counselling hiv/ aids patient
DESCRIPTION
COUNSELLING IN HIV/AIDS Qurrot Ulain Taher P.G Diploma in Nutrition & Dietetics Dietetic Techniques & Patient Counseling HIV/AIDS HIV stands for Human Immunodeficiency Virus. AIDS stands for Acquired Immune Deficiency Syndrome. AIDS is a result of the development of the HIV virus into a more serious condition. AIDS was first recognised by the U.S. Centers for Disease Control and Prevention in 1981 and its cause, HIV, identified in the early 1980s. Understanding HIV HIV is a contagious infection which attacks the immune system, reducing its effectiveness and leaving the body susceptible to infections. The HIV infection damages the cells the body needs to fight illnesses. AIDS can be diagnosed when the number of immune system cells (CD4 cells) in the blood of a person with HIV drops below a certain level. There is no cure for HIV or AIDS, but there are treatments that can slow down the disease, and help prevent the onset of AIDS. It takes around ten years for someone with HIV to develop AIDS, but it can be prevented with early detection and treatment of the HIV PREVENTION OF Mother to child transmission Treatment for HIV and AIDS HAART TYPES OF HIV TESTS Why Is Counseling Necessary Objectives Whom to counsel Characteristics of a Counselor Skills Required in Counseling Stages of Counseling Risk assessment counseling Pre test counseling Post test counseling Follow up counseling Role of Counselor Advocacy role Health education Referral Clinical and therapeutic role Special Situations in HIV Counseling Pregnant women Childless couples Breast feeding positive mothers Spouse and family members of HIV infected personsTRANSCRIPT
COUNSELLING IN HIV/AIDS
Qurrot Ulain TaherP.G Diploma in Nutrition & Dietetics
Dietetic Techniques & Patient Counseling
HIV/AIDS
HIV stands for Human Immunodeficiency Virus. AIDS stands for Acquired Immune Deficiency Syndrome. AIDS is a result of the development of the HIV virus into a more serious condition. AIDS was first recognised by the U.S. Centers for Disease Control and Prevention in 1981 and its cause, HIV, identified in the early 1980s.
Understanding HIV
• HIV is a contagious infection which attacks the immune system, reducing its effectiveness and leaving the body susceptible to infections. The HIV infection damages the cells the body needs to fight illnesses. AIDS can be diagnosed when the number of immune system cells (CD4 cells) in the blood of a person with HIV drops below a certain level.
• There is no cure for HIV or AIDS, but there are treatments that can slow down the disease, and help prevent the onset of AIDS. It takes around ten years for someone with HIV to develop AIDS, but it can be prevented with early detection and treatment of the HIV
PREVENTION OF Mother to child transmission
• An HIV-positive mother can pass HIV on to her baby any time during pregnancy, labor, delivery and breastfeeding, so the transmission of the virus must be blocked at each stage.
• Current World Health Organization guidelines recommend that HIV-positive pregnant mothers should go on a regimen of three antiretroviral drugs (ARVs) as soon as possible and stay on these drugs until their infants are born and breastfeeding has concluded. Ideally, the mothers themselves will also remain on treatment once breastfeeding has concluded, for their own health.
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• As soon as the infant is born, the baby should be given nevirapine — a very inexpensive drug — daily for six weeks.
• The infant should be formula-fed rather than breastfed if possible, but it’s recognized that formula feeding is both expensive and difficult to do safely in resource-limited settings.
• As such, if the mother cannot formula-feed her child, it is recommended that the mother should breastfeed her child exclusively for six months while continuing to take her ARVs.
• this regimen can reduce transmission of HIV to their babies by an amazing 95 percent or more.
Treatment for HIV and AIDS
HAART There is treatment available for HIV which will slow
down the progression of the virus, allowing people to lead a normal live. This treatment is called highly active antiretroviral therapy (HAART), and is a combination of medicines administered in two or three pills to be taken once or twice daily.
They will also need to have regular blood tests to monitor the HIV.
Counseling skills properly used are tools to help individuals seek
and find their own solutions to the dilemmas they face.
Definition
TYPES OF HIV TESTSAntibody Tests: The most common HIV tests look for HIV antibodies in your body, rather than looking
for HIV itself:• Enzyme immunoassay (EIA) tests use blood, oral fluid, or urine to detect HIV antibodies. Results
for these tests can take up to two weeks.• Rapid HIV antibody tests also use blood, oral fluid, or urine to detect HIV antibodies. Results for
these tests can take 10–20 minutes.• If you get a positive result from either of these tests, you will need to take another test, called
a Western blot test, to confirm that result. It can take up to two weeks to confirm a positive result.Antigen Tests
These tests are not as common as antibody tests, but they can be used to diagnose HIV infection earlier—from 1-3 weeks after you are first infected with HIV. Antigen tests require a blood sample.
• PCR Test (Polymerase chain reaction test)This test detects the genetic material of HIV itself, and can identify HIV in the blood within 2-3 weeks of infection.Babies born to HIV-positive mothers are tested with a special PCR test, because their blood contains their mother's HIV antibodies for several months. This means they would test HIV-positive on a standard antibody test—but a PCR test can determine whether the babies have HIV themselves.Blood supplies in most developed countries are screened for HIV using PCR tests. PCR tests are also used to measure viral loads for people who are HIV-positive.
Why Is Counseling Necessary?
• Because infection with HIV is life long• To cope with HIV positive status and live a
meaningful life• To adjust and to learn about change in
one’s life style in order to reduce risk of contracting HIV infection
Objectives
• To provide psycho-social support• To prevent transmission of HIV infection• To improve quality of life of HIV infected
people• To provide risk assessment for people who
are potentially at risk of contracting HIV infection
Whom to counsel?
• Self motivated counseling seekers• Persons seeking HIV tests• HIV positive persons• High Risk Behavior Groups• Family Members• Employers• Health professionals• People unaware of risks
Characteristics of a Counselor
• Committed• Open minded• Non judgmental• Sense of responsibility• Patient listener• Tolerant• Attentive• Informed• Positive body language
Skills Required in Counseling
• Excellent communication skills• Ability to judge state of mind of a person• Quick empathetic response• Focused• Reflection of feeling• Questioning• Paraphrasing
Skills Required in Counseling
• Respectful• Structuring and prioritization• Help to formulate strategies • Help develop coping mechanisms
Stages of Counseling
1. Risk assessment counseling2. Pre test counseling3. Post test counseling4. Follow up counseling
1. Risk assessment
INTERNATIONAL LAW:Consent to HIV testing and confidentiality of HIV status
are key components of the right to privacy (UniversalDeclaration of Human Rights, Article 12, InternationalCovenant of Civil and Political Rights, Article 17(1)).
As the International Guidelines on HIV/AIDS andHuman Rights clarify, “The right to privacy encompasses
obligations to respect physical privacy, including theobligation to seek informed consent to HIV testing andprivacy of information, including the need to respect
confidentiality of all information relating to a person’sHIV status” (para. 119). Thus, under Guideline 3, “HIVtesting of individuals should only be performed with the
specific informed consent of that individual” (para. 20(b)).
2. Pre test counseling Counselling before the test should provide the individuals being tested with information on:
• Technical aspects of screening & possible personal, •Medical, • Social, •Psychological, &• Least implications of being tested positive or negative.
The information should be simple & up to date.Testing should be organized in a way that minimizes the possibility of disclosure.
Issues in pre Test counseling
A. Personal history & assessment of riskB. Assessment of factors & Knowledge
• Sexual Behaviour• Drug users
•Blood Transfusion•Organ Transplant
i. Why the test is being requested?
ii. What behavior? Symptoms are of concern to the client?
iii. What the client knows about the test & its uses?
iv. What will the client do if test is positive or negative?
v. Beliefs regarding HIV transmission
vi. What roles will family play?
3. Post test counselling A. WHAT YOUR TEST RESULTS
MEAN - NEGATIVE TEST RESULTB. WHAT YOUR TEST RESULTS
MEAN - POSITIVE TEST RESULT
Negative result• a negative result may not always be
accurate. It depends on when client might have been exposed to HIV and when they took the test.
• It takes time for seroconversion to occur. This is when body begins to produce the antibodies an HIV test is looking for—anywhere from 2 weeks to 6 months after infection. So if client had an HIV test with a negative result within 3 months of thier last possible exposure to HIV, the CDC recommends that you be retested 3 months after that first screening test.
• A negative result is only accurate if they have had any risks for HIV infection in the last 6 months—and a negative result is only good for past exposure. If they get a negative test result, but continue to engage in high-risk behaviors, they are still at risk for HIV infection.
Positive Result• If the initial HIV test comes back
positive, they will automatically be offered a confirmatory test. If the confirmatory test is also positive, the client will be diagnosed as “HIV-positive.”
• At this point, Discuss• what having HIV means for patient and
their health. • informed about how the virus can
affect .• how to protect others from becoming
infected. • informed about resources and
treatments available • Finally referred to a medical
professional for follow-up treatment.
Principles of Counseling
• Unconditional positive regard for the client• Trust and confidentiality• Empathy• Time
Steps in Counseling
• Rapport building• Gaining trust• Explaining limits• Problem identification• Discuss options• Take action• Follow up
Role of Counselor
Advocacy roleHealth educationReferralClinical and therapeutic role
Contents of Counseling
Contents of counseling will depend on the ability of the client to grasp. It’s a dynamic process. The counselor must be able to assess the clients need and state of mind quickly.
However, following components should be incorporated in all counseling scenarios:
Contents of Counseling
• The need to prevent infection and re infection
• Basic information about HIV infection and associated diseases
• Review of possible sources of client’s infection
• Methods of safe sex including condom use• Exploration of obstacles to change of
behavior
Contents of Counseling
• Information about what HIV testing can and cannot do.
• Coping with HIV test results.• Need to tell the HIV status of the client to
the key persons in his/her life.• Handling hostility, fear, violence,
depression, suicidal tendencies etc.
Working Goals of HIV Counseling
Forming a helping relationshipClarifying and addressing problemsEstablishing personal goalsProviding information on alternative resourcesSelection of realistic alternativesStimulation of motivation and decision makingHelping client to develop competenceRecognizing and diagnosing signs of psychological distress and providing support
Possible Reactions to a Positive Test Result
• Fear• Sense of loss• Grief• Guilt• Denial• Depression
• Anger• Anxiety• Stress• Shock• Loss of self esteem• Suicide
Special Situations in HIV Counseling
A. Pregnant womenB. Childless couplesC. Breast feeding positive mothersD. Spouse and family members of HIV infected
persons
Some Common Counseling Errors
a. Directing and leadingb. Being judgmental and evaluatingc. Moralizing, preaching and patronizingd. Unwarranted reassurancee. Not accepting the client’s feelingf. Interrogatingg. Encouraging dependencies
Aids awareness
These are just some of the days that promote HIV/AIDS awarenessNational Black HIV/AIDS awareness day every February 7th.· National Women’s and Girls HIV/AIDS awareness day every March 10th.· National Native American HIV/AIDS awareness day every May 20th.· HIV vaccine awareness day every May 18th.· National Asian and Pacific Islanders HIV/AIDS awareness day every May 19th.· National Caribbean HIV/AIDS awareness day every June 8th.· National HIV testing day every June 27th.· National Latino HIV/AIDS awareness day every October 15th.· World AIDS day every December 1st.· December is AIDS awareness month.