Title: Lessons Learned: Giving HIV Positive Results
1Lessons Learned Giving HIV Positive Results
- The Door A Center of AlternativesAdolescent
Health Center - Carolyn Glaser, L.C.S.W.
- Supervisor, Health Education
- and Outreach
- June 2007
THE
DooR
2The Door Adolescent Health Center
- 1876 HIV Tests given in 2006
- 4 positive results
- 7 Health Educators
- 268 tests per Health Educator
THE
DooR
3The Door Adolescent Health Center
- A LOW AMOUNT OF
- POSITIVE RESULTS
-
- A HIGH AMOUNT OF
- STAFF ANXIETY
THE
DooR
4The Door A Center of Alternatives
- The mission of The Door is to empower young
people to reach their potential by providing
comprehensive youth development services in a
caring, supportive environment, where young
people are treated with respect and
confidentiality.
THE
DooR
5Services Provided at The Door
- Health Care
- Counseling
- Education
- Arts and Recreation
- Legal
- Career
THE
DooR
6HIV Testing Demographics 2006
-
- 1876 Young People Tested
- 79 female
- 21 male
- 1 under the age of 15
- 32 between the ages of 15-17
- 41 between the ages of 18-19
- 26 over the age of 20
- 46 Black
- 35 Latino
- 5 Asian
- 7 White
- 7 Other
- 81 Conventional testing
THE
DooR
7Adjustments Made for Implementing Rapid Testing
- Not offered to walk-in patients only to those
with appointments. - Use of venipuncture rather than the finger stick
or oral swab. - Having a Social Worker or Senior Counselor on
call during the hours that testing is offered. - Staff training.
THE
DooR
8The Adolescent Health Centers HIV Rapid Testing
Training
- One day training for the entire Adolescent Health
Center staff tailored specifically to meet our
needs with a focus on delivering a positive
result. - Learn appropriate language to use when delivering
positive results, what needs to be covered in the
post-test counseling session, anticipate patient
reactions and needs. - Utilization of role playing.
- Forum for staff to discuss their anxieties.
- Give staff confidence they are already
comfortable with and skilled at delivering bad
news.
THE
DooR
9Immediate Steps following Notification of a
Preliminary Positive Result
- The Health Educator who performed the pretest
counseling informs the Supervisor of Health
Education or her designee. Brief planning and
supportive supervision takes place. - The Social Worker or Senior Counselor on duty is
notified and placed on standby. - The medical provider scheduled to see the patient
is notified and placed on standby. - The Health Educator delivers the result.
THE
DooR
10The First Post-test Counseling Session Includes
the Following
- The exploration of thoughts and feelings.
(Includes screening for suicidal ideation.) - A review of the meaning of the preliminary
positive result. - Access the physical and emotional stability of
the young person. (Existing support systems,
housing, income, mental health needs,
employment/education.) - Determine immediate referrals necessary based on
the stabilization assessment. - A discussion regarding medical care and the
Adolescent Health Centers linkages to primary
care providers. - A review of the ways to prevent the spread of the
HIV infection.
THE
DooR
11The First Post-test Counseling Session Includes
the Following (cont.)
- A conversation about the patients current and
past partners and partner notification. - A screening for domestic violence.
- Appointment scheduling for a confirmatory test
and a discussion regarding the likelihood of a
positive confirmatory test result. - A conversation with the young person about how
s/he will immediately cope with the diagnosis.
(Example Who will they tell? What will they do
if they get very anxious or upset? What will
they do for the rest of that day/week?)
THE
DooR
12Following the Post-test Counseling Session
- A blood sample is automatically sent out for the
confirmatory test. - Supportive supervision of the staff member
continues. - The Health Educator remains in contact with the
patient as needed while s/he waits for the
confirmatory result. - The Health Educator presents the experience at a
team meeting so the rest of the staff can learn
from his/her experience. - The patient returns for the confirmatory result
and a second post-test counseling session occurs.
This session will include linkages to care and
the completion of partner notification.
THE
DooR