LECTURE NOTES ON HIV AND AIDS COUNSELLING

BY MR. MUSONDA

CONTACT: 0977336942

INTRODUCTION

This topic covers myths and facts about HIV and AIDS, pre-test counselling, testing, post-test
counselling and care for people infected with HIV and those affected with AIDS. The topic is
intended to impart skill and knowledge in counselling, testing and caring for people infected and
those affected with AIDS.

MYTHS ABOUT HIV INFECTIONS

A myth is unreliable source of information that can be passed around mostly by the words of
mouth (MOH, 2001). Myths become widely known and are believed to be true when in actual
fact there are not. The original source of a myth is usually forgotten or revered sacred.

The most common myths about HIV infections include:

 HIV is a punishment from God

 AIDS can be cured when an infected person engages in sexual intercourse with a child
(usually a close relation).
 HIV can be spread through mosquito bites
 HIV is caused by evil spirits
 People who are circumcised are immune to HIV.

FACTS ABOUT HIV INFECTIONS

 HIV stands for human immunodeficiency virus. Therefore, the virus can only be
transmitted only between humans.
 HIV affects human beings only
 The virus attacks the immune system and creates deficiency in its capacity to fight
diseases
 HIV is a virus that causes
  AIDS
 AIDS stand for acquired immune deficiency syndrome.
 AIDS is a disease caused by HIV
 AIDS is characterized by signs and symptoms of different diseases
 You CAN’T GET HIV from…
I. Kissing
II. Hugging
III. Sharing food
IV. Insect/animal bites
V. Toilet seats
VI. Bathing
VII. Sneezes and coughs
VIII. sweat

TRANSMISSION OF HIV

Adults Children
 Sexual intercourse with  Infected mother to her unborn baby
someone infected with HIV  Contact with HIV infected blood at
 Blood transfusion through contact birth
With HIV infected blood  Sexual abuse or rape by HIV
 Through HIV contaminated needles, infected person
syringes and blades  Breast feeding from HIV infected
mother

NB: Body fluids such as saliva, tears, urine and sweat do not transmit HIV. Therefore, it is
relatively safe to come in contact with these fluids even if a person is HIV positive.

PREVENTION OF HIV

HIV can easily be prevented if someone knows its transmission. The table below shows some of
the ways of preventing HIV transmission.
Adults Children
 Have one uninfected sexual  Practice PMTCT now EMTCT
partner.  Abstain from sex before marriage
 Avoid using sharp HIV  Learn about HIV and AIDS
contaminated  Avoid indulging in risky enticing behaviors
instruments. such as drug and alcohol abuse
 Avoid HIV contaminated  Avoid contaminated unscreened blood
unscreened blood  Report child sex abusers or rapist to parent or
 Learn facts about HIV and AIDS to the nearest police station
and act upon
them.
 Know about your HIV status and
notify your partner
 Care for yourself and spouse
 Practice safe sex when in doubt
 Practice health traditional
practices in ritual
Cleansing rites

STAGES OF HIV INFECTION

HIV infected persons go through a lot of stages that include:

1. INFECTION STAGE: A person exposed to HIV for the first time, may not know that
s/he is infected because there are no immediate signs or symptoms to indicate that s/he is
infected. Some people may experience slight flu-like symptoms after exposure.
2. WINDOW PERIOD: This is the time between first exposure and the production of
detectable antibodies. The period takes between 4-12 week, but could go up to 2 years or
longer (ZCC, 2003). An HIV test taken during this period may be negative if there is no
enough antibodies in circulation.
3. AIDS-related disease: During this stage a person is said to have a period of illness with
combination of the following diseases fevers, skin rashes, chest infections, ulcers, loss of
weight, TB, cancers
4. AIDS disease: a person is said to have AIDS if his or her immune system so weak that it
cannot fight off diseases. The stage lasts between 1-3 years in adults and 0-12 months in
children.

PRE-TEST HIV COUNSELLING

This is aimed at imparting skills and knowledge about pre-test HIV counselling. Before the
test is done the following should be done by the counsellor:

i. Creating a rapport with the client- warmly welcome the client.

ii. Obtain the client’s particulars which should include:
 Name
 Age
 Gender
 Residential address/phone number
 Occupation
 Educational level
 Tribe/ religion
 Marital status
 Economic status
iii. Discuss the client’s medical history including
 Any serious illness in the past, blood transfusion, chronic cough, diarrhea and
any related sexual transmitted illnesses.
 If female, how many pregnancies or miscarriages
 iv. Discuss personal habits- such as smoking, beer drinking or drug intake
v. Discuss sexual history
vi. Discuss client’s knowledge about HIV and AIDS
vii. Explore potential risky behavior of the client such as multiple sexual partners.
viii. Self-disclosure- find out who the client will tell in case found negative.
ix. Explain what positive, negative or invalid results mean
x. Explain how the test is done
xi. Explain the different HIV results

HIV TESTING

HIV testing is the process of finding out whether the client is positive or negative.

TYPES OF HIV TESTS

There are several tests that are used to determine a person’s HIV status. The first line test is the
Abbort test, the second line or confirmatory tests include Gene II, Uni-Gold, Capillus, HIV spot
and Hema-strip.

POST-TEST HIV COUNSELLING

For the counsellor to conduct effective post test counselling he or she must start with creating
rapport with the client, then proceed to review what was covered in the pre-test counselling. Note
that most HIV clients experience shock and distress some may even cry. This is a natural
response. If this happens the counsellor must give them time to cry. One of the aims of post-test
counselling is to help a client pass through all these stages of shock and distress and come to
accept his or her condition (results).

CARE FOR PEOPLE AFFECTED AND THOSE INFFECTED WITH HIV AND AIDS

Care for people affected and those infected with HIV and AIDS focuses on three things namely
psychological, physical and spiritual care.

PSYCHOLOGICAL CARE

This focuses on a client’s volatile frame of mind. This problem is compounded when a client has
not been taught about positive living. Too much dos and don’ts is discouraged as it will make the
client to feel oppressed. In addition, too much care may confirm the client’s fear of been
incapacited. The counsellor needs to help the client accept the situation and think positively of
themselves. If the client becomes annoyed, the counsellor needs to withdraw and allow the client
to calm him/herself down. This is because it will be more harmful for a counsellor to argue with
the client.

PHYSICAL CARE FOR PEOPLE WITH HIV AND AIDS

Physical care involves putting into consideration the following:

 Covering cuts or sores with waterproof dressings

 Using bleach, for instance, dettol, to disinfect spilled blood, stool, urine, vomit and then
wipe up with paper and dispose off down the toilet or latrine. If the client is too ill that he
or she cannot care for him/herself.
 Wear surgical gloves or plastic bags on your hands when handling HIV infected body
fluids, wash hand immediately if there is accidental contact with HIV infected body
fluids
 Encourage clients not to share toothbrushes or razors
 Protect the person from infectious diseases by giving him/her fresh foods, boiled drinking
water or treated water
 Keep the room where the patient stays clean

SPIRITUAL CARE

Every human being is a creation of God almighty and has a spirit. In times if sickness it is
important to feed the spirit with spiritual food. Love and hope can revive the soul of a sick
person in a great way. The Bible in proverbs 18 vs 14 says, ‘the spirit of a man will sustain him
or herself in the time of infirmity but a wounded spirit who can bear?’ the clergy or people who
have faith in the Bible must therefore be called upon to provide such care. Where it is the clergy
who needs spiritual counselling the counsellor should encourage him or herself like David did in
the Bible.