COUNSELING IN HIV/AIDS

Dr Arun Kr Sharma
Department of
Community Medicine
University College of

Definition

Counseling skills properly used

are tools to help individuals seek
and find their own solutions to the
dilemmas they face.

Why Is Counseling Necessary?

Because

infection with HIV is life long

To cope with HIV positive status and live a
meaningful life
To adjust and to learn about change in
ones life style in order to reduce risk of
contracting HIV infection

Objectives

To

provide psycho-social support

To prevent transmission of HIV infection
To improve quality of life of HIV infected
people
To provide risk assessment for people who
are potentially at risk of contracting HIV
infection

Whom to counsel?
Self

motivated counseling seekers

Persons seeking HIV tests
HIV positive persons
High Risk Behavior Groups
Family Members
Employers
Health professionals
People unaware of risks

Characteristics of a Counselor
Committed
Open

minded
Non judgmental
Sense of responsibility
Patient listener
Tolerant
Attentive
Informed
Positive body language

Skills Required in Counseling

Excellent

communication skills
Ability to judge state of mind of a person
Quick empathetic response
Focused
Reflection of feeling
Questioning
Paraphrasing

Skills Required in Counseling

Respectful
Structuring

and prioritization
Help to formulate strategies
Help develop coping mechanisms

Stages of Counseling

1.
2.
3.
4.

Risk assessment counseling

Pre test counseling
Post test counseling
Follow up counseling

Principles of Counseling

Unconditional

positive regard for the client

Trust and confidentiality
Empathy
Time

Steps in Counseling
Rapport

building
Gaining trust
Explaining limits
Problem identification
Discuss options
Take action
Follow up

Role of Counselor

Advocacy role
Health education
Referral
Clinical and therapeutic role

Contents of Counseling
Contents of counseling will depend on the
ability of the client to grasp. Its a dynamic
process. The counselor must be able to
assess the clients need and state of mind
quickly.
However, following components should be
incorporated in all counseling scenarios:

Contents of Counseling
The need to prevent infection and re infection
Basic information about HIV infection and
associated diseases
Review of possible sources of clients infection
Methods of safe sex including condom use
Exploration of obstacles to change of behavior

Contents of Counseling
Information

about what HIV testing can and

cannot do.
Coping with HIV test results.
Need to tell the HIV status of the client to
the key persons in his/her life.
Handling hostility, fear, violence,
depression, suicidal tendencies etc.

Working Goals of HIV

Counseling
Forming a helping relationship
Clarifying and addressing problems
Establishing personal goals
Providing information on alternative resources
Selection of realistic alternatives
Stimulation of motivation and decision making
Helping client to develop competence
Recognizing and diagnosing signs of psychological
distress and providing support

Possible Reactions to a Positive

Test Result
Fear
Sense

Anger

of loss

Anxiety

Grief

Stress

Guilt

Shock

Denial

Loss

Depression

of self esteem
Suicide

Special Situations in HIV

Counseling
A.
B.
C.
D.

Pregnant women
Childless couples
Breast feeding positive mothers
Spouse and family members of HIV
infected persons

Some Common Counseling

Errors
a.
b.
c.
d.
e.
f.
g.

Directing and leading

Being judgmental and evaluating
Moralizing, preaching and patronizing
Unwarranted reassurance
Not accepting the clients feeling
Interrogating
Encouraging dependencies