Special features when counselling women about HIV

2021-03-20 12:00 AM

It is advisable to advise women to have an HIV test before deciding to become pregnant. Emphasize the meaning of the possibility of mother-to-child transmission if they are pregnant and infected with HIV

In addition to the common points about HIV / AIDS counselling mentioned above, there are special features in counselling women, especially young women, in their sexual and reproductive age. Note the following:

Joint counselling for women on HIV / AIDS

Due to the anatomical structure, the mucosa of the female genital organ has a wide contact area, and in sexual intercourse, the woman who receives the semen should be more susceptible to infection than the male. In addition, when infected with sexually transmitted diseases, the disease is often harder to detect in women than men, so it is easier to become chronic causing ulcers on the genitals, increasing the likelihood of HIV infection. through sex.

In the process of performing reproductive functions, pregnancy, labor and delivery, health often collapses, women are prone to blood loss, so they have to transfusion, blood transfusion ... so they are also susceptible to infection.

Beauty needs such as cosmetic surgery, ear piercing, tattoos, if not done in a sanitary manner can also be a source of exposure.

In addition, due to the remaining gender inequalities, many women are unable to actively use protective measures such as condoms and practice safe sex, so they are more susceptible to infection than men.

It is advisable to advise women to have an HIV test before deciding to become pregnant. Emphasize the meaning of the possibility of mother-to-child transmission if they are pregnant and infected with HIV. If they are pregnant, they need periodic antenatal check-ups and early HIV tests to be promptly managed.

Counselling for pregnant women / women infected with HIV

Early counselling should be given to HIV-infected women who should not become pregnant for the reasons outlined above.

If a woman is already pregnant, give them information about the possibility of mother-to-child transmission as well as preventive treatment so that they can make the right choice for themselves about how to handle the pregnancy. , depending on their needs, circumstances as well as pregnancy status, including gestational age.

Especially, for pregnant women who are tired of pregnancy (gestational age is less than 12 weeks according to the last menstrual period), it is necessary to focus on counselling them on voluntary abortion because the possibility of transmission from mother to child is quite high.

In case the woman and family agree to voluntarily abortion after having been fully informed and indicated for abortion (still young, in the first or second trimester), it is possible to resolve the abortion. Abortion takes appropriate measures. In these cases, pregnant women need to be cared for at facilities capable of surgery (with an obstetrician and an operating room), the district hospital's obstetrics department or provincial hospitals. After an abortion, these women need counselling to continue treatment.

If the gestational age is too large (from 16-20 weeks onwards), there is no indication for abortion or who is counselled to keep the pregnancy, they need to be consulted about the need to be referred to the obstetrician. Provincial or higher-level hospital to determine whether there is specific intervention in terms of treatment and follow-up. They need to be treated or continued to take anti-HIV drugs to lower the chance of mother-to-child transmission during pregnancy (for AZT) and labor (AZT or nevirapin). Antenatal care and midwifery need to be carried out in these facilities to ensure application of the necessary technical procedures.

In any case (the woman or the couple decides to terminate the pregnancy or continue to follow-up) they should be advised to follow up or carry out the procedure in a qualified, qualified facility. the condition follows the necessary infection prevention procedures to prevent themselves and others.

In cases where HIV-infected pregnant women want to give birth, or are found to be infected with HIV during labor, they need to be counselled about responsibility for the child, neither should abandon nor give breastfeeding because of the possibility of infection.

The counsellor needs to sensitively assess the mother's needs and conditions in order to provide appropriate advice for their nursing because they are still providing adequate care but just not breastfeeding. and it should be made clear that health workers will help them (for example, in reducing or stopping lactation after childbirth).

Mothers need to be counselled about the importance of giving infants AZT syrup or nevirapine postpartum to prevent infecting their babies so that they can accept treatment for their babies.

Counsellors advise HIV-infected mothers to follow medical guidelines to facilitate them not to breastfeed as well as during other postpartum care procedures such as bathing and caring for the umbilical cord, take care of yourself, including taking care of your breasts to prevent possible injuries (eg avoiding rubbing in the skin causing bleeding ...).

Without preventive treatment, the rate of HIV transmission from mother to child is about 20-35%. Whereas if the correct prophylactic treatment (in the uterus from 36 weeks gestation with AZT or the mother's labor with nevirapin as well as giving the child syrup and alternative food), the rate of infection from mother to child is only about 8-10%.

Counselors should instruct HIV-infected mothers to follow up on postpartum follow-up and treatment, body nurturing, drug treatment, and adherence to an anti-iron deficiency anemia regimen and opportunistic infections they have. can be acquired while raising a child.