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The need to discuss investigations for HIV infection with patients beforehand and to interpret the results to them afterwards is discussed elsewhere in this series. Except in special circumstances, permission to collect a sample for anti-HIV testing should have been sought by the doctor and expressed or implied by the patient. Clotted blood should be obtained by careful venepuncture without spillage or risk of an inoculation accident. The needle and syringe should be disposed ofsafely and the blood placed in a leakproofcontainer, properly identified, and sent by a secure route to the laboratory.The patient's identity and the suspected diagnosis should not be exposed, so numbers or codes rather than names may have to be used, even though the risk ofmisidentification is increased. In this delicate area information should be shared over the telephone only between individuals who know each other and written reports should be sent to named members of staffin confidence. All positive results should be checked again on a freshly drawn specimen. The consequences offailures and breaches ofthese procedures may be very serious for patients and prove costly to doctors. Because of the implications ofpositive laboratory findings for the patient's health, for his family and contacts, and for his social and professional life a high level of competence and sensitivity is to be expected from all who are concerned in instigating investigations for HIV infection.Laboratory tests for HIV have increased understanding ofAIDS and greatly facilitated diagnosis, management and control measures. However, to derive most benefit and do least harm with them they must be used wisely.

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