Nivel socio-económico en el país de origen

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I•••• 111\ Tnliwa R111n

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I IIV ,�1ing of Jl!'Cgn11n1 v,·on1en ,hould be occon1pan1cd hy eullunllly occer1a.hle coun:;cllin11 1hu1 covers benefits of dc1cm1in1n1? I IIV status and its impli�tJons for o

\\on1nn·� lili::. prcgnuncy 1111d unhom chihl (fMOII. 2007):fhc ^elements of erfecu,·c cou11scllin11 _nre confidcnlinlity. _time. occ:eptnncc, ucc:c)�ihility 11nJ .,ccurncy. TI1c rei:11mmcnded uppro.ich 10 1 IIV counselling nntl 1cs1in11-- acconl1ng lo Nigeria No1ion;1I Gui,Jelint:s on Prevcnuon of Mother-to-Child trornrnission or HIV (PMfCTJ, (2007). is

the routine npproach (nlso rcfcTTCd to as the "opt-out" upproxh) "here I HV testing is

oITcn:d ^II.\ pan of routine tesa in nn1cnallll clinics. the ,vomnn has the right to refuse Ull:ing the tc�l Mandatory lt:iting " not recommended. 1llc US Prc\'cn1h·c Services Task fion:e {USPSTI-), (2007), �trongly recommend, that clin1ci:llls screen for human imn,unodeficiency (HIV) nil ndolesccnts and ndu!LS ut increased risk for infccuons ( A­

recomm.:nd.11ion),TI11: USPSTf makes no n:commc:ndation for or ag;iinst rouUnd) screening for HIV adolcsccnL� not.I ndulL� \\ho arc no1 a1 risl: for JO\'. (C­

n:com1111:nda1ion) (Al IJ1c lime this rccommcnd:uion Y."M made, o C. ra:ommc:nd;itJori fron1 the USf'STI 1ndica1ed th:it bcncfits'ond hamu ,,ere ^Sllah I.Ml _the USf'STF m:idc ^no

rccomn,cndation for or t.r,o.inst screening, 11,is interpn:wion dilfcn rrom the c:um:nt ^I.DC of {. rccommcnt1B1ion, \\hich indicates o m:ommcndluion not 10 perform on mten'Clllion (U.S. Pre'-COll\'C Sen·1ces Tosi.. Force Grade lkfin11ions, 2008). l'hc USPSF :i.lso ro:commend.� 1ha1 clinieinru scr«n oil prcgl\lll1t "�men ror HIV. (A·

recorn111e11d1111on) '11,e stutcd purpo� of the usrsrr- suitlclinc i� to c,-olua.tc the n;dcocc on the _benefits ond _harm, or 111 V ·.crccnin11, I he USPSTI' guideline is bo...,;cd on an�°""

5ys1,,.-mo1ie review of the evidence add��ing ,crttnini; for Ill\' lChou. Jluff ^m;m. Fu.

Smit, nnd Konhui,. 2005. Chou, nnd lluOrnnn, 7.007)

I he I JSl'S 11' rc.:omn1cnJn11on� �UJlJIOn the U5C of 1n.J.,1Ju:tli:rcd ^a=i of ru.t fac1t1r.1 fur IIIV inf«1i11n 11nJ sup(llln �l't'cnins in '-"OSC'S "� :t po1icn1 � ^tn o hia;b

prc111len(e or hll!,h rh\.: cllnicnl selling. ns one: or nk're n I.. tn.:11.,n ^ut ti.."1\.. 1'he n)}. t'1 ton for IIIV 111cluJo n1cn \\(11, hn\'C had �.-, \\tlh men aO,-r 1q1_s, men and "bo h:i,'t' unpro1cc;h:d IICll w11h 11111l11rh: f\-inn.-ri, po.,1 ur pre.5eu1 111jc.:tl\m ,lruj; u..sc men llDJ ,, ^;wn...�

,,ho c"ch1111cc AC/I hu money ur Jni(P 11r ll:I,,· sc.,1111I !'1nOCTII y,h,., t.lo, l'-"1-.an .. "h.'-"" IU'l ur 111�111 se;,111.11 p:tnncni \\-cr.: inkdcd 1\llh 111\', ^\\'l:n' h,...-,,i:it, "' ,,1:n:- 1�-i,�"' d�

uter�, [1Cfl!On• bcl111111�111cd fur 5<'.:\11,111) llnn 111111c1d 1ILS«t'IC'I lS I lb\ 1111J l'""™m: .,.,th 0

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history of blood U111\Smission bct\Oiccn I 978 o.nd 1985. In addition, lhe ^guidtlint

�-ncnurngcs scrccnini P3tients who request un Ill\' 1es1 bccou.<;c these patient� ore liktl) 10 include those \loho ure 01 high risk but ^DrC not willin11 lo disclose their at-risk behaviours

llii:h-risl. clinical scnin!l5 include STD clin1c.", corm:1io1\.,I facilities, homeless r.hchcr,.

tubt rcuh:>sis clinics, chnic:s serving men \\ho have "<CX ,vith men, and odolcsccnl health clinic" with a hish prcvnlcnce ofSTDs.

Jn nil hcallh-QJ'C scnings, according 10 Ccnll'C, for Disease control and Prevention,

(2006), :;cn:cning for I !IV infection �hould be performed routinely for oil potients uged 13

lo 114 ycurs. I lcnhh c.m: provider.\ �hould initiate scrccn1nv unlc:s.� pn:vokncc ol undini;now! IIIV inf�-c,ion in their patients has bttn documented 10 be <0.1 ��- In the nbs1·ncc of e11is1ing dalD for I IIV prevalence. hCG!th cnrc providers should initiate volunlllry ..cn:ening until they cstohlish lhnt the dingnoslic )'icld is I�. per 1,000 P3licnl!.

�i.rccnc:d, 01 \lohich point such screening 1s no loni;cr ,vnmin1cd All Jlllllcnts inuiating 1rcn1n1cn1 for rn shoulll be screened rou1inely for I IIV inftclion \II pa1ients seeking

lrt mcn1 for STT>s. Including nil p.11icn1, nucnding STD clinic• �hould be screened ro111inely for I TIV dunn1; ew:h \'isit for u ne,v co1npl11in1, rc�.rtllc:� of ,vhclher lhc p:11ien1

1s knoY>n or �uspcclc:d lo hove specific behaviour ri:.l. for Inv infc:c:1ion. All pn:gnnnl

\\On1cn in tht US hould be scr«ru:d for IIIV infc:c:t1on (CDC 206).

2. Iii llrntfltt or ,nv THilng and C1111n1tlllng at Anttnatal Clinic Mtting

HIV testing and counselling in the nn1c1U1l1>.I setting. nccol'\lin� 10 FMOI I ('?007), has

n1ony bcnctic, ,vhich include the following:

I. II n:1nfo= SDfl!r sex pmctiCC!I nnd empowcs the HIV-ncg:uive preSJllllll \\onUlJl

to rcmn,n ncgnti\'c ^•

2. ll provides opportunily for counselling on inf11n1 feeding option�.

J. It oho cMblcs H!V-infec1cd \\-Omen to nca:� prophylllC1ic -\nll-Rctroviral drugs.

•I HIV negative molhcr.i will he cncoun1gcd 10 c�clU:ii\'CI)' breastfeed whilc ^llll 111fcc1cd ,vomAn ,viii hnvc the option of minimizing the risl. 11f J IIV lf1U\9nis.�ion to

h, r 1nfnnt

:,, 11 cnnhles ¹¹ ,vonu,n lu make infonnc:d chniCC'.'I nho111 f111urc pregnancies.

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11. It provides I IIV-infcctcd women tJ1e opportunity 10 seek early medical care for related conditioru. e.g. Tuberculosis.

7, II provides opportunity for referrals.

II. It allo,� early diagnosis, 1reatmen1 nnd follo"'·-up support for the exposed 1nfnn1s

C), It provides the pmncr and other family mc,nbcrs or a "oman ^11J1 cnlry point in10 the HIV services

10. It demystifies IUV and AIDS in the community.

11. It cmpo,ver, \\'Omen to to.ke part in peer SUJ'(lOrt grou(l1.

12. It oho enables id1:111ificd HIV-infected ,vomen odopl a po!i1ive life s1ylc

2.19 Tht Concept of IIIV Counstlllng

I ITV couni;elling is the conlidential dialogue bct"'·cen individuals and their health care pro, idcr.; to help clicnl!I cxruninc their risk. or IIC{!Uiring or tronsmitting HIV infection and to make informed decisions based on information avnilablc lo them (fl>.1011, 2007).

I UV counselling sew ¹⁰ reduce IIIV acquisition and tronm1iss1on through the follo,,,og

\\1l)'S;

I. tnforma1ion Clients -1hould receive informauon rcganhng 111\' 1ransn11SS1on ond prevention ond 1hc meaning of Hrv tcsl result� Provi,ion of infnmuuon ^IS

dilTerenl fn1m informed conscnL

.?. IIIV prevention counselling - clicnlS should rccch·c help 10 idau.ify sp:cific lxh3,•iow-s pulling lhcm 01 n!J. for OC4tuinng or tmnsmi111ng HIV anJ corwni1 10

filtJ>110 R:Jucc ^1h1� riil:. Pn:vcn1inn counselling can ,n,ohc one or matt sessions.