Durham News Features - View Article - Patient counsellors break good news and bad

(Originally published May 8, 2006)

On average, one out of every four people who come to Kasama’s Location Urban Clinic for voluntary counselling and testing (VCT) learn they are HIV positive.

It is never easy telling someone their status, says Beauty Maluti, a midwife and head nurse at the clinic.

But it’s part of the job.

“In Kasama, the incidence is not that bad. For pregnant women we are looking at 10 per cent (who are positive),” she says.

“There are times when it’s more. One day we counselled five and three were positive. You feel bad about the day and your morale goes down,” she says. “Breaking bad news is always difficult.”

But HIV/AIDS is not a death sentence, she says, noting many patients respond well to anti-retroviral drug (ARV) treatment.

“Many have come back looking very well,” she says.

When a person comes to the clinic seeking counselling and testing, they are taken into a private room in an effort to ensure confidentiality.

“I will make you feel at home and we will discuss your concerns,” Ms. Maluti says. “I am going to explain what HIV is, what AIDS is and what the consequences are of having HIV/AIDS.”

She talks to clients about the modes of transmission and the individual has an opportunity to ask as many questions as they like.

“The client should trust in you. She should feel comfortable,” Ms. Maluti says. “Her life history matters.”

She said the counsellor will explain the kind of care offered and will attempt to address all of the client’s questions and concerns before proceeding with the test.

“After counselling, you have the right to choose if you want to be tested or not. Then we can go about taking blood. Within 15 minutes the results should be provided to the patients,” she says. “After the testing has been done, then within the room, you are able to tell her the result if she is ready to receive the result.”

If the result is negative, and it has been less than three months since the individual had unprotected sex, the counsellor will explain that HIV is not completely ruled out because it may not yet be possible to detect the virus, Ms. Maluti explains.

“When it is negative, you can come again and be retested,” she says, adding, “We also counsel, in a positive way, those who are negative.”

For example, if the client is a single woman, the counsellor will talk with her about prevention methods.

If she is married, the counsellor will “encourage that person to involve their partner to help them continue to be a happy couple who is negative,” Ms. Maluti says.

If the test results are positive, the counsellor will explain the services available and send the patient for a CD4 count (blood test).

The woman would also be referred to an ARV clinic for treatment.

If necessary, patients will be placed on the home-based care list.

The clinic also provides patients with herbs to supplement their diet and counsels each person on good nutrition and how to live a healthy life.

“If the woman is married, we counsel them on living without re-infecting each other,” she says. “If they want children, we talk about how we can help with family planning … we look at their future.”