) swabs positive Chlamydia positive Gonorrhoea positive M. genitalium positive Glomerular filtration rate < 60 mL/min (if >60 mL/min see below) Hepatitis A immunoglobulin M (IgM) positive Hepatitis C RNA or antibody positive Lymphogranuloma venereum positive Trichomoniasis positive Cervical screening results requiring immediate referral	Recall patient on receipt of result Up to 4 attempts in total at different times Co-ordinate subsequent follow-up in accordance with management guidelines Consult with senior clinician if unable to contact patient Document all attempts at contact
Results requiring review and action by clinician	Recommended action to be taken by clinician
Syphilis Treponema pallidum enzyme immune assay (EIA) positive; RPR serology nonreactive Herpes simplex virus (HSV) positive Hepatitis B surface antibody negative, surface antigen positive HIV monitoring results (chemistry, immunology, haematology) Cervical screening results not requiring immediate referral All nonroutine test results negative Hyphae or spores Candida albicans culture positive Clue cells Urine showing any pathogen or microscopic findings Glomerular filtration rate 60–90 mL/min Any other positive, indeterminate or abnormal results not listed for urgent action All patients requiring immunisation	Determine action required if any Co-ordinate subsequent follow-up in accordance with standard or local operating procedures If action is required: Recall patient within 7 days of receipt of result Make up to 2 attempts at contact in total at different times of the day If unable to contact patient, flag system to ensure follow-up at next visit Document all attempts at contact
No action required
All negative routine STI tests Syphilis NAAT swabs negative HSV NAAT negative M. genitalium negative Hepatitis A immunoglobulin G (IgG) positive or negative Hepatitis B core antibody positive and Hepatitis B surface antigen negative Hepatitis B core antibody negative Hepatitis C antibody negative	Where patient is not immune, recommend that they attend for vaccination.

Provision of test results

All actions are to be documented in patients medical record.

1. RACGP Standards for general practices, System for follow up of tests and results.