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

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ContentsIntroduction............................................................................................................................................... 2Important Terms.................................................................................................................................. 3Basic Counselling Skills and Techniques.......................................................... 5Counsellor preparation........................................................................................................... 5What is counselling?.................................................................................................................. 6Skills and attitudes needed to be a treatment counsellor............... 7Counselling techniques.......................................................................................................... 8Conducting a counselling session............................................................................... 14Information about HIV and AIDS and PTCT Counselling...... 16Pregnancy, HIV and the mother’s health........................................................... 16Why counsel around HIV and pregnancy?..................................................... 17Testing for HIV................................................................................................................................. 19Why test for HIV during pregnancy?..................................................................... 19Why test for HIV before conception?..................................................................... 22ART and conception................................................................................................................... 22Discordant couples....................................................................................................................... 24Termination of pregnancy................................................................................................... 25Prevention of MTCT.................................................................................................................. 26PMTCT during infant feeding........................................................................................ 27Testing a baby for HIV............................................................................................................. 31Disclosure................................................................................................................................................ 33Where To Go for More Information.......................................................................... 35Notes..................................................................................................................................................................... 36
IntroductionThis book has been written for counsellors who are helping women andcouples who are:thinking about becoming pregnant;thinking about the options of having a baby;already expecting a baby.It is possible that one or both people are HIV positive. An HIV-positivemother can pass on the virus to her baby even before it is born, throughblood or body fluids. This can happen:before childbirth;during childbirth;after childbirth;during breastfeeding.This is known as mother-to-child-transmission (MTCT) or parentto-childtransmission (PTCT). It is possible to help prevent MTCT ofHIV after becoming pregnant, but it is even better to start taking stepsto prevent transmission before the baby is conceived. This is why it isimportant for counsellors to encourage couples who are thinking abouthaving a baby to test for HIV.If a client is already pregnant, it is also important to encourage her to testfor HIV. There are many programmes that help to prevent a baby frombeing infected with HIV during birth and during infant feeding.This book has two sections. The first section reminds counsellorsabout basic counselling skills and techniques. The second section givescounsellors basic information about HIV and AIDS, PTCT, and testing ababy for HIV.The book does not give the names and details of PMTCT programmes.Different countries use different drugs for their programmes and mighthave different ways of dealing with issues. As a counsellor, it is importantfor you to find out about the PMTCT programmes in your area, thetypes of infant HIV testing done, and the laws about termination ofpregnancy. In this way, you can help your clients make informeddecisions.Important TermsThis is a list of words and ideas that could be difficult to understand. .It might help to read the list before beginning the book, and think aboutsome of the ideas. The words that are here are bold in the book, so you cancome back to this page if there is something you don’t understand.Adherence counselling: This is helping .clients to take their ARV treatment correctlyevery day.Adopted/Adoption: This means when a childlegally becomes part of a family, with parentswho are not the child’s birth parents.Antenatal clinic: A clinic that looks afterwomen who are pregnant.Antibodies: Part of the blood that fightsillness and infection, such as HIV. Anantibody test is a blood test that looks for .the presence of a particular antibody.ART: ART stands for Anti-RetroviralTreatment.ARV drugs: The drugs used in ART are calledAnti-retroviral drugs (ARVs).Artificial insemination: A procedure doneby a health worker or doctor, where a man’ssperm is put inside a woman, without thecouple having unprotected sex.Birth defects: Physical health problems that .a baby is born with.Body fluids: These are liquids made by yourbody, such as blood, semen and amniotic fluid.Amniotic fluid is the liquid around a baby inthe womb (uterus).Caesarean section: This means giving birthby an operation in a hospital. This is alsocalled a C-section or Caesarean).CD4 count: Is a blood test that shows .how many CD4 cells you have and thestrength of the immune system. A healthyperson can have a CD4 cell count of between500 to 1 500 (the number of CD4 cells in amillilitre of blood). When someone has .AIDS, he or she has a CD4 cell count of .200 or less. .Compassionate: This means caring forother people.Conceive: To become pregnant. This isalso known as conception.Confidentiality: Information given to acounsellor by a client is not shared withanyone else, unless the client has given hisor her consent. It is confidential.Disclosure: This is telling people (ordisclosing) your HIV status.Discordant couple: A couple .where one partner is HIV positive and theother partner is HIV negative.Discrimination: This is when peopleor groups of people are treated unfairlybecause they are different.Empathy: This is when you canunderstand how someone feels,because you can imagine what it islike to be in his or her position.Empowered: When people feelthey are being listened to, andthey have the strength to dothings for themselves.Exclusive breastfeeding:Feeding an infant onlybreastmilk, (no water or otherfoods, only breastmilk andmedicines prescribed by adoctor).Exclusive formula feeding:Feeding an infant only milkformula.Expressed breastmilk: This meansto squeeze breastmilk out of thebreast by hand or with a special typeof pump.
Page 1 and 2: SATSouthern AfricanAIDS TrustSuppor
Page 3: ForewordTh. is.is.the.thirteenth.pu
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 and 20: As a counsellor it is important to
Page 21 and 22: The fear of domestic violence is on
Page 23: SAT’s HIV Counselling SeriesThis

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