Hiv.counseling And Management

What Is HIV?

"HIV" stands for Human Immunodeficiency Virus. Many people also refer to HIV as the "AIDS virus." How Is the Virus Transmitted? HIV lives in blood and other body fluids that contain blood or white blood cells. People have gotten HIV through: Counseling for Patients with HIV Infection Patients can be expected to be distressed when first informed of a positive HIV test result. Such patients face several major adaptive challenges, including
a) accepting the possibility of a shortened life span,
b) coping with others'' reactions to a stigmatizing illness,
c) developing and adopting strategies for maintaining physical and emotional health, and
d) initiating changes in behavior to prevent HIV transmission to others. Many patients also require assistance with making reproductive choices, gaining access to health services, and confronting possible employment or housing discrimination.
Therefore, in addition to medical care, behavioral and psychosocial services are an integral part of health care for HIV-infected patients. Such services should be available on site or through referral when HIV Infection is diagnosed. Recently identified HIV infection may not have been recently acquired. Persons newly diagnosed with HIV may be at any stage of infection. Therefore, health-care providers should be alert for symptoms or signs that suggest advanced HIV infection (e.g., fever, weight loss, diarrhea, cough, shortness of breath, and oral candidiasis). The presence of any of these symptoms should prompt urgent referral for medical care. Similarly, providers should be alert for signs of psychologic distress and be prepared to refer patients accordingly.
Evaluation Of Patients An evaluation of the infected person should be carried out and this should include
a) a detailed medical history, including sexual and substance-abuse history, previous STDs, and specific HIV-related symptoms or diagnoses;
b) a physical examination (including a gynecologic examination for women);
c) testing for N. gonorrhoeae and C. trachomatis (and for women, a Pap test and wet mount examination of vaginal secretions) and other STDs;
d) complete blood and platelet counts and blood chemistry profile;
e) a CD4+ T-lymphocyte analysis and determination of HIV plasma RNA (i.e., HIV viral load); f) a tuberculin skin test (TST) (sometimes referred to as a purified protein derivative );
i) a urinalysis; and
j) a chest radiograph Once the results of laboratory and skin tests are available, the patient may be offered antiretroviral therapy, if indicated, as well as specific medications to reduce the incidence of opportunistic infections


Adewale Olayemi