HIV/AIDS Counselors and Case Managers

HIV/AIDS counselors and case managers help HIV and AIDS patients deal with their illness in the best way possible. A person who has tested positive for HIV or who has been diagnosed as having AIDS has to deal with many issues. Some of the issues are similar to those faced by anyone diagnosed with a potentially terminal illness—grief, fear, and concerns over health care, financial planning, and making provisions for children or other family members. Other issues these patients may face are unique to HIV and AIDS sufferers. These may include discrimination, prejudice, and exclusion by family and acquaintances who are afraid of or do not understand the disease. Another special consideration for these patients is how to avoid passing the disease on to others.

Counselors and case managers offer support and assistance in dealing with the various social, physical, and emotional issues patients face. Together counselors and case managers work with clients in all stages of the disease—from those who have first tested positive for HIV to those who are in the final stages of the illness. They may work at HIV testing centers, public health clinics, mental health clinics, family planning clinics, hospitals, and drug treatment facilities.

Counselors who work at testing facilities, sometimes called test counselors, work with individuals who are being tested for HIV. These counselors usually meet with clients before they are tested to find out about the client's level of risk for the disease, to explain the testing procedure, and to talk about what the possible test results mean. They also explain how the HIV infection is spread, discuss ways to prevent it, and answer general questions about the disease and its progress.

Depending on the type of test, results can become available after 10 to 20 minutes. Results for other tests may take up to two weeks after the client has had the initial meeting. When the client returns to find out the results, the counselor again meets with him or her. If the results are negative, the counselor may suggest re-testing if, during the six months before the test, the client engaged in any behaviors that might have resulted in infection. Since the infection does not show up immediately after it is contracted, it is possible to be infected and still test negative.

If the results are positive, the counselor talks with the client about his or her sexual activity and drug use to determine how they might have gotten the disease. They also help them decide whom to notify of the test results, such as previous sex partners.

At some testing clinics, such as those offering STD (sexually transmitted disease) testing as well as HIV testing, a client initially meets with a nurse who conducts the test. In these circumstances, when the client returns for the test results he or she may then meet with an HIV counselor if necessary.

The counselor is often the first person the HIV-positive client talks to about the illness. A large part of the job, then, is referring the client to appropriate sources of help, including AIDS-related agencies, social services, and health care providers.

Case managers, unlike counselors, follow patients through the various stages of their illness, helping them coordinate and manage the resources necessary to deal with it. In some instances, case managers may not begin working with a client until that client has developed AIDS. Through e-mails and letters, phone calls, and contacts with a network of available service providers, case managers help their clients get access to the agencies or organizations that offer the assistance they need. Assistance may include medical care, legal help, help with living expenses, or visits by home health care aides.

People with HIV and AIDS are under severe emotional strain. In addition to coping with the physical effects of the disease, they must also cope with the burden of having a disease that much of society does not understand or accept. They may feel anger, depression, guilt, and shame as they learn to live with their disease.

Counselors and case managers help clients deal with these emotional challenges. They may conduct AIDS support groups or group counseling sessions in which HIV or AIDS patients discuss their experiences and questions about living with the disease. In these group sessions, the counselor or case manager oversees the conversation and tries to move it in a positive direction.

HIV/AIDS counselors and case managers may also work with the family members, friends, and partners of those with HIV or AIDS, either in individual or group sessions. They may meet with family members or partners to discuss the client's progress or to help them understand their loved one's needs. They may also set up and oversee grief counseling sessions for those who have lost relatives or partners to the disease.

In order to monitor clients' progress, case managers keep written records of each of their sessions. They may be required to participate in staff meetings to discuss a client's progress and treatment plan. They may also meet with members of various social service agencies to discuss their clients' needs.

In addition to the primary duty of counseling clients, these workers may participate in community efforts to increase HIV and AIDS awareness. They may help develop workshops, give speeches to high schools or other groups, or organize and lead public awareness campaigns.

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