Counselling HIV/ AIDS patient
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Counselling HIV/ AIDS patient

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COUNSELLING IN HIV/AIDS ...

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 persons

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  • Am Dolly smith i will like to share my testimony to you all.i just got married to my husband about a year ago we start having problems at home like we stop sleeping on the same bed,fighting about little things he always comes home late at night,drinking too much and sleeping with other women out side.i have never love any man in my life except him.he is the father of my children and i don't want to loose him because we have worked so hard together to become what we are and have today.few month ago he now decided to live me and the kid,being a single mother can be hard sometimes and so i have nobody to turn to and i was heart broken.i called my mom and explain every thing to her,my mother told me about Dr Ofua how he helped her solve the problem between her and my dad i was surprise about it because they have been without each other for three and a half years and it was like a miracle how they came back to each other.i was directed to Dr Ofua and explain everything to him,so he promise me not to worry that he will cast a spell and make things come back to how we where so much in love again and that it was another female spirit that was controlling my husband.he told me that my problem will be solved within two days if i believe i said OK.So he cast a spell for me and after two days my love came back asking me to forgive him.i Am so happy now. so that why i decided to share my experience with every body that have such problem. Contact Dr Ofua because I can swear with my life that he is a man to trust.his EMAIL is thegreatherbalhealinghome@gmail.com
    visit the link to know more about him :http://thegreatherbalhealinghome.blogspot.com you can also reach him on this number +238135200383
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  • MY HIV HEALING TESTIMONY

    My mouth is short of words, i am so so happy because Dr Ekpiku has healed me from HIV ailment which i have been suffering from the past 5 years now, i have spend alot when getting drugs from the hospital to keep me healthy, i have tried all means in life to always i can become Hiv negative one day, but there was no answer until i found Dr Ekpiku the paris of african who provide me some healing spell that he uses to help me, now i am glad telling everyone that i am now HIV Negative, i am very very happy, thank you Dr Ekpiku for helping my life comes back newly without any form of crisis, may the good lord that i serve blessed you Dr Ekpiku and equip you to the higher grade for healing my life. i am so amazed. so i will announced to everyone in this whole world that is HIV positive to please follow my advice and get healed on time, because we all knows that HIV disease is a deadly type,contact Dr Ekpiku for your Hiv healing spell today at: Ekpikuspelltemple@live.com.... He will be always happy to assist you online and ensure you get healed on time, contact Dr Ekpiku today for your healing spell immediately, thank you sir : Ekpikuspelltemple@live.com
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  • The medication involves commitment – the individual will have to take these drugs every day for the rest of their life, as well as making sure they stay healthy, eat well, exercise regularly and try and avoid being exposed to illnesses where possible <br />
  • Alternative definitions are: <br /> It is a special form of interpersonal communication in which feelings, thoughts and attitudes are expressed, explored and clarified. <br /> In relation to HIV/AIDS prevention, counseling is the only practical means for promoting changes and adoption of long term low risk behaviors. <br />
  • Counseling becomes necessary because people are at a loss and unable to decide what to do with their lives, once they are found to be HIV positive. Those who have practiced high risk behavior are unable to take a decision whether to go for HIV test or not. Another important issue is breaking the news to the family members and sex partners. In such circumstances, counseling helps a person to come to term with the realities of HIV/AIDS and act in a balanced way. <br />
  • It is important to counsel persons seeking HIV test because usually they are not aware of the fact that there is no cure for the disease and once positive life will be different. Counseling helps them to face the results in a pragmatic manner. <br /> Family members and employers usually take a harsh view of HIV positive status of a person. He is usually thrown out of the job and rejected by family members. They need to be counseled to accept the person in a empathetic manner. <br /> I have seen medical students, doctors and nursing staff becoming paranoid about having spilled blood of a person (whose HIV status is not known) on their body, and then assuming that they have become positive themselves. Such fears turn into serious psychological problems. Such health professionals need skilful counseling. Counseling also helps them to practice universal precautions. <br />
  • Counseling at times is a very demanding job. One has to work with stressed people. Burn out phenomenon is quite commonly seen in counselors. Hence a high level of commitment is required. <br /> The counselor has to remember that his/her value system should not be imposed on the client. The client’s point of view has to be appreciated. This requires open mindedness and non judgmental attitude of the counselor. <br />
  • Counseling is a dynamic process. The counselor has to quickly understand the clients state of mind, his/her concerns, worries, level of confidence and ability to cope with crisis. And the counselor has to proceed accordingly. The counselor may have to change his/her approach as per the client’s response. The counselor should appear to be actively participating in understanding the client’s dilemma by reflection of feeling, questioning and paraphrasing. <br />
  • Pre test counseling helps a person to understand the possible results of an HIV test. It may be positive, negative or equivocal. The counselor must explain the meaning of each such test result. This should be utilized as an opportunity to assess the likely reaction of the client to a positive or negative test result. <br /> An essential element of post test counseling is breaking the news. It requires special skills and right judgment about the client’s state of mind. <br />
  • The more a counselor gives his/her time to the client, the better the results. In some situations, the counseling sessions cannot be bound by time. <br />
  • For example, when talking to a college student, the counselor should be free and make the student feel free and comfortable. It should not be a class room like scenario. <br /> In case of uneducated persons and people with low level of confidence, the counselor may have to take the upper hand and provide advice and guidance as well. <br /> Some times, the counselor has to behave more like a friend and treat the client at par with him to gain his confidence. <br />
  • Pregnant women face the dilemma: whether to continue the pregnancy or not? In such conditions, duration of gestation becomes a key issue. Late in pregnancy abortions are not advisable. Similarly mental state of the pregnant women should be understood by the counselor. To abort or to give birth to the child, the decision will depend on woman’s mental state, financial support and ability to understand the implications of having a child. <br /> Childless couples may be desperately needing a child. In such conditions, adoption as an option should be discussed. <br /> It becomes difficult to handle family members of positive persons. <br />
  • Putting thoughts in the client’s mind by speaking out options instead of letting the client decide for himself/herself <br /> Thinking or opining that some one is a CSW. Assuming that the person is of ill habits <br /> Asking the client not to have sex with many partners because it is ‘bad’ <br /> Telling some one not to worry. Even if he/she is positive, will live a normal life. That HIV can do no harm to him. <br /> Assuming that the client is pretending to be affectd by the news <br /> Asking too many questions about one’s personal life <br /> Telling him that you as a counselor will take care of all his problems. <br />

Counselling HIV/ AIDS patient Counselling HIV/ AIDS patient Presentation Transcript

  • 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 • 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.
  • PMtct • 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.
  • DeFInItIOn cOUnSelIng SkIllS PrOPerly USeD Are tOOlS tO HelP InDIVIDUAlS Seek AnD FInD tHeIr Own SOlUtIOnS tO tHe DIleMMAS tHey FAce.
  • TYPES OF HIV TESTS Antibody 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 23 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 HIVpositive 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. 2. 3. 4. Risk assessment counseling Pre test counseling Post test counseling Follow up counseling
  • INTERNATIONAL LAW: Consent to HIV testing and confidentiality of HIV status are key components of the right to privacy (Universal Declaration of Human Rights, Article 12, International Covenant of Civil and Political Rights, Article 17(1)). As the International Guidelines on HIV/AIDS and Human Rights clarify, “The right to privacy encompasses obligations to respect physical privacy, including the obligation to seek informed consent to HIV testing and privacy of information, including the need to respect confidentiality of all information relating to a person’s HIV status” (para. 119). Thus, under Guideline 3, “HIV testing of individuals should only be performed with the specific informed1. rISk of that individual” (para. 20(b)). consent aSSESSmEnT
  • 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 risk B. Assessment of factors & Knowledge i. ii. • Sexual Behaviour • Drug users •Blood Transfusion •Organ Transplant iii. iv. v. vi. Why the test is being requested? What behavior? Symptoms are of concern to the client? What the client knows about the test & its uses? What will the client do if test is positive or negative? Beliefs regarding HIV transmission What roles will family play?
  • 3. Post test counselling A. B. WHAT YOUR TEST RESULTS MEAN - NEGATIVE TEST RESULT 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 “HIVpositive.” 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 role Health education Referral Clinical 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 relationship Clarifying and addressing problems Establishing personal goals Providing information on alternative resources Selection of realistic alternatives Stimulation of motivation and decision making Helping client to develop competence Recognizing 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. B. C. D. Pregnant women Childless couples Breast feeding positive mothers Spouse and family members of HIV infected persons
  • some Common Counseling errors a. b. c. d. e. f. g. Directing and leading Being judgmental and evaluating Moralizing, preaching and patronizing Unwarranted reassurance Not accepting the client’s feeling Interrogating Encouraging dependencies
  • aids aWareness These are just some of the days that promote HIV/AIDS awareness National 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.