Wednesday, December 22, 2010

HIV

A 30-year-old previously well Primigravida @ 12 weeks POA presented to you in a Klinik Kesihatan for booking. Upon routine screening, it was noted that her HIV Rapid Test was positive.


Question 1: How would you approach this patient?

Question 2: What would you do if this patient refuse to proceed with the HIV confirmatory test?

Question 3: What would you do if this patient refuses to inform her spouse regarding the HIV Rapid Test results?

Question 4: If the HIV confirmatory test is positive, what are your next step in managing this patient?

Drug Discussion: What are the medical treatments for pregnant HIV patients according to the clinical practice guidelines? What are the different regimes available?

2 comments:

  1. Salam.
    HIV QUESTION 2: What would you do if this patient refuse to proceed with the HIV confirmatory test?

    ANSWER:
    Good counselling and effective communication is very important in order to make patient understand and willingly to follow the standard steps in making a positive diagnosis of HIV. Health care provider must explore about patient ideas, concern and expectation regarding the reasons why she refuses to undergo the HIV confirmatory testing. Health care provider must discuss with the patient regarding the benefits of the confirmatory testing:-

    1)The patient can seek medical intervention to
    prevent complications of opportunistic infections and to improve the course of the disease.
    2)The patient can reduce the risk of transmission to others,including children.
    3)The patient can make healthful lifestyle changes to improve his or her life.
    4)The patient can be empowered with new
    information and can actively seek help for signs
    and symptoms.

    Healthcare provider also needs to address to the patient that a positive diagnosis can only be made after both HIV antibody screening and confirmatory test must be performed before any HIV diagnosis can be made.

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  2. answer question 3.

    Under the Infectious Disease Act 342 (1988), health care providers are legally
    bound to notify the local health authority about anyone found to be HIV
    positive.31 Providers should recommend that their partners receive HIV
    testing. Health departments can assist patients by notifying, counselling
    and providing HIV testing for partners without disclosing the patient’s
    identity.

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