1. Risk Assessment and Reduction Counselling Session 5

2. Learning objectives Risk assessment and Counselling for risk reduction

3. Risk assessment Changing behavior is a complex process. Risk assessment is the first step towards counselling for HIV. Risk assessment should involve the identification of the potential adverse effects.

4. Risk Assessment 4 Number of sexual partners during past 3 months, including new partners. Gender of partners Sexual practices (anal, oral, vaginal intercourse) Condom use or other safe sex practices; History of unintended pregnancy Alcohol and/or drug use prior to sexual activity Injection drug use (IDU) and needle-sharing practices Past history of STI

5. Case study 1: 5 A woman comes to you with a complaint of vaginal discharge, for the last two weeks. She mentions that it is continuous and causes a bad smell. Recently, her husband also complained of burning sensation while passing urine. What will you do?

6. Case study 2: 6 After conducting a one ‐ group education on STI and HIV in the community, a youth walks up to you and informs you that his friend is suffering from a genital ulcer and wants to know what to do. You begin to explore his knowledge about STI. He then admits that he himself has the ulcer, which he noticed a few days ago? What will you do?

7. Risk Reduction 7 Behavioral change is affected by multiple factors Knowledge alone does not produce behavior change Client-centered Counseling for risk reduction Skills neutral, non-judgmental attitude, open-ended questions, review and acknowledge positive risk- reduction client has tried, assist client identify barriers to risk reduction and address misconceptions.

8. Summary of session 8 Possible to prevent STI HIV Knowledge on STI/HIV important not sufficient for behaviour change Treatment of STI important Counsellor – sensitive taking history of client Risk reduction should be contextualized to ensure implementation