Counselling Principles

HIV counselling  for adults:

A good counsellor gives viable options to enable counselee make informed choices. A Counsellor does not give ADVICE.

Why Counselling?

India is sitting on a HIV/AIDS time bomb and there is a real need to approach this threat from all angles. The only tools in our hands are Prevention and Interventions like Counselling, Care and Support in the form of Medical and Home Care facilities and these, despite the efforts made by NGOs and some Government agencies are far from adequate.

The best tools for prevention are AWARENESS and PROPHYLACTIC measures like inoculation. Since to date, no inoculation against HIV is available we must depend on creating AWARENESS about this dangerous infection which often proves to be fatal.

It is very tragic to hear  people who are already  suffering from this infection say that they had never heard of it. “If only I had known about it, I would have been careful.” This refrain is heard over and over again.

People suffering from an HIV infection are in urgent need of counselling. Once infected, the clients feel their life has come to an end. They feel suicidal.  They need someone they can trust and speak to freely, they need emotional support. And this is where a good, well trained and experienced counsellor comes in. Counsellors like lawyers and doctors are bound by a very strict code of   confidentiality.

Stages of counselling:

Pre Test, Post Test, On going.

Pre Test Counselling

Key issues/ elements in pre-test counseling:

• Ask client the reason he/she came for testing. 
• Assess the client’s knowledge of HIV /AIDS and related conditions and provide accurate information.

• Provide information about testing procedure and provision of results.

• Explain the HIV test and clarify its meaning; explain the limitations of test results, i.e. window period.

• Check to see if client has questions/issues for discussion.
• Help client understand the benefits of HIV testing and to make a decision about testing.
• Access Coping style
• Positive Living message
• Discuss Follow up arrangements

Post Test Counseling:

HIV negative (HIV-) test result:

How to interpret this result: There are no HIV antibodies present in the blood on the day of the test.

True negative

The client is not infected (true negative).

False negative

The client may be infected but is in the window period (false negative). 

With Positive Result: Empathy is the key element

Sharing of results should be immediate; the counselor should not delay the result as the client is already in a lot of tension, the counselor should explore family support, how to convince for sharing results with the spouse etc to share with other doctor when ever going for treatment, reference of hospital or networking with NGO (s).

HIV Positive (HIV+) test result:

• HIV antibodies were detected in the person’s blood sample.
• The person can pass the virus to another person.

• The client is infected with HIV but may not have AIDS.
• The client can still lead a healthy and productive life.
• The client needs to adopt safer sex practices.
• The client remains infectious for life.
• The client’s partner may be negative but needs to be tested.
• The client should be referred for clinical care.
• The client may need support to plan for disclosure of HIV status.

On Going Counselling:

As the name implies counseling is ongoing. The patient seeks counseling whenever he/she feels the need for it, that is, to clarify doubts, learn more about the infection, medication, seek access to opportunities and facilities in place for People Living with HIV and AIDS..

Types of counselling for HIV:

One to one

One to group

Mass

Family

Community

Code of Confidentiality:

Can discuss HIV+ve status with family/ friends /Community ONLY with permission of the patient.