Session 5

1. Session 5 Risk Assessment and Reduction Counselling

2. Learning objectives • Risk assessment and Counselling for risk reduction

3. Risk assessment • Changing behavior is a complex process. • Risk assessment is the first step towards counselling for HIV. • Risk assessment should involve the identification of the potential adverse effects.

4. Risk Assessment • Number of sexual partners during past 3 months, including new partners. • Gender of partners • Sexual practices (anal, oral, vaginal intercourse) • Condom use or other safe sex practices; History of unintended pregnancy • Alcohol and/or drug use prior to sexual activity • Injection drug use (IDU) and needle-sharing practices • Past history of STI

5. Case study 1: • A woman comes to you with a complaint of vaginal discharge, for the last two weeks. She mentions that it is continuous and causes a bad smell. Recently, her husband also complained of burning sensation while passing urine. What will you do?

6. Case study 2: • After conducting a one‐group education on STI and HIV in the community, a youth walks up to you and informs you that his friend is suffering from a genital ulcer and wants to know what to do. You begin to explore his knowledge about STI. He then admits that he himself has the ulcer, which he noticed a few days ago? What will you do?

7. Risk Reduction • Behavioral change is affected by multiple factors • Knowledge alone does not produce behavior change • Client-centered Counseling for risk reduction • Skills • neutral, non-judgmental attitude, open-ended questions, review and acknowledge positive risk-reduction client has tried, assist client identify barriers to risk reduction and address misconceptions.

8. Summary of session • Possible to prevent STI HIV • Knowledge on STI/HIV important not sufficient for behaviour change • Treatment of STI important • Counsellor – sensitive taking history of client • Risk reduction should be contextualized to ensure implementation