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Heather Jamieson Hassle Free Clinic. HIV Counselling Overview. What is HIV counselling?. Provides information about HIV, testing, prevention and services that will help clients: Assess their own HIV risk Make an informed decision to be tested
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Heather Jamieson Hassle Free Clinic HIV Counselling Overview
What is HIV counselling? Provides information about HIV, testing, prevention and services that will help clients: • Assess their own HIV risk • Make an informed decision to be tested • Know how to take precautions to protect themselves and others from exposure or re-exposure to the virus and other infections • Know where to go for more information or support
Pre-test counselling – HIV Risk History • HIV tested before? What was the result? • Risks since last test – client risk and partner risk if known? • Unprotected anal or vaginal sex? • Endemic area risks? • Needle or shared straw or pipe use? • Regular and/or casual partners? • Any health concerns? • Most recent possible exposure? • What is the client’s concern? • Was there a known HIV + contact?
Pre-test counselling con’t... • Safer sex practices; male/female condoms, review proper usage • Single needle use, needle exchange, safer crack use (HIV and Hep C) • Ability to negotiate safer sex with resistant partner(s) • Perceptions of risk, especially with long-term partners • Risk-taking behaviours • Prevention/Harm Reduction Education
Pre-Test Counselling – Preparation for an HIV Reactive/Positive Result • Discussed with every client; in relation to their risk history • Assure them they are not alone; offering and assessing supports • Referrals, partner notification • Criminalization of HIV (Cuerrier) – remember we’re not lawyers – refer, refer, refer! • Earlier detection means better health outcomes • What kinds of supports do they have?
Post Test Counselling – HIV Negative results • Always in person • Easier with POC testing – person is right there • Give result; review window period • Review prevention/harm reduction information as appropriate • Review strategies for staying HIV negative • Review what the result means (or doesn’t mean) with the client
Post Test Counselling – HIV Reactive/Positive • May (hopefully) happen over a few sessions; dependent on resources • Be prepared to listen, not try and ‘fix’ it • “Not the news we hoped for, you’ve tested HIV positive” (don’t delay in giving results) • Not a “death sentence”, provide perspective and hope • Be ok with silence • Ask client what s/he needs • Offer appropriate resources • Set up a time for client to return the next day if possible • Wide range of reactions – shock, disbelief, anger, acceptance, relief, fear about future health, guilt, anxiety about health of partners or children • Connecting with appropriate medical care • Past, unsafe partner notification • Criminalization of HIV • Disclosure to friends, family, workplace etc. • Future safety for self and others
For people who test HIV positive, the goals of counselling are also to: • Provide information and support in dealing with an HIV diagnosis • Connect client to services that will help them cope with the diagnosis, manage their HIV, prevent the spread of HIV and live healthy, satisfying lives.