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Pre training reading materials and pre exam 2012

Pre-Training Reading MaterialsAnd Pre-Exam 2012


How this course works

How this Course Works

This online course offers the information that forms the foundation for the face-to-face HIV Counselor Training you will be attending soon. Both trainings build on over 25 years of experience talking with people about stopping the transmission of HIV.

This online course is separated into pre-reading modules, followed by a 34-question quiz. There is no time limit to complete the pre-reading or quiz. Once you begin the quiz, you may go back to the readings. However, you may only submit your quiz answers once. Your quiz will be scored by a training administrator, and you will receive and email with your score. You need at least 80 percent of correct responses in order to be eligible to sign up for the training. If you do not pass on the first try, you will receive an email notification and you can re-take the quiz.


Hiv aids the basics

1

HIV/AIDS the basics…

Goal:

This module will present an overview of HIV/AIDS, the basics of how HIV passes from person to person, and a brief description of who is at risk for HIV in California.

Learning Objectives:

At the end of this module participants will be able to:

  • Differentiate basic HIV concepts, such as: exposure, infection, modes of transmission, replication, infectious/non-infectious body fluids

  • Explain the effects of HIV in the human body

  • Express basic AIDS concepts such as diagnosis and opportunistic infections

  • Evaluate basic local HIV epidemiology


What are hiv and aids

H

uman

What are HIV and AIDS?

I

mmunodeficiency

V

irus

A

cquired

I

mmuno

D

eficiency

S

yndrome


What is hiv

What is HIV?

  • A retrovirus

  • Transmitted only between humans

  • Multiplies inside specific cells of the immune system

  • Destroys immune system cells

  • Causes inflammation of arteries and of the heart

  • Causes a condition called AIDS


Hiv invades cd4 cells

HIV Invades CD4+ Cells

  • HIV is a virus that invades CD4+ cells, which are a critical part of our immune system.

  • Once inside a CD4+ cell, the virus uses the cell to create more virus. In the process HIV destroys the original cell.

  • As more and more immune system cells are destroyed, the body has a harder time fighting off both HIV and other illnesses.


Hiv is an inflammatory disease

HIV is an Inflammatory Disease

We are learning that HIV seems to do more than just impair the immune system. It is also an inflammatory disease which over time can cause damage to arteries and to the heart.

Because of this inflammatory effect, a person who has HIV and who does not smoke has the same risk for heart attack as a person who doesn’t have HIV but who does smoke.


What is aids

What is AIDS?

  • A serious health condition caused by an advanced stage of HIV infection

  • The immune system becomes severely damaged by HIV and can no longer protect the body from infections.

  • Rare “opportunistic” infections and cancers become more common.


Opportunistic infections ois

Opportunistic Infections (OIs)

Illnesses that takes advantage of a person’s weakened immune system. OIs do not normally appear in persons with healthy immune systems.

The Centers for Disease Control and Prevention (CDC) have generated a list of 40 OIs, which includes: Kaposi’s sarcoma, pneumocystisjirovecipneumonia, Toxoplasmosis, Cryptococcal Meningitis, Mycobacterium Avium Complex (MAC), Cytomegalovirus retinitis, among others.


What gives an aids diagnosis

What Gives an AIDS Diagnosis?

  • HIV positive, AND

  • CD4 (T-cell) count below 200

  • OR presence of one or more opportunistic infections


Viral load vl

Viral Load (VL)

Viral load is the amount of HIV in a sample of blood. HIV medications fight HIV and work to keep the virus from making copies of itself. VL tests is used along with the CD4 cell count to monitor the status of HIV disease, guide recommendations for therapy, and predict the future course of HIV. It is important to keep VL at an undetectable level. Undetectable does not mean your HIV infection is gone. It means that the amount of HIV in your blood is too low to be measured with current tests. Also, an undetectable VL means that the risk of transmitting HIV has decreased but has not been eliminated. People do get infected with HIV even when their HIV+ partner is undetectable. Undetectable VLs in blood are not a guarantee that HIV is also undetectable in semen


Exposure vs infection

Exposure vs. Infection

Not every case of exposure will result in HIV infection.


Infectious bodily fluids

Infectious Bodily Fluids

  • Blood

  • Semen

  • Precum

  • Vaginal Secretions

  • Breast Milk

  • (for infants)

The body fluids containing HIV at levels high enough to infect someone else include:


Non infectious bodily fluids

Non-Infectious Bodily Fluids

  • Saliva

  • Tears

  • Sweat

  • Urine

  • Sputum

  • Nasal secretion

  • Feces

Small traces of HIV have been found in some of the body fluids mentioned above. However, the amount of virus present is so small that these body fluids are not able to transmit HIV. These fluids only present a risk for HIV transmission if they are mixed with blood.


Requirements for infection

Requirements for Infection

The following three factors need to happen in order for HIV to cause infection:

1. HIV must be present,

2. In sufficient quantities to cause infection,

  • Blood

  • Sexual fluids

  • Breast milk

3. And be able to get into the bloodstream

  • Directly through damaged skin or through injection

  • Absorption through mucous membranes

If you remove one of these factors, infection cannot take place.


Pre training reading materials and pre exam 2012

HIV is transmitted through….


Hiv is not transmitted by

HIV is NOT transmitted by:

  • Hugging

  • Kissing

  • Massage

  • Shaking hands

  • Insect bites

  • Pets

  • Donating blood

  • Swimming pools or hot tubs

  • Casual contact with someone who has HIV (sharing dishes, food, showers or toilets, phone)

  • Casual contact with saliva, tears, sweat, or urine

The U.S. National Institutes of Health and the U.S. Centers for Disease Control and Prevention have found that none of the above are ways that people contract the virus.


How does hiv look like in ca

How does HIV look like in CA?

  • 74%of those who are HIV-positive are men who have sex with men (MSM) including MSM who inject drugs (MSM-IDU) (6%)

  • 29% are between 20 and 29 years old;

  • 36% are between 30 and 39 years old,

  • and 22% are between 40 and 49 years old

  • 18% are African American (7 percent of Californians are African American)

  • 30% are Latino (36 percent of Californians are Latino)

  • Women are the fastest growing demographic for HIV

Source: California HIV/AIDS Surveillance Statistical Reports 2011


Hiv prevention

2

HIV Prevention

Goal:

This module will present the continuum of risk and some ways to reduce the chance of sexual transmission of HIV and the concept of harm reduction.

Learning Objectives:

At the end of this module participants will be able to:

  • Apply the continuum of risk in HIV counseling

  • Convey different options that might lessen the chance of infection during sex

  • Explain the concept of harm reduction


Continuum of risk

Continuum of Risk

Different sexual activities pose different risks for HIV. It may be easier to think of sexual risk in terms of a continuum wheresome sex activities carry more HIV risk than other. As a counselor, you might rely on the continuum of risk to help clients think of small, incremental steps to reduce the chance of infection. For example, if a client is not going to use a condom, substituting oral sex for anal intercourse is a step that dramatically reduces the client’s chance of contracting or transmitting the virus.


Continuum of risk1

Continuum of Risk


How to prevent hiv during sex

How to Prevent HIV During Sex

People can prevent HIV infection during sex by not taking blood, semen, pre-ejaculate, or vaginal secretions into the mouth, vagina, or anus. The following screens offer other options that might lessen the chance of infection during sex:

HIV


Condoms

Condoms

When used properly, male and female condoms, and barriers such as dental

dams are effective

prevention methods. Condoms nearly eliminate

the risk of HIV transmission during anal and vaginal intercourse.


Use lube for vaginal and anal sex

Use Lube for Vaginal and Anal Sex

Lubrication helps prevent tears

in mucous membranes and lowers the risk of transmission


Testing linkage and retention in care and treatment of hiv

Testing, Linkage and Retention in Care and Treatment of HIV

Early detection, proper care and treatment of HIV can prevent new HIV infections


Test for and treat stds

Test for and Treat STDs

Identifying and treating other sexually transmitted infections

reduces the chance of infection with HIV


Replace intercourse with oral sex

Replace Intercourse with Oral Sex

The risk of HIV transmission from oral sex is extremely low. However, the presence of cuts, bleeding gums, or and STD elevates the risk. Options for lowering the risk of transmission during oral sex include using a barrier like a condom or dental dam. If a client does not want to use condoms, not allowing partners to ejaculate into the mouth offers some protection.


Serosorting

Serosorting

Some people make a practice of only having sex with people of a specific HIV status. This could be the same or the opposite of their HIV status. This is called serosorting. The advantages and limitations of serosorting can be a rich topic of conversation during a counseling session.


Concept of harm reduction

Concept of Harm Reduction

  • Reducing and not necessarily eliminating harm resulting from drug use and/or sexual behaviors


Harm reduction

Harm Reduction

  • Meet people “where they’re at”

  • Support clients in making any positive change

  • Although the concept of harm reduction was developed by substance users and their counselors, the principles are applicable to many other kinds of activities. For example, switching to more oral sex and less anal sex could be seen as an example of harm reduction


Harm reduction approaches

Harm Reduction Approaches

Here are some suggestions, adapted from the Harm Reduction Coalition and Training Institute, for working with clients on harm reduction:

Maintain a policy of respect for all clients: Recognize and set aside judgments about drug use and sexual behaviors

Focus on a client’s strengths and abilities

Support all positive changes

Let people identify and set their own priorities

When asked, provide accurate and honest information about the possible harm of drug use and sexual behaviors, both in general and specifically in terms of the client’s life


Harm reduction examples

Harm Reduction Examples


Hiv testing and counseling

3

HIV Testing and Counseling

Goal:

This module will present the principles of HIV counseling.

Objectives:

At the end of this module participants will be able to:

  • Understand the goal and characteristics of HIV test counseling


What is hiv testing

What is HIV Testing

  • HIV testing is a health tool people use to find out if they are infected with the virus that causes a condition called AIDS

  • Conventional HIV tests are designed to detect HIV antibodies. Other more specific tests can detect antigens*, or even the virus itself

*A pathogen that stimulates the production of an antibody when introduced into the body. Antigens include toxins, bacteria, viruses, and other foreign substances.


What is counseling

What Is Counseling

  • Counseling is a two-way communication process that helps individuals:

    • Examine personal issues

    • Make decisions

    • Make plans for taking action

  • In HIV counseling and testing the focus is to help clients make decision based on their HIV status


Hiv counseling involves

HIV Counseling Involves

  • Active listening

  • Being client focused

  • Maintaining confidentiality

  • Asking questions

  • Allowing clients to make their own decisions

  • Helping clients find other services they may need


Hiv counseling is not

HIV Counseling is Not

  • Advising clients what to do

  • Criticizing clients

  • Forcing ideas or values on clients

  • Fixing anything for the client

  • Internalizing clients’ resistance for ambivalence to change

    The purpose of counseling is to help clients work through their own decisions. As a counselor we can give some queues regarding the possible pros and cons to a decision, but we are not to give advice, pass judgment, or force our ideas as to what we believe the client should decide.

    People are their own experts in their lives!


Things you need to know about a person before you counsel

Things You Need to Know About a Person Before You Counsel

4

Goal:

This module will present the basic concepts of the stages of change, the window period, and clients’ context

Learning Objectives:

At the end of this module participants will be able to:

  • Name the 5 Stages of Change

  • Identify appropriate interventions for each stage of change.

  • Understand and explain the “Window Period”

  • Apply the concept of context when counseling clients


The stages of change

The Stages of Change

If you have ever tried to stop smoking or lose weight, you know how hard it is. Going through this process, you probably went through several stages, starting with not wanting to change at all. Maybe later you considered the pros and cons of changing for a long time. Perhaps you had a few unsuccessful attempts before you succeeded in making a change, or maybe you’re still thinking about whether you want to try. That is totally normal.

Two researchers, James Prochaska and Carlo DiClemente, discovered that there is a series of Stages of Change that almost everyone goes through when faced with changing an ingrained behavior.

As HIV test counselors, understanding the Stages of Change can be important. The more we adapt our discussion with a client to the client’s stage, the more likely we are to be effective. Let’s look at those stages.


The stages of change1

The Stages of Change

According to Prochaska and DiClemente, there are five

stages of change:

Precontemplation

Contemplation

Preparation (Ready for Action)

Action

Maintenance


Stages of change characteristics

Stages of Change: Characteristics

  • It is not realistic to expect change after a single intervention

  • Once a clients initiate behavior change, they are susceptible to revert to a previous stage at any time

  • Clients may revert through stages repeatedly

  • Successful change involves not only restructuring patterns of behavior, but also restructuring thoughts about oneself and one‘s actions


Staging interventions

Staging Interventions

  • When counseling clients around changing behaviors, it can be most helpful to match an intervention with their stage of change

  • Intervention: An action by the counselor that result in a change in the client’s thinking or understanding of themselves or their behaviors in relation to HIV

    On the following screens, we’ll look at each stage one at a time.


People in the precontemplation stage

People in the Precontemplation Stage…

  • Have no intentions to change their behavior, they have difficulty in seeing that a problem exists in the first place

  • Are unaware of their HIV risk or deny the adverse outcome that could happen to them or others

  • Have made a decision not to change behavior, which can be due to personal safety or other survival issues


Precontemplation appropriate interventions

Precontemplation: Appropriate Interventions

  • Establish rapport and build trust

  • Follow the client’s lead to get a sense if they want to talk about their risks

  • Get a reaction, either cognitive or emotional

  • Help them think about their risk taking behavior patterns by:

    • Offering factual information about the risks of having unprotected sex and needle sharing

    • Exploring the meaning of events that brought the client to testing

    • Eliciting the client’s perceptions of the problem

    • Explore the pros and cons of risk taking behaviors

    • Examining discrepancies between the client’s and others perceptions of the problem behavior

  • Express concern and keep the door open


People in the contemplation stage

People in the Contemplation Stage…

  • Recognize that a problem exists and seriously think about changing a behavior, but has not yet committed to action. The contemplation stage can last for long periods of time.

  • Have indicated they are seriously considering changing their behavior within the next six months.

  • Know where they want to go but are not ready to do what is necessary to get there.

  • Spend considerable effort weighing the pros and cons of the problem and its solutions. However, they can’t maintain the change and sustain the new behaviors that change requires.


Contemplation appropriate interventions

Contemplation: Appropriate Interventions

  • Normalize ambivalence

  • Help the client “tip the decisional balance scales” toward change by:

    • Eliciting and weighing pros and cons of engaging in risky behaviors and change

    • Changing form external to internal motivation

    • Examining client’s personal values in relation to change

    • Emphasizing client’s free choice, responsibility, and self-efficacy for change

  • Elicit self-motivational statements of intent and commitment from client

  • Elicit ideas regarding client’s perceived self-efficacy and expectations regarding change

  • Summarize self-motivational statements


People in the preparation stage

People in the Preparation Stage…

  • Bring together the intention to change and the preliminary behavioral efforts to make the change.

  • Intend to take action within the next month or had unsuccessfully taken action in the past year.

  • Need work on strengthening commitment.


Preparation appropriate interventions

Preparation: Appropriate Interventions

  • Clarify the client’s own goals and strategies for change

  • Offer a menu of options for change

  • Negotiate a change and behavior contract

  • Consider and lower barriers to change

  • Help the client enlist social support

  • Elicit from the client what has worked in the past either for him or others who he knows


People in the action stage

People in the Action Stage…

  • Make adaptations in order to change his or her attitudes, behaviors, or environment.

  • Try new behaviors, but these are not yet stable.

  • Have abstained from their risk taking behavior for a period ranging from one day to six months.

  • Have spent a considerable time and energy altering their behavior and their change is notable

  • Are particularly susceptible to relapse to an earlier stage


Action appropriate interventions

Action: Appropriate Interventions

  • Engage the client in new behaviors and reinforce the importance of maintaining them

  • Support a realistic view of change through small steps

  • Acknowledge difficulties for the client in early stages of change

  • Help the client identify high-risk situations and develop appropriate coping strategies to overcome these

  • Assist client in finding new reinforces of positive change

  • Help client assess support networks


People in the maintenance stage

People in the Maintenance Stage…

  • Focus on sustaining a change in behavior, preventing relapse, and consolidating the gains of the action stage.

  • Have successfully sustained their behavior change for six months or longer.

  • Maintenance was once considered static. It is now viewed as the continuation of change, rather than its absence. “Once you’re there, there is still plenty of work to do.” Relapse to an earlier stage is always possible.


Maintenance appropriate interventions

Maintenance: Appropriate Interventions

  • Help the client identify and engage in lower risk behaviors

  • Support lifestyle changes

  • Affirm the client’s resolve and self-efficacy

  • Help client practice and use new coping strategies to avoid a return to former behaviors

  • Review long-term goals with the client


People in the relapse stage

People in the Relapse Stage…

  • Have experienced a recurrence of their risk behavior and must now cope with consequences and decide what to do next.


Relapse appropriate interventions

Relapse: Appropriate Interventions

  • Normalize relapse

  • Help the client reenter the change cycle and commend any willingness to reconsider positive change

  • Explore the meaning and reality of the recurrence as a learning opportunity

  • Assist the client in finding alternative coping strategies

  • Maintain supportive contact


In summary

In Summary…

  • Assessing a client’s stage of change and negotiating a stage appropriate intervention can help clients make decisions to reduce their risk for HIV

  • Participants who relapse or revert to a previous stage tried to do something different…They didn’t fail, it just didn’t work and need to revisit their steps, amend them and try again


What is the window period

What is the Window Period?

…the time it takes for a test to detect the presence of antibodies, antigens or virus.

  • The state of California defines the window period to take place between two weeks to six months with most people developing antibodies by the third month.


Pre training reading materials and pre exam 2012

HIV/HCV Antibody Testing &

the Window Period

Sept 1st

Dec 1st

June 1st


Context

Context

con·text /käntekst/

Noun:“The broader circumstances surrounding a client’s potential risk behaviors. These may include their sexual partners and behaviors, substance use, physical environment, their emotional state, peer influences, personal history, motivations for participating in the behaviors and so on. A client’s social environment can

have a large complex set of cofactors that might include

the communities they live in, their cultural influences, the languages they speak, and the impact of poverty and other forms of oppression on their ability to initiate and be supported in risk reduction.”


Hepatitis c brief overview

Hepatitis C Brief Overview

5

Goal:

  • This module will present a basic overview of hepatitis C.

  • Learning Objectives:

  • At the end of this module participants will be able to:

  • Describe what is hepatitis C

  • Asses who should be tested for hepatitis C

  • Identify the different types of hepatitis C testing

  • Provide appropriate counseling based on the clients test result


What is hcv

What is HCV?

  • RNA virus

  • Transmitted primarily by blood (mostly IDU)

  • ~4 million with HCV in U.S.

    • 50-75% unaware of infection

  • Causes chronic infection in 3 out of 4 people exposed

  • Can cause liver disease, liver cancer, death

  • Can be treated and, in some case, cured

  • There is no preventable vaccine for hepatitis C


Hcv who should be tested

HCV: Who Should be Tested?

  • Ever injected drugs, even once, years ago*

  • HIV-positive*

  • Liver disease, unexplained elevated liver enzymes

  • Received blood transfusions before July 1992

  • Received clotting factor; organs before 1988

  • Children >1 year born to HCV+ mothers

  • Known exposure to HCV+ blood

  • Ever on hemodialysis

  • People born during 1945-1965**

* Priority groups for HCV testing in non-healthcare settings

** Draft recommendation by CDC; final recommendation expected by late summer 2012


Types of hep c tests

Types of Hep C Tests

  • HCV antibody

    • Used to detect the presence of the hepatitis C antibodies

    • It confirms there was an infection but it does not tell us if there is a current infection

      • About one in four people exposed to hepatitis C virus clear the virus naturally without treatment. These people will have antibodies but no virus

    • Unlike HIV this is not a diagnostic test

    • Testing can be rapid or lab based

  • HCV nucleic acid test (NAT)

    • Used to detect the presence of the hepatitis C virus

    • This tests confirms current infection


What happens after someone is tested

What Happens After Someone is Tested?

  • Discuss window period (2 weeks to 6 months)

  • Risk reduction

  • Referrals

  • Referral to diagnostic testing

  • Evaluation by primary care provider

  • Discuss social support

  • Make plan until follow-up testing


The counseling session

The Counseling Session

6

Goal:

This module will present what HIV test counselors do and introduce you to the nuts and bolts of a counseling session.

Objectives:

At the end of this module participants will be able to:

  • Differentiate each of the steps of an HIV counseling session


Session flow

Session Flow

Welcome,

Framing,

Consenting

Sample Collection

Assessing and Prevention Counseling

Yes? No?

Results and Counseling

The work we do as counselors revolves around a series of clearly defined steps which help us frame the HIV testing session. The following screens illustrate these steps:

Referrals

Close


Pre training reading materials and pre exam 2012

Welcome,

Framing and Consenting

The first few minutes of the counseling session might be the most important. This is your chance to make sure that your client feels comfortable and respected.

Basically, the goals in greeting a client are:

  • Establish rapport

  • Explain the counseling and testing process

  • Ask for questions

  • Get informed consent in writing from the client


Establish rapport

Establish Rapport

Welcome,

Framing and Consenting

Your clients have shown tremendous courage in seeking your help. For some people, it is uncomfortable talking about sexual and reproductive health. Make them feel as much at ease as possible:

  • Provide a private, quiet counseling area

  • Introduce yourself in a warm, friendly manner


Framing the process

Framing the Process

Welcome,

Framing and Consenting

  • Explain what will happen during the session and when the client will receive test results

  • For rapid tests, make sure the client knows that a preliminary positive result requires a confirmatory test

  • Check for questions and concerns


Written consent

Written Consent

Welcome,

Framing and Consenting

  • Consent means that the client understands what is going to happen and agrees to the procedure:

    • The test is an antibody test

    • It could take from 3 to 6 months for antibodies to show up in the test

    • If reactive, a confirmatory test must be performed

    • All positive confirmed tests must be reported to the state health department

  • Have client give written consent to the test


  • The rapid test

    The Rapid Test

    Sample Collection

    • Is performed on either an oral sample or a blood sample, usually from a finger stick

    • Takes between 15 to 20 minutes to develop a result

    • Looks for the antibodies that the body creates to fight HIV infection

    • Is a “screening” test and not intended to diagnose an illness.

    • Is over 99% accurate

    • It can detect antibodies for both HIV 1 and HIV 2


    Pre training reading materials and pre exam 2012

    Assessing and Prevention Counseling

    Part of the session involves gathering contextual information. This includes environmental factors, sexual and drug use behaviors, and personal beliefs and feelings. With this information we can help clients explore activities in their lives that could result in HIV transmission.


    Rapid test results

    Rapid Test Results

    Results and

    Counseling

    There are three possible rapid test results:

    • Reactive / Preliminary positive test result:the test very likely detected HIV antibodies. The individual is very likely infected with HIV. Preliminary positive results must be confirmed. This means the client must submit a second sample and returns after seven to 14 days to receive the results of the confirmatory test. If the confirmatory test is also positive, it is considered a positive result.

    • Negative test result means that noantibodies to HIV were detected in the sample. The person is either not infected with HIV, or the person is infected but has not yet produced enough HIV antibodies to show up on the test.

    • Invalid test result is very rare. If it occurs, the test must be redone with a new sample.


    Disclosing hiv negative results

    Disclosing HIV-Negative Results

    Letting clients know their HIV status- State results in a direct, neutral tone

    Helping clients make sense of their result

    – what does it mean for them?

    – revisit the window period

    Supporting them in protecting themselves from HIV

    Giving referrals to help with HIV prevention in the future

    Continuing the prevention counseling conversation

    Exploring re-testing


    Disclosing reactive preliminary positive results

    Disclosing Reactive / Preliminary Positive Results

    • Letting clients know their HIV status status- State results in a direct, neutral tone

    • Helping clients make sense of their result…what does it mean for them?

      • Providing linkage to medical care

      • Discussing disclosure and partner services

      • Providing a supportive environment for the client to express feelings about the result.

      • Helping them consider their next steps


    Close the session

    Close the Session

    Close & Referrals

    When closing your session, thank your clients for coming in and tell them you look forward to seeing them again in six months.

    At the end of your session, all of the participant's issues will not be resolved. However, it is the job of the counselor to make the participant leave feeling they have specific and appropriate steps to take in the present, and options for further follow-up in the future.

    Let’s review what makes a referral a good referral.

    CLOSE THE

    SESSION,

    BUT NOT

    THE DOOR!


    Giving a good referral

    Giving a Good Referral

    Close & Referrals

    1. APPROPRIATE: The referral is appropriate for the client: the service is needed, the service will be accessible, the client will feel comfortable in the setting, etc.

    2. WRITTEN: The information is written down in easy-to-read fashion. Clients should be given the name, phone number, and address of the referral.

    3. PURPOSE IS CLEAR : The purpose of the referral is clearly stated to the participant. For example, ―This is a place where you can talk to someone regularly about your plans to reduce your substance use.


    Giving a good referral1

    Giving a Good Referral

    Close & Referrals

    4. GIVE A NAME : Whenever possible give the name of a specific individual to the participant. If you can add something about what this person has to offer, it may help clients feel more comfortable following through on the referral.

    5. EXPLORE OBSTACLES AND SOURCES OF SUPPORT FOR FOLLOW-THROUGH: Many people do not follow through on referrals. Discuss this frankly with clients and problem-solve ways to overcome obstacles, if they exist.

    6. INVITE FEEDBACK: Ask clients to let you know if the referral does not work out for any reason. Such feedback can alert you early on to changes in or misunderstandings about your referral resources.

    Regardless of HIV status, clients should be referred to STD testing !


    Thank you for all your hard work

    Thank you for all your hard work!

    We have covered a lot of material in this online pre-training course. By now you are well prepared for the HIV Counselor Training.

    The HIV Counselor Training is an intense, hands-on learning experience. It includes opportunities to discuss counseling issues and practice skills. You will watch experienced counselors model the Prevention Counseling and Disclosure portions of the HIV counseling session. You will have opportunities to practice specific sections of the counseling session and to get feedback. You will be trained and certified to administer and read the Stat-Pak Rapid HIV-1/HIV-2 Antibody Test.

    This online training has given you the background to be a knowledgeable and engaged participant in the live training. We hope you feel confident and committed to participating actively in that training. It will help you be an effective HIV test counselor.

    You have now completed the training and are ready for your Course Mastery Test. This test will reflect important information you have learned throughout this training. You must score at least 80 percent on this test to be eligible to take the HIV Counselor Training.


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