Counselling after HIV

Counselling after HIV-testing is also very important. It helps to interpret the results of the test.
If they are tested negative, it is a good time to talk about reducing risk—a negative result
does not mean that one will never contract the virus. A negative test result must be confronted
with the possibility of the person being within the window period. If they have tested positive,
they may not immediately understand the meaning of this. They need to be helped and to realize
that a positive test does not mean they will die immediately. Remember that AIDS symptoms
may take up to 10 year to develop. They can learn to improve their quality of life and be told
about possible medical care. They also need to learn how to protect others—meaning how to
avoid further spread of the virus.
“Christine got sick living in the streets and was placed in a hospital where she was tested
for HIV. ‘One night I overheard two nurses talking about the young girl in this bed being HIV
positive. I opened my eyes and asked her to repeat what she said, and she told me that you
are going to die of AIDS soon. I cried all day and all night and kept thinking of suicide.’”
Christine, Kenya [7].
The most important aspect of counselling is confidentiality. Young people need to feel sure that
unless they give permission, the results of their test will not be disclosed to anyone. You
should refer youth to a centre where counselling and HIV-testing can be done. Make sure that
testing there is always voluntary and confidential. Remember that places you refer to reflect on
your programme—if there is no confidentiality there, youth will lose trust in your project. It is
also important for youth to go to youth-friendly services, which are open and accepting to
young people.
Young people may also want to talk about a wide range of other problems in counselling. They
will likely be facing various problems simultaneously, with family, with money with work and
so on . . . Counsellors should be open to them, not judge them and listen to their issues.
Health workers, physicians, teachers, social workers or others can provide counselling. They
need training to learn all the necessary skills for counseling [33].
Drug treatment services
When there is enough trust and a stable relationship has been built with the IDUs, they can
also be referred to drug treatment services. If you recall the prevention hierarchy, you will
remember that our main aim is abstinence from drugs. However, you should realize that you can
not expect that your target group will be open or willing to go to treatment right away. Some
may never agree to attempt treatment. Far from being disheartening, this is a typical example
of those difficult situations we all face when working on drug demand reduction issues. How do
we gain the trust of our “clients”, be non judgmental and yet nudge them towards seeking
treatment is an operational rather than ideological problem, one that demand reduction
practitioners confront every day.
Substitution drug treatment: Drug treatment programmes have been found to be effective in
assisting drug users to reduce or stop injecting, especially when they are involved in substitution
drug treatment (such as methadone or buprenorphine) [19].