National Guidelines on Management of Sexual Violence in Kenya

7.3 Counseling Related to Possible STIs Including HIV
Infection
HIV Pre- and Post-Test Counseling
Counseling procedures should follow the established <strong>National</strong> HIV testing <strong>Guidelines</strong>.
While the counselor may provide information to the survivor, the survivor may not be
in a position to pay careful attention to the information given to her/him because s/he
is highly traumatized. Therefore, it is essential for the counselor to clarify the survivor’s
understanding of the information provided.
Pre-Test Counseling
The pre-test session introduces basic HIV-information. The benefits of taking HIV-test
should be explained. The implications of HIV test results if positive or if negative and
the HIV testing process should be explained. Then the survivor should be offered the
test on site or taken to the appropriate site for testing.
The window period between the time of exposure to HIV and testing positive for HIV
is approximately 6-weeks. It is possible that a person will show a HIV negative result
when tested but can transmit the virus during this period. It is therefore important to
discuss previous risks and the possibilities of HIV infection prior to the rape.
Post-Test Counseling
It should be remembered that PEP only reduces the risk of infection and does not
definitively prevent HIV infection. This needs to be communicated to the survivor
at the beginning of counseling. Many survivors cannot understand why if they are
HIV negative they are given HIV drugs, whereas if the test is positive these drugs are
stopped. Subsequent counseling sessions should be booked to coincide with PEP
clinical follow ups. Communicate and show the HIV test results to the survivor and
explain appropriate follow up steps. Counselor should be aware of the survivor’s
reaction and advise appropriately.
• If positive: The counselor should refer the survivor to a facility where s/he can
access the following information and services: HIV literacy and psychosocial
support; Clinical assessment; Management of common opportunistic infections
(OIs); Provision of cotrimoxazole prophylaxis; Antiretroviral treatment;
Provision of condoms; PMTCT including family planning and infant feeding;
TB screening and referral; Malaria prevention and treatment; STI management;
Palliative care and symptom management; Safe drinking water interventions.
• If negative: The counselor will ensure the following take place: Prevention
counseling; Partner testing and disclosure; Emotional support; Referral to
additional prevention services as needed e.g. Male circumcision; Needle
exchange for injecting drug users (IDUs); Condoms education and distribution;
Post-exposure prophylaxis (PEP). Safe sex information and condoms should
also be provided appropriately.
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