While the Philippines has been listed as a low prevalence country for HIV infection, the trend changed in 2007 onwards. Increases in new infections were noted at unusually high rates that in 2013, the Department of Health pegged the number of new infections to 13 Filipinos a day. This means that one Filipino is infected every 2 hours.
There is no other urgent time than today for health care providers to receive HIV-positive individuals at our health service facilities. It is also imperative to regard counseling as crucial and essential.
The AIDS Society of the Philippines (ASP), in partnership with the Philippine Obstetrics and Gynecological Society Foundation, Inc. (POGS) Women Reproductive Health Advocacy Committee (WRHAC), embarked on a pilot workshop on “Appreciating HIV and AIDS Counseling” on June 13 and 14, 2013 to build awareness and understanding of the process of counseling on HIV and AIDS and appreciating the need for counseling skills, specifically in the conduct of pre and post test counseling.
Dr. Jose Narciso Melchor Sescon, a fellow of POGS and currently the president of ASP, was the team’s lead trainer for the workshop. Dr. Sescon recalled that “counseling was not part of any medical curriculum – unlike in other paramedical courses such as nursing and social work, but it is still an assurance that they can effectively handle HIV and AIDS counseling processes.” He said, “It is very timely that POGS members be acquainted with what and how the counseling process is correctly undertaken.”
“Counseling is a dynamic process between the counselor and the client, undertaking a common ground, working towards a pragmatic course of action that is realistic and time-bound”, said Dr. Sescon. “At all times, HIV and AIDS counseling is client-centered based and it is where informed decisions are made.”
The entire workshop content was culled from POGS 2012 edition: “A Silent Infection: A Sourcebook on HIV and AIDS Competency.” The primer workshop used lectures, case studies, role-plays and other forms of learning methodologies and techniques. A total of 33 workshop participants attended, 25 of them completed the 2-day appreciation training. All were OB GYN consultants sent by their respective departments from the different POGS-accredited hospitals in Metro Manila, including representatives from Batangas and Cavite City.
The workshop was opened by Dr. Mario Bernardino, committee chair of POGS WRHWA. The “Getting to know you” session was a lively Bingo social activity wherein participants moved around and searched for partners, making way for formal introductions. In the first topic, “Understanding HIV and AIDS”, Dr Nerissa Sescon FPCP, FPSMID, elaborated on the basics of HIV biology, life cycle, modes of transmission, and prevention. Her lecture also explained antiretroviral therapy and information as to where to link HIV services.
Dr. Sescon provided the “Global situation vis-à-vis the local situation of HIV and AIDS in the Philippines”, followed by the “HIV continuum of risks”, in which participants identified a full range of sexual activities and classified them according to the risks of contracting HIV. Dr. Sescon stated that the risks for HIV are different with the risks of contracting other sexually transmitted infections (STI) and health workers have to know this by heart.
Dr. Sescon explained and demonstrated the proper use of condoms in the next session on “Correct and consistent condom use”. The session revealed the fact that most of the OB GYN participants do not know how to use a condom.
The “Psychosocial dimensions of HIV and AIDS” and “All about communication and counseling processes”, were provided by Dr. Anjoy Aguadera and Bro. Lito Cruz respectively. Dr. Aguadera presented a case study that served as a springboard for discussing bio-psychosocial events in the life of a person living with HIV and AIDS. Bro. Cruz emphasized the need to revisit health care providers’ language styles in dealing with “clients”, a term best referred to patients who are undergoing counseling, and how counseling has to highlight verbal and non-verbal cues in communication. Dr. Aguadera also presented the differences between “Voluntary counseling and testing” and “Provider-initiated Counseling and Testing”.
In the session on the AIDS Law or RA 8504, Dr. Sescon stressed the relevant provisions for health service providers to know. He said it is imperative to inform, educate and reduce the risk all patients contracting the virus and cautioned against giving misleading information to clients, such as condoms having holes. Dr. Sescon said the law clearly articulates that an HIV test would need a written informed consent from the client, coupled with the conduct of pre and post test counseling. On confidentiality and disclosure issues, he said it is important that a health care provider knows to whom an HIV test is conducted and disclosed. For each violation of the law, there are corresponding penalties and sanctions to include revocation of medical licenses of the health care provider and health facility.
Bro. Lito Cruz’s session on the “Different Stages of Counseling” entailed a discussion and an actual role-play of what constitutes counseling and what does not. Lorna Garcia, president of Babae Plus, facilitated a review of safer sex practices and condom use.
The participants took turns in counselor and client roles for them to experience how it is done. After a synthesis on learning processes, Dr. Sescon engaged the participants in a “Wildfire” that simulates a client’s HIV test to the time the test result is revealed.
Dr. Ditas Decena, POGS PRO, congratulated the OB-GYN participants for a fruitful and meaningful workshop initiative and for all participants during the closing ceremony. Post test and evaluation of the workshop was conducted to complete the session.