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HIV Counselling for Asia and the Pacific Region – First ever epidemic specific resource guide

By Karen Emmons

08 January 2010 - For the first time in more than two decades, HIV counsellors in Asia and the Pacific have useful guidance tailored to the epidemic context of the region. The guidance provides relevant advice on the specific needs of the population who are at risk of HIV AIDS primarily - injecting drug users, sex workers and men who have sex with men (MSM). While there are many HIV counselling resources, few offer focused guidance on sex workers, MSM and other marginalized groups.

“The kinds of people counsellors have had to deal with, they weren’t prepared to deal with,” says Dr. Kathleen Casey, Senior Technical Officer in the Family Health International (FHI) Asia-Pacific Regional Office. “They didn’t know how to apply appropriate behavior change counselling,” she adds.

The 2008 Commission on AIDS in Asia Report states that up to 10 million Asian women sell sex and at least 75 million men buy regularly. The report points out about 20 million men are at higher risk of HIV infection and can easily transmit HIV to their male or female sex partners.

Women, who are increasingly at risk, because their spouses or sex partners fall into the most at-risk groups are not being sufficiently counselled. “High-risk sexual behaviors put at least 50 million women at risk of acquiring HIV from their male partners,” notes Festo Kavishe, UNICEF Deputy Regional Director for the East Asia and Pacific Regional Office. “We need to do more to protect them and their children. Appropriate counselling can make a difference.”

“HIV infection among infants,” says Wing-Sie Cheng, EAPRO Regional HIV and AIDS Advisor, “stems from the lack of antenatal care and insufficient information and counselling provided to women about AIDS and their sexual and reproductive rights.”

UNICEF in collaboration with Family Health International (FHI) and the World Health Organization has recently published a training package entitled “HIV Counselling Resource Package for the Asia–Pacific Region”. The resource is developed in consultation with experts throughout the region and tested with selected targeted users in urban and rural environments meet the socio- cultural and epidemic context of the region.

Dr. Casey states “Even though the package is developed to meet the type of HIV epidemic we have in the Asia Pacific region, it can also be useful in other types of epidemics,” The counselling package is the result of immense consultation and “has a strong sense of ownership.”

The three-part package comprises, a comprehensive HIV counsellor’s handbook; an HIV counselling trainer’s manual, and tools for HIV counselling (forms, worksheets, information cards, flipcharts and counsellor resources).

The material is structured in ways that provide users with flexibility to translate certain modules or adapt to specific training needs. Countries can also insert relevant examples that address local needs or context.

The training package also provides seasoned counsellors with an understanding of coping with specific types of clients. The modules on ‘counselling sex workers’, ‘working with MSM and transgender clients’, ‘counselling pregnant women, new mothers and partners’, ‘working with suicidal clients’, ‘supporting HIV disclosure’ can be used to train new counsellors.

The material can easily be used by medical staff and other care providers, community-based workers and lay counsellors. The text is written in technical-jargon free language to benefit counsellors with a low level of education.

In China the package has already been translated and is being used in two provinces already, “it is making a huge difference” says, Li Ling, FHI Senior Strategic Behavior Communication Officer. “Counsellors love to use it because it gives a very simple way to explain difficult medical terms, such as window period, immune system, behavior change and HIV transmission, with pictures taken from China,” Li Ling explains.

Ms. Li Ling points out that in Yunnan province, HIV-positive people are advised to inform their sexual partners within one month of learning their status, HIV-positive people must, otherwise the government will do it. “The six options in the package are very useful and a practical menu for this problem,” she says.

“Counselling children or vulnerable women requires individual approaches,” says Ms. Cheng. “This package is brilliant in how it offers a range of guidance that has been missing for a long time.”



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