What is HIV and what is AIDS ????
HIV is a virus that makes an
individual susceptible to AIDS
Being HIV positive does not
necessarily mean having AIDS,
but it increases the vulnerability
AIDS is a syndrome i.e a
group of symptoms that
collectively indicate or
characterize a disease
The start of AIDS
• The history of AIDS is a short one. As recently
as the 1970s, no one was aware of this deadly
Since then the global AIDS epidemic has
become one of the greatest threats to human
health and development.
At the same time, much has been learnt about
the science of AIDS, as well as how to prevent
and treat the disease.
The global picture
• Statistics for the end of 2009 indicate that
around 33.3 million people are living with HIV,
the virus that causes AIDS.
• Each year around 2.6 million more people
become infected with HIV and 1.8 million die of
The global picture
• Although HIV and AIDS are found in all parts
of the world, some areas are more afflicted
than others. The worst affected region is
sub-Saharan Africa, where in a few countries
more than one in five adults is infected with
HIV. The epidemic is spreading most rapidly
in Eastern Europe and Central Asia, where
the number of people living with HIV
increased by 54.2% between 2001 and 2009.
HIV is transmitted…
• through blood and other bodily
fluids such as semen and
This exchange of fluids can
occur through sexual
intercourse , drug injection ,
breastfeeding or during
pregnancy with an infected
Reducing HIV Risk in Female
There is no single, universal model for
providing prevention activities to FSWs.
The content of the intervention package
itself, and the strategies to deliver that
package, have to be adapted to different
The Intervention Package
• Information and Behavioral change
• Condoms use
• Sexual health services
Information and behavior
• Basic knowledge of HIV transmission and the
protective role of condoms
Behavior change messages should therefore focus on:
Alternative safe sex practices
Use of condoms
Symptoms of STIs
Clarification of misunderstandings about unsafe
traditional practices or beliefs
• The male condom is currently the only
effective, widely available HIV/STI prevention
Access to condoms is therefore essential to
effective preventive behavior among FSWs.
Sex workers with many clients per day may
complain of vaginal irritation and pain when
Water-based lubricants not only prevent these
problems, but also decrease condom breakage.
Sexual health services
It is clear that STIs facilitate HIV transmission,
prompt STI treatment has become a key
strategy for HIV prevention. High STI infection rates
have been reported in FSWs and their clients.
Good quality STI care not only results in immediate
health benefits, but also has the potential to slow
down the HIV epidemic.
Three components, one
Combining the three key elements—
information, behavior change/use of
condoms and sexual health services—
in one package will result in a better,
more effective HIV prevention
To be practiced
• Goals: what do you want to get out of the negotiation?
• Alternatives: if you don't reach agreement with the other
person, what alternatives do you have? How much does it
matter if you do not reach agreement? And what alternatives
might the other person have?
Relationships: what is the history of the relationship? Could
or should this history impact the negotiation? Will there be any
hidden issues that may influence the negotiation? How will you
Expected outcomes: what outcome is expected from this
The consequences: what are the consequences for you of
winning or losing this negotiation?
Power: who has what power in the relationship? Who controls
resources? Who stands to lose the most if agreement isn't
Possible solutions: based on all of the considerations, what
possible compromises might there be?
VCCT as part of HIV/AIDS prevention
and care strategy
• HIV voluntary confidential counseling and
testing (VCCT) has become an integral part of
HIV prevention and care programs.
• VCCT services have evolved to reflect the
changing needs of communities and the
changing capabilities in care and treatment and
support for people with HIV infection.
VCCT is much more than drawing and testing
blood to determine whether one is infected with
HIV. It is a vital point of entry to other HIV/AIDS
services, including counseling for prevention of
HIV, clinical management of HIV related
illnesses, TB control, psychosocial support and
the prevention of mother to child transmission
• HIV counseling requires some of the basic
counseling skills needed for other types of
counseling, but the nature of HIV and AIDS
makes this counseling unique.
• HIV/AIDS related counseling includes
prevention counseling and counseling for
coping, care, and support.
• Why HIV testing needs counseling?
• What is HIV Voluntary Counseling and
• What are the purposes of VCT services?
• Why is VCCT important?
Why HIV testing needs counseling?
• HIV infection can lead to serious illnesses and can
cause fear – clients need to prepare themselves.
Learning about an HIV positive result can be
potentially harmful – clients need to be informed about
implications and potential
The decision to take the test must be voluntarily
– informed consent must be established.
Learning about the positive result can be difficult –
clients need support and information.
A person with HIV/AIDS requires
medical as well as psychosocial
What is HIV Counseling and Testing?
• Confidential dialogue between a
client and a counselor aimed at
enabling the client to cope with
stress and make personal decisions
related to HIV/AIDS.
Voluntary Confidential Counseling and
• - A combination of two activities –
counseling and testing, into a service
that amplifies the benefits of both
How is HIV Counseling Different from
• HIV counseling requires explicit
discussion of sexual practices.
HIV counseling requires explicit
discussion of sickness, death, and dying.
HIV counseling requires that the counselor
considers the reactions and needs of
partners and other family members as well
as those of the client.
Counselors are likely to work with clients
who hold opinions and values very
different from their own and will be
challenged to become aware of their own
biases and stereotypes that could
interfere with effective counseling.
Why is VCCT important?
• A large number of those infected
with HIV do not know that they are
Knowing one’s status allows people
to change their behaviors – to
protect and take care of
themselves, their partner, and
Knowledge of one’s status helps her to
plan and make important life decisions.
• VCCT provides an opportunity for
prevention counseling and referral to
care and support services.
Components of VCCT
•Determining client’s knowledge
•Giving accurate information
•Conduct personalized risk assessment
•Developing a personalized risk reduction
•Demonstrating appropriate condom use
•Explaining the test and obtaining informed
•Discussing implications of HIV results
•Assessing coping ability
•Providing psychological and emotional support and
referral as appropriate