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Abstract
Counseling in the use of anti-HIV rapid test: the experience of the Brazilian AIDS program
D. Serafim, D. Ferraz, P. Chequer
Ministry of Health, Brasília, Brazil
Issues: Implantation of rapid test with counseling, as a diagnosis for HIV infection in accordance with the algorithm validated in 2004, is a priority of the Brazilian AIDS Program. The use of this technology was initiated in the state of Amazonas, a region of difficult access and precarious services network. Preparation of teams with no previous experience in counseling was a challenge involving elaboration of specific protocol, training and monitoring instruments. This sought to minimize insecurity in facing up to positive results and to qualify the preventive intervention
Description: Twelve municipalities in the state of Amazonas were selected and 39 professionals of various categories were trained. Three months after implantation, monitoring was done through: direct observation of counseling sessions, interviews with health staff, managers and service users and meetings with health teams
Lessons learned: Reduction on the result waiting time demands greater ability in handling the impact of positive results.
Training promoted changes in the perception of HIV, lessening of prejudices and of the difficulties in approaching positive cases.
Monitoring made it possible to verify the utilization of the training contents and to integrate it into the work process. This was essential considering that quality of counseling depends on experience, reflection on the praxis and service’s organization.
The restricted use and the inadequacies detected in the use of the counseling protocol showed the need of providing the services with standardized orientation for counseling evaluation.
Recommendations: Training should emphasize the attention to specific vulnerabilities, include simulated use of the protocol and qualify the relationship between professional and service user. It should include practical exercise of counseling and cases discussion.
Counseling protocol for primary care services should be simplified facilitating its insertion in the routine.
Periodic monitoring is essential to reinforce service training thus increasing the staff’s confidence and ability and guaranteeing the quality of counseling.
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