Importance of Counseling and Psychosocial Aspects of HIV Infection

Written by
Dr. Suvash Sahu
and medically reviewed by iCliniq medical review team.

04 Jul 2019  -  4 min read



Apart from the effects it has on your physical health, HIV infection can create significant fear and anxiety. To know how counseling will be helpful, read the article.

Importance of Counseling and Psychosocial Aspects of HIV Infection

Counseling an individual with HIV infection is important because HIV infection is lifelong. An individual can avoid acquiring HIV infection or transmitting it to others by changing their own behavior. The diagnosis of HIV infection in an apparently healthy individual can create a lot of mental pressure and anxiety. It can hamper his or her psychology and worsen the illness, especially in view of the fear of future perspective, misunderstanding and discrimination provoked by the HIV epidemic.

The purpose of counseling is to create awareness and prepare a person to both the seropositive and seronegative status. Also, to address the issues of anxiety, denial, anger and guilt, which a person is expected to go through on knowing the seropositive status.

Who All Can Counsel?

Not only doctors, nurses, paramedical staffs and psychologists, others like social workers, teachers, health educators, religious teachers, community leaders and members of self-help groups can also counsel the patient.

Vital Features of Counseling:

  1. HIV infected people should feel that they are fully accepted by the counselor.
  2. The information provided through counseling should be consistent, up-to-date and any uncertainties in the knowledge should be acknowledged.
  3. Trust is one of the most important factors in the counseling. However, there may be some instances where confidentiality needs to be broken. For example, to notify the sex partner of an infected person, who has refused permission to do so.

Pre-Test Counseling:

Aim of pre-test counseling is to prepare a person to both the seropositive and seronegative status. It addresses the person’s fear and concern about HIV infection. Counseling is focused on two main issues.

  1. Assessment of risk.
  2. Assessment of psychological factors and knowledge.

Assessment of Risk

Assessment of risk is based on the frequency of sexual activity, the type of sexual behavior of an individual, high-risk lifestyles (IV drug users, homosexuals, bisexual men), history of blood transfusion or organ transplant and exposure to non-sterile invasive procedures like tattooing.

Assessment of Psychological Factors and Knowledge

Assessment of psychological factors and knowledge is mainly based on the following questions. Also, one should know the supporter, who can provide emotional and social support, either family or friends or others.

  • What particular behavior or symptom is of concern to the patient?
  • What does the patient know about the requested test, its uses and importance?
  • Has the client considered what to do or how to react if the result is positive or negative?
  • What are the client’s beliefs and knowledge about HIV transmission and its relationship to the risk behavior?
  • Has he sought testing before and if so when, from whom, for what reason, and with what results?

Post-Test Counseling

Counseling After a Positive Result:

The counseling should be private and confidential. The patient should be given time to absorb the news. Thereafter, he should be given a clear, factual explanation of what the news means without speculation about prognosis or estimates of time left to live. The shock of the diagnosis is acknowledged, support is offered, provided hope and optimism for achievable solutions to the possible personal and practical problems are encouraged. If resources are available, then it is justifiable to talk about the efficacy of antiviral treatment.

Counseling After a Negative Result:

It is very important to discuss the meaning of negative result and the following points should be emphasized. After exposure to HIV infection, there is a window period of 3 to 6 months. During the window period, a negative result cannot be considered reliable. A negative result carries the greatest certainty if at least six months have elapsed since the last possible exposure. Further exposure to HIV infection can only be prevented by avoiding high-risk sexual behavior. Other information will be shared on control and avoidance of HIV infection, including the development of positive health behavior.

Psychosocial aspects of HIV Infection

The fundamental premise of modern psychiatry is the emotional life and behaviors which have biological underpinnings that are shaped within a broader social context. Perhaps, that interplay is nowhere more evident than in the psychobiology of HIV infection. The psychiatrist involved in the care of HIV infected patients is asked not only to address the patient’s premorbid psychiatric disorder, but also the new onset emotional distress, which may complicate a patient’s response to infection, disease and treatment.

Because of the high rates of substance abuse, psychiatric disorders and other psychological vulnerabilities, it is imperative that psychiatric treatment be included as an important part of the therapy of HIV infected individuals. The current role of psychiatrists and mental health professionals in caring for patients living with HIV primarily are:

  1. Primary prevention.
  2. Differential diagnosis of mental status.
  3. Support medical care teams.

Liaison with medical caregivers is to help and provide education regarding psychiatric aspects in the diagnosis and treatment of patients with HIV. There are multiple complications that can arise from HIV infection. Recognizing how it could be the symptoms of potential neuropsychiatric problem is vital.

Some of the psychological issues in the terminal care of patients living with HIV can include reactions to pain, suffering and attempts to minimize this by honoring the patient's wishes and directives and finally attending to those left behind.

In adults and children with HIV infection, changes in mental status or the emergence of new psychiatric or cognitive disorders either acute ones or subtle require clinicians to rule out treatable and reversible causes.

To know more about HIV counseling consult a HIV AIDS specialist online -->

Last reviewed at:
04 Jul 2019  -  4 min read


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