Definition of Terms H - Human A - Acquired I - Immunodeficiency I - Immune V - Virus D - Deficiency S - Syndrome
How is HIV Transmitted? Risk Behaviors Unprotected anal, oral, and vaginal intercourse Sharing needles Perinatally Blood Transfusions
The Spectrum of HIV Disease The Immune System The body s natural defense against disease and infections is made up of thousands of cells. These cells make up the immune system and they perform a variety of functions designed to protect the body. HIV destroys the following cells preventing them from working: Macrophage - theimmune systems early warning sign CD4, T cells - protective leaders in the immune system. Instruct other cells to perform defensive functions. B cells - produce antibodies which fight disease Brain cells - the cells located in the brain
The Spectrum of HIV Disease The Immune System s Response Antibodies Proteins produced by the body and found in the blood Function is to kill invading viruses or bacteria Specific to the invading virus
The Spectrum of HIV Disease (Cont d) Window Period Time it takes for antibodies to develop 3-6 months (average) Antibodies can and will destroy some of the virus Individuals are often not aware of infection HIV can be transmitted
The Spectrum of HIV Disease (Cont d) Acute Primary Stage of Infection Shortly after the point of infection: Some people p may experience flu-like symptoms Usually lasts between 1 and 2 weeks Disappears quickly Virus is extremely active during this time HIV can be transmitted
The Spectrum of HIV Disease (Cont d) Asymptomatic ti Stage of Infection No signs or symptoms Average of 7-10 years Look and Feel Healthy HIV can be transmitted Virus is reproducing and attacking immune system cells Not enough damage has been done to cause illnesses
The Spectrum of HIV Disease (Cont d) Incubation Period Time between infection and symptoms of illness No set time frame for disease progression
The Spectrum of HIV Disease (Cont d) Co-Factors for Disease Progression Previous medical conditions Addictions Previous infections Poor hygiene Age Poor or improper nutrition Excessive stress Natural ability to fight infections Reinfection
The Spectrum of HIV Disease (Cont d) T cells (CD4) Programmed to fight foreign invaders Healthy, uninfected adolescents and adults - 800-1200 Viral Load Amount of virus in the body T cell counts decrease - Viral Load Increases Disease Progresses
The Spectrum of HIV Disease (Cont d) Symptomatic Stage of Infection General symptoms or illnesses begin to appear Duration of Symptoms Seek medical assistance to prevent or delay more serious illnesses HIV can be transmitted
The Spectrum of HIV Disease (Cont d) General Symptoms occurring for more than a month Swollen glands (3 months or more) Low grade fevers (100-101) Unexplained night sweats Unwarranted fatigue Headaches, Nasal Congestion Sore Throat White, painful lesions in mouth Cough Shortness of breath Abdominal Pain Change in bowel habits Change in skin Muscle/joint pain Gynecological changes Early Stage Dementia These diseases are not life threatening
The Spectrum of HIV Disease (Cont d) Advanced HIV Disease (AIDS) The immune system is severely impaired T cell counts drop to under 200 Cannot fight off life-threatening diseases Life threatening diseases (Opportunistic Infections OI) appear End stage of HIV Disease
The Spectrum of HIV Disease (Cont d) Opportunistic Infections (OI) could include: Pneumocystis carinii pneumonia (PCP) Kaposi p Sarcoma (KS) Fungal Throat Infections Invasive Cervical Cancer Pulmonary Tuberculosis
AIDS Case Definition HIV Infection and ONE of the following: Life Threatening Disease T cell counts below 200 Recurrent pneumonia within a 12-month period HIV Wasting Syndrome
Transmission of HIV Infectious Body Fluids: Blood (highest concentration of HIV) Semen (including pre-ejaculatory ejaculatory fluid) Vaginal Secretions Breast Milk
Transmission of HIV (Cont d) Routes of Transmission include: Sexually: Needle Sharing: Perinatally: Blood transfusions: Anal, Vaginal, Oral Intercourse Sharing needles used to inject into a vein, muscle, or skin From mother to child Minimal risk
Casual contact How HIV is Not Transmitted Objects in the environment Swimming Pools/Lakes Coughing/Sneezing Food/Food Handlers Mosquitoes Pets
HIV Prevention/Risk Reduction Prevention = eliminating all risks (100%) Risk Reduction = reducing risk (<100%)
HIV Prevention/Risk Reduction (Cont d) Sexually: Prevention: Abstinence Mutually monogamous Risk Reduction: Consistent and correct use of male or female condoms
HIV Prevention/Risk Reduction (Cont d) Needle Use: Prevention: Abstinence (seek treatment for assistance) Risk Reduction: Do Not Inject Do Not Share Clean Your Works
HIV Prevention/Risk Reduction (Cont d) Perinatally: ACTG (AIDS Clinical Trial Group) #076 Transmission reduced from 25% to 8% NJ Law: 1. counseling woman about HIV and AIDS 2. discuss the benefits of testing, and 3. offer the option of being tested
HIV Prevention/Risk Reduction (Cont d) Blood Transfusions Autologous donation - donating own blood Designated donor - family or friends donate
What is Counseling? For purpose of this course, and this work, counseling is: supporting someone in making decisions when their willingness or ability to act is affected by their feelings, circumstances, or special needs.
What do we mean by Client-Centered? Good counseling is client-centered meaning tailored to the behaviors, circumstances, and special needs of the person being served.
Goals in Counseling Counselors use their counseling skills to assist clients in: gaining a better understanding of the problem dealing with their feelings and concerns determining and evaluating options, and making thoughtful htf choices and decisions i
How do we Conduct CCC? First: Build Rapport Second: Assess Third: Plan
How do we Build Rapport? A Counselor should have certain qualities that make him/her easy to talk to and trust What are some qualities that are appealing in a counselor?
Non-judgmental disposition Accepting the fact that we are judgmental, but suspending our judgment in mutual respect to provide services to our clients. Respecting variations on human experience Remaining curious about these variations Providing education and advocacy to ensure persons are more than their "labels" Acknowledge that making judgments is part of being human; Reference from the Housing Works Mission Statement
Setting the Stage How can we make our surroundings set the tone for our counseling session?
Conducting CCC What skills do we need to conduct CCC? Giving Information Simply Open-ended Questions Listening Skills Attending Skills Rf Reframing Offering Options, Not Directives Working With hresistance
Giving information simply Some HIV information can be difficult to understand. Simplify it to make it easier. Here are some things you can do: Show It Paraphrase Be Brief Be Organized Be Understood Repeat Patterning Voice Control Accents Check Understanding
Giving Information Simply Activity The class will be broken up into 4 groups. Each group will be assigned a concept or concepts to simplify. On easel paper, explain the concept in simple terms and give an example or metaphor to help further understanding. Present simplified information to fellow participants. You will have 5-7 minutes to brainstorm and (*record explanation on easel paper).
Open-ended ended questions essential tools that take lots of practice. require more than a yes or no answer. stimulate thinking and promotes discussion. What words start open-ended questions?
Listening Skills What must someone do to listen? Be Prepared Pay Attention Keep an Open Mind Avoid Jumping to Conclusions Stop Talking
Reflective Listening Your clients will tell you what has worked and what hasn't. Include facts about what your client has said and what seems to be. Summarize what your client has told you, emphasizing certain key points
Listening Activity In triads, take 3-5 minutes to practice your open-ended questions, listening skill, and reflective listening by interviewing someone in your group about their favorite holiday. Ask OPEN-ENDED QUESTIONS ONLY.
Listening Activity (cont.) Then, when interview is over, interviewer will reflect back what was discussed using reflective listening. The participant not interviewing or being interviewed will listen for good open-ended questions and questions that are closed-ended. When a closed-ended question is asked s/he will redirect the interviewer to open it up. Also s/he will observe the reflect listening.
Attending Skills. Attending means physically presenting yourself in a way that shows attention to the client. You are communicating to them that you value them as an individual and are interested in them. Attending skills are demonstrated by using positive non-verbal communication.
Directives When have you experienced a time when you were given directives or told do this or else? How did it make you feel? How did it affect whether or not you changed?
Offering options, not directives Being given directives takes the control out of the hands of the individual. It does not take into consideration an individual s unique circumstances This can be avoided by giving the client control over change decisions by offering options rather than issuing directives. *Make sure options are appropriate and realistic for where the client is now (CCC)
Reframing Reframing is a strategy in which you invite clients to examine their perceptions in a new light or a reorganized form.
Counselor boundaries What are boundaries? What do boundaries have to do with us?
Counselor boundaries Identify what needs to be addressed and what needs to be referred. Diane is a female client concerned because her boyfriend abuses her physically. She knows he uses IV drugs. They do not use condoms during sex. Issues to be addressed by counselor: Issues to be referred: Referral to:
Counselor boundaries Joe is a 24-year-old male who exchanges unprotected sex for things like money and drugs. This is Joe s pattern. He started having sex with his stepfather when he was 12 and, in return, his stepfather th provided love, shelter, and food. Issues to be addressed by counselor: Issues to be referred: Referral to:
How to Make an Effective Referral During counseling sessions, the need for additional services often becomes evident Unreasonable to expect counselors to be able to deal with all issues Not unreasonable to expect counselors to be knowledgeable of community resources Networking and referral play major roles in all counseling especial HIV counseling
To make an effective referral, identify: What types of agencies are needed The information needed about each agency How to establish relationships with community agencies How to ensure clients are utilizing referral sources