Importance of Counseling and Psychosocial Aspects of HIV Infection

Creator: Dr. Suvash Sahu
Published: 2017-01-30T09:28:41-04:00

Written by

and medically reviewed by Dr. K. Shobana

Published on Jan 30, 2017 and last reviewed on Nov 21, 2022 - 4 min read

Abstract

Besides its effects on physical health, HIV (Human Immunodeficiency Virus) infection can create significant fear and anxiety. Read the article below.

Contents

What Is the Importance of Counseling and Psychosocial Aspects of HIV Infection?

What are the Vital Features of Counseling -

What Are the Psychosocial Aspects of HIV Infection?

Who All Can Counsel?

What Is the Importance of Counseling and Psychosocial Aspects of HIV Infection?

Counseling an individual with HIV (Human Immunodeficiency Virus) infection is important because HIV infection is lifelong. Individuals can avoid acquiring HIV infection or transmitting it to others by opting for some or other required changes. HIV and AIDS (acquired immunodeficiency syndrome) have become a major element in a comprehensive healthcare model in which psychological issues are recognized as fundamental to managing the disorder. HIV and AIDS counseling has two main aims. The prevention of HIV transmission and the support of those affected directly and indirectly by HIV. It is vital that HIV counseling should have these dual aims because changes in behavior can prevent the spread of HIV. The diagnosis of HIV infection in an apparently healthy individual can create a lot of mental pressure and anxiety. It can hamper the patients after knowing they have HIV infection or disease. They may suffer great psychosocial and psychological stress due to fear of rejection, social stigma, disease progression, and other uncertainties. This can affect the HIV-positive patient’s psychology and worsen the illness, especially because 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 for 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 staff, and psychologists, but others like social workers, teachers, health educators, religious teachers, community leaders, and members of self-help groups can also counsel the patient.

What are the Vital Features of Counseling -

HIV-infected people should feel that they are fully accepted by the counselor. The information provided through counseling should be consistent and up-to-date, and any uncertainties in the knowledge should be acknowledged. Trust is one of the most important factors in 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 -

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

What Are the Psychosocial Aspects of HIV Infection?

The fundamental premise of modern psychiatry is the emotional life and behaviors with biological underpinnings 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 to address the patient’s premorbid psychiatric disorder and the new onset of 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:

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

Liaison with medical caregivers is to help and provide education regarding psychiatric aspects in diagnosing and treating patients with HIV. Multiple complications can arise from HIV infection. Recognizing how it could be the symptoms of the potential neuropsychiatric problem is vital.

Some of the psychological issues in the terminal care of patients living with HIV can include reactions to pain and 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, acute or subtle, require clinicians to rule out treatable and reversible causes.

Conclusion:

Counseling for HIV brings a positive approach to balancing the psychosocial effects of the affected patients and reducing the risk of spread. One-on-one counseling leads to behavior changes which help in further treatment. In the counseling session, patients can come up with their heart feeling and other insecurities, which help them to cope with their disorders.

Frequently Asked Questions

1. Why Is Psychosocial Counseling Necessary for HIV Patients?

Psychosocial counseling is pivotal for HIV patients because they will be under excess mental pressure and anxiety after a diagnosis of HIV (human immunodeficiency virus). This can lead to a further worsening of the symptoms. Psychosocial counseling can help relieve stress and give a better view of the future.

2. Why Is HIV Counseling Important?

Counseling for HIV infection is important because it is a lifelong infection. Also, an HIV-infected person can transmit the infection to others through careless behavior. It also provides information about future treatment and how to cope with and live with HIV infection.

3. What Does Post-Test Counseling for HIV Mean?

During post-counseling for HIV, the counselor gives insight into the HIV results. And let the patient express their feelings about the findings (positive or negative). The counselor answers the patient's queries and provides useful information. If the patient is negative, they will discuss ARV-PEP (antiretroviral - post-exposure prophylaxis). If the result is positive, the counselor will discuss living with HIV.

4. What Is the Process Involved in Pre and Post-HIV Test Counseling?

In pre-HIV counseling, individuals are enquired why they have come for counseling and checked their knowledge about HIV and other STDs. A professional discusses the ramifications of risky sexual behavior and the degree of risk. Knowledge is provided about the type of test and the results. Then an appointment is scheduled one week after the test results. Post-test counseling varies for positive and negative results, and test results are immediately revealed.
Counselors will also address the window period (within three to six months of acquiring the infection). If there is a reason to worry, a retest is scheduled within three to four months. Again, the patient is enlightened about the risks and knowledge of HIV. In the event of positive test results, they are relieved soothingly and gently. Patients exhibit different feelings, like crying, anger, silence, etc. When the patient is back to normal, they are explained about psychological support and medical care and are referred to specialists. They schedule an appointment after a week to start the required therapy

5. Explain the 5C’s of HIV Counseling?

The consolidation guidance for HIV testing, chartered by the WHO (world health organization), aims at five C's that include:
- Consent.
- Confidentiality.
- Counseling.
- Correct results.
- Connection.

6. Why Is It Necessary to Have Knowledge of HIV?

It is essential to know about HIV; it helps to promote and practice safe sex and change behaviors that pose health risks. Moreover, educating young people about HIV is needed as an effective preventive measure. Knowledge of HIV should be provided at a very young age to avoid any risk.

7. What Are the Tests Available for HIV?

There are three types of tests available for HIV testing, which include:
- Antibody Test - Done with a person's oral or body fluids. This test can take 23 to 90 days to find HIV after exposure.
- Antigen or Antibody test - Collecting the affected or suspected person's blood. This test takes 18 to 45 days to find HIV after exposure.
- Nucleic Acid Test (NATs) - This test is also done by collecting blood from the veins. It usually detects HIV 10 to 33 after exposure.

8. What Should Be Done After a Negative HIV Test?

After a negative report, healthcare providers will recommend getting retested after the test window period. If there is no exposure during the window period and the test is negative, there is no chance of HIV. If another exposure occurs during the window period, the patient is asked to wait at least four weeks before testing.

9. When Should a Retest Be Done After a Negative HIV Test?

A retest should be scheduled after the test window period that the individual took. If there is no exposure during the window period and the test is negative, there is no chance of HIV. If another exposure occurs during the window period, the patient is asked to wait at least four weeks before testing.

10. What Is Called the Voluntary Counseling and Testing Process?

Voluntary counseling and testing (VCT) is a confidential HIV counseling and testing process that an individual undergoes to assess their risk of HIV exposure. They decide whether to undergo an HIV test or not. This counseling program is well encouraged by the government.

11. Which Is an Ideal Counseling Technique for HIV?

Counseling techniques for HIV include a pre-test, post-test, couples, crisis, adherence, and grief or bereavement counseling. A correct and timely approach to counseling and the counselor's ability to understand and soothe the patient are important in making each session productive.