What is HIV Counselling?

Counselling in HIV and AIDS has become a core element in a holistic model of healthcare, in which psychological issues are recognised as integral to patient management. HIV and AIDS counselling has two general aims:
(1) the prevention of HIV transmission and (2) the support of those affected directly and indirectly by HIV. It is vital that HIV counselling should have these dual aims because the spread of HIV can be prevented by
changes in behaviour. 

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AIDS and The Lung

The lungs are commonly affected in patients infected with HIV, with over 60% of patients having at least one respiratory episode during the course of their disease.When immune responses are relatively well preserved in early HIV infection the pattern of respiratory infections is similar to that found in the general population, although they occur with greater frequency. The risk ofopportunistic infections and tumours increases as progressive HIV- induced immunosuppression occurs. Over recent years there have been several changes in the pattern of lung disease seen in those infected with HIV. These changes may be accounted for by the widespread availability and uptake of prophylaxis for Pneumocystis carinii pneumonia and combination antiretroviral therapy (also known as highly active antiretroviral therapy or HAART).

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Transmission of the Virus HIV AIDS

HIV has been isolated from semen, cervical secretions, lymphocytes, cell-free plasma, cerebrospinal fluid, tears, saliva, urine, and breast milk. This does not mean, however, that these fluids all transmit infection since the concentration of virus in them varies considerably.

Particularly infectious are semen, blood, and possibly cervical secretions.The commonest mode of transmission of the virus throughout the world is by sexual intercourse. Whether this is anal or vaginal is unimportant. Other methods of transmission are through the receipt of infected blood or blood products, donated organs, and semen.

Transmission also occurs through the sharing or reuse of contaminated needles by injecting drug users or for therapeutic procedures,and from mother to child.Transmission from mother to child occurs in utero and also possibly at birth.Finally, the virus is transmitted through breast milk. The virus is not spread by casual or social contact. Health care workers can, however, be infected through needlestick injuries, and skin and mucosal exposure to infected blood or body fluids.Prospective studies in health care workers suffering percutaneous exposure to a known HIV seropositive patient indicate a transmission rate of0.32%.

As of December 1999 there have been 96 reported cases of documented seroconversion after occupational exposure in such workers. The precautions and risks for such groups are covered in detail in chapter 15. Finally, there is no evidence that the virus is spread by mosquitoes, lice, bed bugs, in swimming pools, or by sharing cups ,eating and cooking utensils, toilets, and air space with an infected individual. Hence, HIV infection and AIDS are not contagious

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