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Counselling and VCT: The inseparables

NAIROBI, August 25 – According to the Kenya Health and Demographic survey 4 out of 5 HIV positive Kenyans have no idea that they have contracted the virus.

It’s Friday afternoon at Nazareth hospital in Kiambu district. A dull and cold day, the hospital’s corridors are busy, with long queues of patients waiting to see a doctor.

My purpose at the hospital is to find out more about HIV counseling and testing.

I headed straight for my appointment for the day, as l was about to knock, the door opened and a smart looking man in his mid-thirties stood there with a smile.

“I was expecting you,” he said. Perhaps he recognised me from my ‘Capital FM’ branded T-Shirt.

 “Please come right in, I am Dr. Thomas Macharia. I work here at Nazareth Hospital as a doctor in charge of the HIV care services,” said he.

Doctor Macharia tells me that Nazareth has a special HIV testing service, called Diagnostic Counseling and Testing (DCT). 

Here, he adds, patients are encouraged to take an HIV test, even if a person did not visit the hospital for that purpose.

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“A diagnostic test is one that is initiated by a doctor as they seek to detect a patient’s ailment,” Dr Macharia proceeds. “This is as opposed to the voluntary test where an individual seeks to know their status.”

He explains that medics here have adopted counseling as an integral part of the testing process.

“When we want to conduct a diagnostic HIV test on a patient, we first explain to them about the test and why we feel it’s important to do it.”

Confidentiality is also critical, Dr Macharia adds, saying results are only released to the patient and to a third party only if somebody else’s life is in danger.

‘’Remember we must seek consent of the person before we divulge these test results to any other party and we must tell the patient why we are divulging these results to the other person.  The guidelines are very clear on the spouse or the people we call ‘at risk’; the patient must be given enough time to, if possible, divulge this information to the spouse but if enough time was given and the patient has not yet divulged the information we are technically supposed to release the information to the spouse.’’

“My name is Ann Mburu and I’m here to counsel you about the test.”

Ann is one of the hospital’s trained counselors. I find her with her fifth patient for the day.

She tells me that counseling plays a major role in guiding the patient’s healthy living.

“We give emphasis on counseling because we have to prepare the patient. Even if it is a diagnostic test, you don’t just go point blank and give results.” Says Mburu. “We first have to prepare the patient and this is where counseling comes in.”

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However, not everybody who has taken a test has been fortunate enough to undergo counseling.

Angela Gathoni was diagnosed HIV positive in India, where she had gone for studies.  The hospital she was admitted to did not have trained counselors.

“For me since it’s a doctor who came and told me ‘Angela, you are HIV positive and you are going to die.’ I was devastated because doctors are supposed to give hope not drop a bomb shell, you can imagine my reaction at that point,” she says. 

‘’I was deported to my home country but I have learnt to live with my condition and at times even joke about it. We have moved a milestone,” says Angela. “With the introduction of Voluntary Counseling and Testing Centers, nowadays patients are assured of better services since they are offered pre and post counseling.”

Today there are many hospitals with DCT services in Kenya. There are also VCT centers for testing and counseling. 

You would not have to go through what Angela had to go through with the modern services available.

Visit any VCT center today to know your status or allow doctors to test you for HIV when they think it is necessary.

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