Guidelines for Counselling around HIV and Pregnancy - Southern ...

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As a counsellor, it is important to encourage your client to have herbaby tested for HIV. It is also important, as a counsellor, to do thefollowing things.Understand that your client might be feeling guilt and anger. This couldbe at herself or her partner, around the possibility of infecting their babywith HIV.Give them a chance to talk about their feelings about their own HIVinfection. Also let them talk about their fears for themselves and theirchild, if he or she is HIV positive. For example, many parents fear that anHIV-positive child will hate them, and wish he or she had not been born.Remember that some of your client’s fears could be because they do nothave correct information about HIV and treatment. Give your clientaccurate information about treatment for HIV and AIDS for adults andchildren.Understand your client’s fears of the unknown – they might have to waitfor almost two years to find out if their child is HIV positive.Other issues to think about as a counsellor.Many women struggle to keep up with all their household tasks as well .as a newborn baby. If a woman is also trying to remember to take herown HAART, or give ART to a baby, she will struggle and will needsupport.A couple who is HIV positive might want to appoint someone to be thelegal guardian of their child or children. This person could care for thechildren if they become too ill. You could guide your client to make theright decisions on who to ask to be a guardian.Help your client understand that it is important to involve the child inmaking these decisions, if they are old enough. Your client may choose todecide on behalf of the child. Do not judge your client’s decision, but helpthem explore the consequences.Find out how to make a legal will, and how to appoint someone as a legalguardian.Make a list of organisations and counsellors who specialise in legal help.You could then refer your client to someone with more knowledge andexperience.Help your client or clients understand that it is important to practisesafe sex while pregnant and after the baby is born. This will stop .re-infection.DisclosureDisclosure is telling people your HIV status. It can be very frighteningfor people who have not yet talked about their status.Being pregnant can sometimes force people to disclose. This is veryfrightening. Many choices around having a child, childbirth and feeding willdepend on disclosure.If your client does decide to disclose, he or she will need your support as acounsellor. He or she will need to decide:who to tell;how to tell them;when to tell them.For more information on disclosure, read SATs HIV Counselling Series No. 1:Counselling Guidelines on Disclosure of HIV Status.Why is disclosure a good idea?Disclosure can help people get medical services, care and support.Someone who has disclosed is free to make the best choices aroundPMTCT and PPTCT.Someone who has disclosed his or her HIV status is usually morestrict about their infant-feeding choices. This is because they are notafraid of other people’s opinions.Someone who has disclosed usually lives a more healthy life.Disclosure helps to reduce the stigma, discrimination and denialaround HIV and AIDS.32 33
The fear of domestic violence is one of the reasons why some women areafraid to have an HIV test, or to ask for ways to help prevent mother-tochildtransmission. For example, she might choose natural childbirth,or breastfeed, so that no-one in her community thinks she might be HIVpositive.For information about counselling around issues of domestic violence,read SAT’s Counselling Guidelines Series No. 4: Counselling Guidelineson Domestic Violence.If your client’s baby is HIV positive, eventually she and her partner willneed to disclose the child’s status to the child, as well as to caregiversand treatment supporters. Disclosing to a child can be difficult. Healthworkers do not all agree on the right age and right way to disclose.Where To Go for MoreInformation.You can make a list on this page of the places in your area that can give you,or your client, more information about HIV and pregnancy.REMEMBERKeep a list of any organisations or counsellors in your area thatspecialise in HIV-positive children. Find out as much as you can fromthem about disclosing to children. You may choose to refer your client toone of these specialists.3435
Page 1 and 2: SATSouthern AfricanAIDS TrustSuppor
Page 3 and 4: ForewordTh. is.is.the.thirteenth.pu
Page 5 and 6: IntroductionThis book has been writ
Page 7 and 8: What is counselling?Counselling IS:
Page 9 and 10: Asking questionsWhen you ask questi
Page 11 and 12: Conducting a counselling sessionBef
Page 13 and 14: As a counsellor, it is important to
Page 15 and 16: Why test for HIV before conception?
Page 17 and 18: Prevention of MTCTPMTCT during preg
Page 19: As a counsellor it is important to
Page 23: SAT’s HIV Counselling SeriesThis

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