Slide Set #1: HIV Prevention Counseling and Rapid Testing

Combined HIV Prevention counseling and Rapid Testing training is designed to teach prospective HIV test counselors how to:

- how to run a 20 minute rapid HIV test
- counsel patient in reducing their risk of acquiring or transmitting HIV

All information regarding counseling is based on:

CDC recommendations

Day 1 Agenda

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Day 1 Agenda
Review

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Day 2 Agenda

Counseling Skills

Unit One- HIV & STDS: A CRASH COURSE
OBJECTIVES

Increased knowledge of HIV/STD prevalence in Louisiana
- HIV and STD transmission, prevention and risk reduction methods
- how to communicate this to clients

Unit Two: Rapid Testing and why is it important?

...

OBJECTIVES

- state at least 3 benefits of rapid testing to the individual, service provider, and community
- state at least 2 differences and similarities of conventional and rapid HIV tests
- state 2 reasons why rapid testing is important

Day 3 Agenda

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What are the CDC's strategies for advancing HIV prevention?

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What are some keys to managing your own emotions and stress:

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Benefits of INSTI

Rapid:
Test yields results in as little as 60 seconds
Flexible: Its rapid results makes it easy to include in a variety of workflow models
Compatible: INSTI works with most testing algorithms
Convenient: Stored at room temperature 2-30�C (35.6-86�F)

What are some characteristics of successful people?

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These types of STDs are bacterial:

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These types of STDs are Viral:

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These types of STDs are parasitic:

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These types of STDs can be cured by antibiotics:

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What is the most commonly reported BACTERIAL STD in the US?

Chlamydia

How is chlamydia transmitted?

through oral, anal, & vaginal sex

What are the long term consequences of
chlamydia
?

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These bacterial STDs rarely show symptoms:

gonorrhea and chlamydia

Males or females tend to show symptoms of gonorrhea and/or chlamydia infections more often?

males

T/F
Tertiary syphillis is curable.

TRUE

What is the most common STD in the US?

HPV (human papillomavirus)

What are the signs of HPV?

appearance of genital warts; dome shaped warts

These two STDs can be diagnosed via blood tests and visual inspection

syphilis and herpes

Primary Syphilis

- highly infectious stage
- 3 weeks- 3 months after becoming infected
- 1 or more chancres at the site of infection
- 1/3 of persons who have sex one time with someone infected with primary syphillis will become infected
- 2-5x more likely to contract HIV

What are the signs of Primary Syphilis?

Chancre: small and painless sores often goes unnoticed or are mistaken for something else
- commonly found on vulva, cervix,m penis, anus mouth
- sores clear up in 2-6 weeks

When does
Secondary Syphilis
occur?

6-12 weeks from initial infection
HIGHLY INFECTIOUS STAGE
Symptoms usually go away on their own in 3 months

What are the hallmark signs of
secondary syphilis
?

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Where are chancres most commonly found outside of the genital area?

mouth

What is the only way to detect
Latent Syphilis
?

Screening

What are the effects of
Tertiary Syphilis
?

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What are some methods to reduce the risk of STD infection?

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How is one tested for chlamydia and gonorrhea?

urine test
vaginal swab
anal/oral swab

What are some recommendations for using a vaginal condom during anal sex?

- use of inner ring is optional
-inner ring (or condom tip should be inserted past sphincter muscles for maximum protection
- finger or partner's penis may be used to guide insertion
- treatment as prevention
- safer injection

T/F you should never use oil-based lube with latex condoms

TRUE

What is PREP's mechanism of action?

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What are the recommendations for taking
Post-Exposure Prophylaxis
?

- take PEP w/in 72 hours of potential exposure
- 1-2 pills for 28 days

When should someone take PEP?

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What are some recommendations for safer injection?

- DO NOT share cotton, cookers, water, or drug mixers (vitamin c)
- mark your equipment if in a group setting
- dispose of equipment immediately
- clean your needles

What are some recommendations for sharing equipment?

1. 3x rinse needles and syringe w/ cold sterile water
2. Fill with undiluted household bleach, rinse 3x
3. 3x rinse with cold, fresh, sterile water

Unit Two:
Rapid HIV Testing:
What is it and why is it important?

- state at least 3 benefits of rapid testing to the individual, service provider, and community
- state at least 2 differences and similarities of conventional and rapid HIV tests
- state 2 reasons why rapid testing is important

State 2 reasons why rapid testing is important:

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What are some recommendations for preventing HIV infections?

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What are the CDC's recommendations for HIV/AIDs screenings?

- screen all individuals ages 13- 65
- opt out screening: patients are notified that testing will be performed unless they decline
- people with multiple risk factors should be screened at least annually

What are the CDC's recommendations for Syphilis screenings:

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Providers should routinely test persons for
Syphillis
:

- are pregnant, opt out screening should occur during 1st and 3rd Trimester
- are members of an at-risk population (correctional facility and MSM)
- describe sexual behaviors that put them at risk for STDs (have unprotected vaginal, anal, or oral sexual c

What are the benefits of rapid testing for the individual?

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What are the benefits of rapid testing for the community?

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What are the benefits of rapid testing for the service provider?

- providers are certain they've received results
- connects them to services immediately

Unit Three: Universal Precautions and Safework Practices

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What is
Occupational Safety and Health Administration (OSHA)
BLOODBORNE PATHOGENS (BBP) STANDARDS:

Protect employees from exposure through needle sticks and cuts from sharp instruments contaminated w/ an infected patient's blood or through contract of the eye, nose, mouth, or skin with a patient's blood

What are universal precautions?

consider all human blood and certain human body fluids infectious for blood borne pathogens

Health care personnel are at risk of these infectious diseases:

- hepatitis B Virus (HBV)
- hepatitis C Virus (HCV)
- HIV

What is the
Three Rule
?

- HBV is transmitted in
30%
of exposures
- HCV is transmitted in 3% of all exposures
- HIV is transmitted in .3% of all cases

How is HBV transmitted?

- blood, semen, and vaginal
- survives up to 7 days in dried blood
- more infectious than HIV

OSHA requires that this vaccine be provided free of charge:

HBV

Who is most at risk of HCV?

- intravenous drug users
- 3.2 million infected and don't know their status

What percentage of people with HIV who are also IDU also have Hep C?

- 50-90%; increases in mortality in the past 8 years

How long can HCV survive outside the body?

16 hrs- 4 days at room temperature; longer in 40F

What are some safe work practices?

- using protective equipment
- wash or use hand sanitizer after every test
- dispose of sharps and waste in plastic bag
- DO NOT fill sharps bag more than 3/4 of the way full
- use a freshly prepared solution of 10% bleach to clean the area

What should you throw into the biohazard waste bag?

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What should you do in case of accidental exposure?

- flood the exposed area with water (10-15 minutes) and clean any wound w/ soap and water or a skin disinfectant if available
- report this immediately to your employer
- seek immediate medical attention

Unit Four: Performing Rapid HIV Test & Running Controls

- describe 6 tasks that need to be done before testing as a part of assuring the quality of the test
- demonstrate the steps to conduct two different rapid tests according to the manufacturer's instructions
- perform proper fingerstick blood collection

What are the 5 Rapid tests?

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What does Surecheck test for?

HIV-1