Counselling

Question 1

How do pre-test counselling for HIV testing (10)

Answer 1

• Ensure confidentiality
• negotiate number of consultation sessions required
• determine prior knowledge of patient,
• provide information about HIV infection, transmission, AIDS, links to sti + Tb
• technical aspects of test: window period (2 - 3 weeks post infection), how long it will take, reliability of result
  → positive: need to repeat
  → negative: true negative vs window period
• implications positive/ negative result: how pt will cope, Pros + cons (stigma, abandonment)
• who to inform of status (not obligated to tell anyone except sexual partners)
• evaluate behaviour risk, how can pt change to decrease infection risk
• identify support system
• get consent

Question 2

How counsel positive HIV result (8)

Answer 2

• Give result
• ask how pt feels
• tell pt they’re infectious, discuss risk / elimination
• identify support systems: partner, family, support group
• info about treatment and adherence
• provide info: prevent transmission, disclosure of result, condoms
• Examination to determine WHO stage, further blood tests
• arrange follow up + counselling

Question 3

How manage conflict (5)

Answer 3

ABCDE

Acknowledge difficult relationship with 4 e’s (engage, empathy, educate, enlist)
Boundaries
Compassion
Determine pts meaning (active listening, open ended q)
Extend system care (referral, transferral, co-assistant/external help)