What is HIV counseling? Definition

HIV testing and counseling (HTC) is an essential and important program that contributes significantly to HIV prevention, treatment, care, and support services. It is the service rendered to an individual to acquaint him/her with his HIV status,

An HIV-positive person is counseled on the benefits of treatment and good lifestyle habits and his/her responsibility to the community of preventing the transmission of the infection.

An HIV-negative person is counseled on the risk factors that can endanger him and make him prone to getting the HIV infection.

Stress is a lifelong companion of a person infected with the human immunodeficiency virus (HIV). It is a hopeless situation and the person knows it. Fear of death looms large and there is nothing the person or anyone else can do about it. HIV mental health counseling, therefore, forms a major responsibility of the program.

There is the prohibitive cost of HIV treatment. Add to it the difficulty of getting a job, what with the stigma attached to the HIV-positive patient. Treatment, therefore, should also cater to this situation of the patient.

These social, emotional, and financial aspects of the HIV life are managed through counseling.  A qualified and experienced counselor can make a significant impression on the life of an HIV patient.

WHO’s “5 Cs” for HIV Counseling and Testing

The World Health Organization has defined five crucial factors that all HTC services must adhere to.

  1. Consent. The person to be tested must give his/her consent to be tested willingly. The person has the right to refuse to test and undergo counseling. Nothing is compulsory or forced.
  2. Confidentiality. Confidence will be observed to guard the privacy of the person. There will be strict secrecy maintained between the person concerned and the health and counseling care provider. The information must stay between the person concerned and his counselor.
  3. Counseling. Testing must accompany pre-test and post-test information and counseling.
  4. Correct test results. Testing must be performed using high-quality international norms. Results must be communicated to the person tested only unless he/she refuses the results.
  5. Connection/linkage to prevention, care, and treatment. HIV prevention, treatment and care, and support services should be assisted by well-resourced patient referral and tracking systems.

CDC guidelines at a glance

The Centers for Disease Control and Prevention proposed new guidelines in 1999 that made some modifications to those of 1994. They contain recommendations for policymakers and service providers of human immunodeficiency virus (HIV) counseling, testing, and referral (CTR).

Although some recommendations are present in the old guidelines, the new recommendations focused more on standard counseling and testing procedures and stressed the importance of HIV prevention, counseling, and the need to maintain the confidentiality of the patient.

You can read all about it in the CDC’s article on HIV counseling.

Goals of HIV counseling

  1. Being under constant stress and anxiety, there is fear of the HIV patient slipping into depression.
  2. To help him/her deal with the emotional aspects of HIV disease.
  3. To help the patient deal with the social stigma that comes from being HIV positive.
  4. Access to other related health issues
  5. Ensure that all HIV-relevant people are provided information regarding transmission, prevention, and the interpretation of HIV test results.
  6. Ensure that the HIV-infected persons and those at high risk:
    • have access to HIV testing to help know their HIV status at the earliest;
    • receive high-quality HIV prevention counseling to reduce their risk of transmitting or acquiring HIV;
    • have access to appropriate medical, preventive, and psychosocial support services.

Different types of counseling

  1. Relationship counseling focuses on current relationships and helps find ways to ignore or improve them. This is a time-limited therapy, which lasts from 12 to 16 weeks.
  2. Cognitive behavioral therapy makes you aware of your negative thinking, view it from a challenging perspective, and find ways to respond to it in a positive manner. A limited number of sessions are taken.
  3. Psychodynamic therapy focuses on your past life to understand your present mental status better. This is because your present mental status could be due to some internal conflicts of the past that you may not be aware of. This type of treatment could last from a few weeks to a few years.

What happens during counseling?

  1. The test results are discussed and you are informed about the meaning of the result.
  2. You will be referred to the physician for treatment. You will also be told of the importance of strictly adhering to the prescribed treatment.
  3. What complications can arise and the symptoms you should look for.
  4. Your counselor will advise you about the healthy lifestyle you must now follow and why.
  5. You will also be informed that throughout life you can infect others and how you should prevent it.
  6. You will be analyzed and a series of psychotherapeutic talk sessions will be held, which will help you deal with emotional, social, and financial issues of your life, post-HIV.
  7. Group therapies with other people under similar situations are held. Seeing others with the same problems makes you feel you are not alone and gives psychological relief when you open up in such sessions.
  8. HIV mental health counseling includes stress management techniques, which the counselor teaches, such as :
    • Relaxation techniques through deep  breathing exercises
    • Acupuncture involves piercing thin needles into the skin to increase energy flow in the body
    • Yoga exercises to relax the tensed-up body muscles
    • Meditation to calm the stressed up mind

Is HIV counseling effective? Prognosis

Counseling is effective and the progress of its success varies from person to person. Some people benefit more than others.

It typically depends on how well your psychotherapist has analyzed you and how well he conducts your therapy — and of course how well you follow his/her advice.