HIV/AIDS Counselling: Disclosure Counselling

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DISCLOSURE COUNSELLING

This type of counselling assists clients to understand the need to share their HIV status with trusted loved ones for the purpose of support and care. In addition, it assists clients understand the importance of disclosure to reduce risks of re-infection by partner(s).

PLWHA may need support to disclose their status to loved ones and their loved ones may need support to cope with their feelings about the information. This is what makes Disclosure counselling a complicated process because the counsellor has to give support to the primary client but also to the significant others of the client and in some instances it is the counsellor that may have to disclose the HIV status of client to loved one.

Motivations for disclosure vary greatly, and debates about “degrees of disclosure” have been evoked. The “degrees of disclosure” refer to level of disclosure a client seeks, some want to disclose to loved ones while others may want to go public with their disclosure to help in reducing stigma in the community and to work as HIV/AIDS activists.

The Benefits of Disclosure Counselling

• Helps the client ensure that an HIV negative partner does not become infected
• Help ensure that positive partner can also access early care, treatment and support
• It can also reduce the risk of an unborn baby contracting HIV from its mother.

Guidelines for disclosure counselling

• Counsellor must respect a client’s decision not to disclose to partner when adamant and not put any pressure on client to disclose status out of coercion.
• Counsellor must never disclose client’s status without consent.
• The Counsellor must support client through the decision-making process with on-going counselling sessions.
• If the client refuses or is taking time to disclose status then Counsellor must work and encourage the client to identify at least actions that would be adopted to reduce risk of infecting partner during this period.
• The Counsellor must be ready to have series of counselling sessions with client before arriving at a final decision.

PARTNER NOTIFICATION IN DISCLOSURE

There are three ways in which partner notification can be carried out. They are:

• Client Referral: This is a situation where the PLWHA chooses to inform the partner himself or herself. The advantage of this sort of disclosure is that Client is familiar with the partner and knows the best way to approach difficult issues with the partner and also knows what to do to calm or appease partner during such emotional crisis. The disadvantage is that the client lacks the counselling skills and experience which may help to alleviate the situation.
• Counsellor referral: This is a situation whereby the Counsellor provides disclosure of client’s status to client’s partner with client’s consent.
• Dual referral: In this situation the partner is informed by both client and counsellor after rehearsal has been done to see how best the disclosure can be carried out. The advantage of this sort of partner notification is that both client and counsellor can promptly react to any situation that arises from partner, the counsellor handling the situation with a professional touch while the client gives it a personal colouring.

Disclosure counselling, especially partner notification, is a controversial subject still highly debated in many countries and society, so it is wise to consider every aspect including the legal provision of the country.

REFERENCES

1. World Health Organization (1994); Source Book for HIV/AIDS Counselling Training,
2. Thomas, Prof. Gracious (2010), HIV/AIDS: Stigma, Discrimination and Prevention, IGNOU, New Delhi
3. World Health Organization (2004): Voluntary HIV Counselling and Testing, Manual for Training of Trainers, New Delhi, India
4. NACO (2011): Annual Report 2010 – 2011, National AIDS Control Organisation, Ministry of Health & Family Welfare, GOI
5. UNAIDS (2007); Counselling and HIV/AIDS, UNAIDS Technical Update, Best practice Collection