Fauzia Saeed
By Fauzia Saeed, Psychologist VCCTC, PRCS Punjab Lahore
HIV/AIDS counseling is a form of confidential dialogue between a client and counselor.
Counselling is a private conversation with a specially trained person aimed at helping you to help yourself. Counselling encourages you to explore possible solutions to your problems, and to consider the impact that certain decision may have on your life. HIV/AIDS counselling provided at VCCT sites is free and confidential. This means that the Counsellor cannot tell anyone about your result without your permission. You must receive face-to-face counselling before you have the test. This is known as pre-test counseling, and is aimed at ensuring that you make a well-informed decision about whether to have the HIV test or not, and encourages you to explore the possible impact that having the test may have on your life.
Types of Counseling
- Clinical Based Counseling
- Crisis Based Counseling
- Community Based Counseling
- Problem solving Counseling
- Decision making Counseling
- Peer Counseling
Ongoing HIV/AIDS Counseling
Ongoing counselling is the king of counselling that happens after you have received your test result. The aims of ongoing counselling are to:
- Help you to manage the impact that HIV has on your own life, and the lives of the people around you.
- Encourage you to take control of your health and take charge of your life.
- Help you to accept your result and live positively with HIV/AIDS
- Explore the advantages and disadvantages of telling other people about your status.
- Assist you in tackling your problems
- Provide emotional and psychological support
- Help you to strengthen your support system
- Help you to plan for the future
- Explore issues around death and dying
- Refer you to community resources
What’s new?
Voluntary and Diagnostic HIV Testing and Counselling in Infants and Children
In June 2006, a number of documents relating to the policy and provision of HIV testing and counselling to infants and children were added to the toolkit. They include a selection of documents covering policies, child’s rights and strategic frameworks, child-focused counselling, consent, confidentiality and disclosure, clinical diagnosis and laboratory issues, monitoring and evaluation and case studies.
Who is it for?
The toolkit is a resource for people involved in setting up or scaling up HIV testing and counselling services. It has a target audience of programme managers and implementers and their partners in the public and private sectors, including nongovernmental organizations (NGOs), community-based organizations (CBOs) and faith-based organizations (FBOs).
Structure
The toolkit is organized in the following sections:
Guiding principles
Components of HIV counseling and testing services:
- Policy, advocacy and stakeholder mobilization
- Community mobilization
- Supply and management of commodities
- Service delivery
- Capacity-building and training
- Management and coordination
- Determining costs and financing
- Additional resources for HIV counseling and testing Good practice in HIV counseling and testing services: case studies
Good practice in HIV counseling and testing services: case studies
Style
The text of the toolkit highlights and discusses key issues. References are included wherever relevant, providing practical direction on how to address the highlighted issues. The references cover:
- information – reports, articles, etc.;
- tools – practical know-how, action-oriented guidance, skill-building;
- examples – documentation of experience (good practice, lessons learnt, what has not worked, new and emerging experience, case studies, etc.);
- web sites – useful web sites containing related resources;
- Miscellaneous resources – academic and other resources for additional information.
In order to learn from and contribute to rapidly evolving experience, the toolkit is structured as a ‘living document’. Its content will be regularly updated with the latest experience and developments in good practice and lessons learnt. WHO will manage the updating process? The online version of the toolkit has a user feedback facility, allowing regular monitoring of its use. Feedback will be used to make improvements to the toolkit and ensure that it continues to respond to emerging and changing needs.
Pre-Test Counselling: (25-30 min)
This is the kind of counselling you get before you decide whether you want to have the HIV antibody test. Some of the issues the counsellor will discuss with you are:
- Why you decided to come for counselling
- What counselling is, and the role of the counsellor
- What your personal history is
- Whether you have any health problems
- What your risk of being HIV infected is
What you know about HIV/AIDS
Post Test Counselling
This is the kind of counselling you get after you have had the test. During this session the cousellor will:
Give you your test result.
Let you express your feeling about being HIV antibody positive, negative or indeterminate. Help you to revisit the issues you raised during the pre test counselling session, including any plans you many have made.
Discuss any immediate problems and help you to decide on a plan of action
Answer any questions you may have and provide you with useful information
Discuss positive living
Give you positive information on what resources there are in your community to help you.
Commonly asked Questions about HIV/AIDS Counseling and Testing
Here are some answers you may have about HIV-antibody counseling and testing.
1. “Why get tested?”
If you know you are infected, you can take steps to protect your health and the health of others. There are clear benefits to early treatment, even though there is no cure for HIV infection. Medical options, including medications and other approaches, can help slow the infection and delay or prevent life-threatening conditions.
2. “I think I recently placed myself at risk of infection with HIV. Should I get counseled and tested right away?”
Yes. If you get infected with HIV, tests may not detect it until a few weeks after infection. The test detects HIV antibodies in your blood. If you are infected, your body takes time to make enough antibodies for the test to measure. It can take as little as 2 weeks. But it might take several months. Nearly all infected people develop antibodies within 3 months of infection. For some persons it may take up to 6 months. If you think you placed yourself at risk for HIV infection, you should get counseling, and, until you know you are not infected, you should protect others as if you were infected.
3. “Does it take long to get an appointment to be counseled and tested?”
It depends on where you live. Some counseling and testing facilities can schedule appointments very quickly. Others may take a few weeks. Call your local health department to find out.
4. “How much does HIV counseling and testing cost?”
Most publicly funded sites are free or require only a minimum fee. If you go to your doctor for counseling and testing, the cost can vary. In some areas, it can be more than $200. You can ask the cost beforehand.
5. “When I had blood tests done for my physical, marriage license, or insurance, was I tested for HIV antibodies? Do hospitals routinely test for HIV infection?”
You should not assume that your blood was tested for HIV antibodies. If you are concerned, ask your health care provider what tests will be done whenever you have blood taken. If you are still concerned, ask specifically if your blood was or will be tested for HIV antibodies.
6. “If I’m pregnant or thinking about having a baby, should I be counseled and tested?”
If you or your sex or drug partner has engaged in behaviors that can transmit HIV, you should get counseling and testing. If you test positive you should be aware that without treatment there is a one-in-four chance that you will pass the virus to your unborn baby. Medical treatment can reduce this to about 1 chance in 12. If you are already pregnant, you should tell your health care provider that you tested positive. This will help your provider care for you and your baby during and after the pregnancy.
7. “What if my insurance company wants me to take a test?”
An insurance company may require that you be tested for HIV infection if you apply for a health or life policy. You have the right not to take the test. You must choose whether to take the test or find an insurer who will not ask you to do so. If the test is required, either to determine if you will be covered or to set the rates, you may wish to be tested anonymously or confidentially first.
8. “Will my insurer find out if I test positive?”
Your insurer will know you took the test if you pay for the test through insurance. Insurers can find out your test result only if you release it. On some insurance forms, your signature authorizes release of medical records. If you are concerned, do not sign medical release forms unless you know their purpose. You may also choose to be counseled and tested at a facility separate from your health care provider. These facilities include publicly-funded testing sites, sexually transmitted disease clinics, and family planning clinics. Call your health department of the CDC National AIDS Hotline (1-800-342-AIDS) to find out the nearest facility that offers confidential counseling and testing.
9. “Even though I tested negative, why do I have symptoms?”
See a doctor about your symptoms. They are most likely caused by something other than HIV infection. Early symptoms of HIV infection can be the same as those of many other diseases that occur in people who are not infected with HIV. If you test negative and still think you might be infected, consider retesting. If you test negative again, and you have not engaged in behavior that can transmit HIV in the past 6 months, you are probably not infected with HIV.
“My partner tested negative. That means I’m not infected, right?”
Your partner’s test does not always tell your status. The only way to know whether you are infected is to have your own test.
“Can I continue to work if I have HIV infection?”
Yes, you can continue working if you have HIV infection. HIV cannot be spread by contact that does not involve blood, semen, or vaginal secretions. Many years after infection, some people still have no symptoms and continue to work productively. In the later stages of HIV infection, illness may cause you to be too sick to work. It depends on your health and your job duties.
“How can I find a doctor who will treat me?”
Call your local medical society. They should be able to refer you to a doctor who will help you. For additional help, you can contact a local AIDS organization. The people there may be able to help you find a doctor who is experienced with HIV and AIDS-related issues.