COUNSELLING
The following areas should be specifically covered in counselling: (i) Diagnosis. The patient should be told the diagnosis, natural history of the disease, sequelae and the effectiveness of therapy.
(if) Treatment. The patient should be told the dose, frequency and duration of medication and the importance of compliance with the full course. Side effects of therapy and what the patient should do if they occur should be clearly explained.
(iii) Sexual activity. Patients undergoing treatment should refrain from
sexual intercourse until treatment is complete. Patients with infectious
STD must be advised how to modify their sexual behaviour.
(iv) Contact tracing. The importance of tracing and investigating the
sexual contacts of the patient must be stressed. Patients generally
respond well when it is explained that sexual partners may be
unaware of the infection and that untreated STDs can have serious
complications.
Information about contacts is sought in order to identify the source contact and to identify people to whom the infection may have spread. Patients are often incorrect in attributing the source of infection.
Contact tracing requires some expertise and public health agencies in the States and Territories may assist. It should be done formally with a list of the names and addresses of contacts and full records of communications with them together with outcomes of investigation, treatment and counselling. The patient’s private medical attendant may undertake the tracing and management of contacts. Patients can be their own contact tracers. Generally, the tracing of contacts of a patient with HIV infection should not be undertaken by the patient. Contact tracing can be a difficult and time consuming task and patients and practitioners may elect to have it done by officers of the health authority.
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