HIV COUNSELLING

HIV counselling seeks to reduce HIV acquisition and transmission through:

– Information. Clients should receive information regarding HIV transmission and prevention and the meaning of HIV test results.

– HIV prevention counselling. Clients should receive help to identify the specific behaviors putting them at risk of acquiring or transmitting HIV and commit to steps to reduce this risk.

Information

All clients who are recommended or who request HIV testing should receive the following information, even if the test is declined:

. Information regarding the HIV test and its benefits and consequences.

. Risks for transmission and how HIV can be prevented.

. The importance of obtaining test results and explicit procedures for doing so

. The meaning of the test results in explicit, understandable language

. Where to obtain further information or if applicable, HIV prevention counselling

For efficiency, information can be provided in a pamphlet, brochure, or video rather than a face-to-face encounter with a counsellor. Information should be provided in a manner appropriate to the client’s culture, language, sex, sexual orientation, age, and developmental level.

HIV Prevention Counselling

HIV prevention counselling should focus on the client’s own unique circumstances and risk and should help the client set and reach an explicit behavior-change goal to reduce the chance of acquiring or transmitting HIV. HIV prevention counseling is usually, but not always, conducted in the context of HIV testing.

Additional Counselling Considerations for Special Situations

Persons with newly identified HIV infection. Clients with newly identified HIV infection have immediate and long-term needs. Some clients might be better prepared to receive positive test results than others. The emotional impact of hearing an HIV-positive test result might prevent clients from clearly understanding information during the session in which they receive their results. Providers should provide appropriate referrals and, when necessary, additional sessions.

Persons with indeterminate HIV test results. Until follow-up test results are available, persons with an indeterminate result should receive information regarding the meaning of test results. HIV prevention counselling should be the same as for a person with newly identified HIV infection. Behaviors that minimise the risk for HIV transmission to sex and needle-sharing partners should be emphasised, even if the client reports no risk behaviors.

Persons seeking repeat HIV testing. In addition to brief prevention counselling sessions, ongoing HIV prevention counselling aimed at personal risk reduction might be useful for persons seeking repeated HIV testing who have continued HIV risk. Counsellors should encourage clients to explore alternative prevention strategies and to identify and commit to additional risk-reduction steps.

AIDS TERMS YOU SHOULD KNOW

Antiretroviral therapy:

Treatment with drugs designed to prevent HIV from replicating in HIV-infected persons. Highly active antiretroviral therapy (HAART) is an antiretroviral regimen that includes multiple classifications of antiretroviral drugs.

False negative:

A negative test result for a person who is actually infected.

False positive:

A positive test result for a person who is actually not infected.

HIV:

Human immunodeficiency virus, which causes AIDS. Several types of HIV exist, with HIV-1 being the most common in the United States.

HIV test:

More correctly referred to as an HIV antibody test, the HIV test is a laboratory procedure that detects antibodies to HIV, rather than the virus itself.

HIV prevention counselling:

An interactive process between client and counsellor aimed at reducing risky sex and needle-sharing behaviours related to HIV acquisition (for HIV-uninfected clients) or transmission (for HIV-infected clients).

Indeterminate test result:

A possible result of a Western blot, which might represent a recent HIV infection or a false-positive.

Positive test:

For HIV, a specimen sample that is reactive on an initial ELISA test, repeatedly reactive on a second ELISA run on the same specimen, and confirmed positive on Western blot or other supplemental test indicates that the client is infected.