AEGiS-14IAC: Role of counseling in spousal communication to reduce risk of STD/HIV.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Role of counseling in spousal communication to reduce risk of STD/HIV.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. F11743)

Sahasrabuddhe VV, Gholap TA, Jethava YS, Joglekar NS, Brahme RG, Gaikwad BA, Wankhede AK, Mehendale SM
National AIDS Research Institute, Pune, India

ISSUES: Appropriate treatment of sexual partners of male STD patients is critical to curb the rapidly increasing incidence of HIV among married monogamous women in India. Syndromic management strategies that integrate motivational counseling of male STD patients will enhance the scope of treatment for their female partners and reduce their partners' vulnerability to HIV.

DESCRIPTION: A structured questionnaire was administered after written informed consent to 157 male patients attending a Government STD clinic in Nashik, Maharashtra, India to assess their "intent to inform" and "refer their regular sexual partners" (spouses) for clinical evaluation. The attending physicians provided information based counseling which highlighted the modes of transmission of STD/HIV, importance of condom use and the necessity of partner treatment. Patients and their returning partners were linked. Though 121(77.1%) respondents had expressed a positive intent to inform and refer their spouses, only 63(40.1%) of them actually succeeded in doing so. Of the 63 referrals, 61 were spouses of patients who had an initial intent to inform. Information-based counseling had thus motivated only 2 patients to change their negative intent.

ISSUES: Information based, single shot physician-provided counseling neither changed the risk perception of the patients nor motivated them to refer their partners for treatment. The aspect of counseling has to move beyond information to that of evoking concern.

RECOMMENDATIONS: The role of motivational counseling has to be examined in context of barriers to disclosure. Policy around provision of counseling by trained counselor who can engage in discussion and assist in decision making is essential. Recognition, cognition and insight have to be instilled to enhance the scope of partner notification and referral. Redefinition of counseling in the context of client-centered versus couple-centered has to be undertaken.

Keywords: AEGIS, Counseling, HIV Infections, Sexual Partners, Communication, Contact Tracing, HIV Seropositivity, Risk-Taking, Spouses, Ambulatory Care Facilities, Referral and Consultation, Interpersonal Relations, Health Knowledge, Attitudes, Practice, India, Human, Female, Male

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F11743