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Biomedical subjects

R Bor

Publications and source records attributed to R Bor.

At least 19 recordsLinked to original sources
PubMed1992

Discussing safer sex in HIV counselling: assessing three communication formats.

Although it is acknowledged that counselling can be an important factor in behaviour change, we lack information on how HIV counselling works in practice. Research is reported based on transcriptions of audio-tapes of counselling drawn from seven hospital centres in England and the USA. It is shown that communication occurs in the context of three different formats. Certain formats and conversational strategies used by counsellors produce far greater patient participation. Such participation may hold out the prospect of greater behavioural change than simply listening to information and advice.

Communication↗
PubMed1992

Social care services for patients with HIV at a London teaching hospital; an evaluation.

OBJECTIVE: To investigate outpatients' use of, and satisfaction with social care services in an HIV unit. DESIGN: Survey of patients with HIV infection using self administered questionnaire. SETTING: Outpatient HIV clinics at the Royal Free Hospital, London, March-April 1991. MAIN OUTCOME MEASURES: Patients' social circumstances, use or intended use of social care services and satisfaction with social care services. RESULTS: The greatest demand was for counselling about coping with HIV (38% of respondents), available medical treatment (24%), counselling for the HIV test (33%), psychological support for emotional (24%) or relationship problems (16%), advice about housing (24%) and financial matters (20%). In general, the use of social care services by men and women was similar. Twice as many men, however, sought help with payment of domestic bills, compared with women. Women were more likely to seek advice about financial benefits, obtaining sterile injecting equipment and discuss sleep and relationship problems. Thirty eight percent of patients were unemployed. Overall, 84% thought the service was good or excellent. Although less than 40% of patients currently used any one service, 60% thought they would use these services in the future. CONCLUSION: The greatest demand for social care services was for coping with HIV, housing and financial matters, and HIV test counselling. More than half the patients stated that they would probably need social care services in future.

Adaptation, Psychological↗
PubMed1991

Open access clinic providing HIV-I antibody results on day of testing: the first twelve months.

OBJECTIVES: To determine the sociodemographic profile, risk category, and prevalence of HIV-I infection among people attending a clinic providing counselling, medical advice, and results of HIV-I antibody testing on the day of consultation; to determine the stage of infection and peripheral blood CD4 cell count among attenders with detectable HIV-I antibodies. DESIGN: Analysis of prospectively collected data for the 12 months from March 1989. SETTING: Same day testing clinic run by the HIV/AIDS team at an urban teaching hospital. PATIENTS: 561 consecutive people choosing to attend and proceeding to HIV-I testing. RESULTS: The demand for the service caused it to run to capacity within six months. The median age of those attending was 28 years and 65% (364 patients) were male. The overall prevalence of HIV-I infection was 3.9% (22 patients). The greatest prevalence was in men reporting their primary risk as homosexual contact (11.9%, 13/109). The median CD4 cell count in the 22 patients who had detectable HIV-I antibodies was 0.31 x 10(9) cells/l (normal range 0.5 x 10(9)/l to 1.2 x 10(9)/l). Twenty of these patients were asymptomatic (Centers for Disease Control stages II or III), 14 had CD4 cell counts below 0.5 x 10(9)/l. CONCLUSIONS: There is a recognisable demand for a service providing rapid results of HIV-I antibody testing in this setting. The overall seroprevalence of 3.9% is comparable with the 5.8% reported from freestanding clinics in the United States. Most patients with HIV-I antibodies detected in this way are asymptomatic but could benefit from early medical intervention because of low CD4 cell counts.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Counselling patients with HIV infection about laboratory tests with predictive values.

Laboratory tests, including CD4 counts, p24 antigen, raised levels of B2 microglobulin, neopterin and CMV antibodies, have been established as important predictive markers of disease progression in patients with HIV infection. As HIV antibody testing becomes more accepted in medical practice, counselling about these laboratory predictors of progression can help patients and doctors plan together the patients' care and treatment. Addressing patients' main concerns at each stage of investigation and illness may help them to plan ahead of crises, reduce stress, and enhance communication between patients and health care providers.

Adult↗
PubMed1991

AIDS--ten years on.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Research into HIV and AIDS between 1981 and 1990: the epidemic curve.

The main features of research into HIV and AIDS between 1981 and 1990 were examined using a database of medical, nursing and dental journals [compact disc read-only memory (CD-ROM) version of the Medline database (Silver Platter Information Services, London, UK)]. More than 30,000 papers on HIV and AIDS were indexed by Medline between 1981 and 1990. Of these, only 3% were concerned with African populations although a quarter of AIDS cases worldwide were reported from African countries during the decade. The number of papers on HIV/AIDS increased from 24 in 1982 to an estimated 8300 in 1990. Between 1983 and 1988 the number of indexed papers on HIV/AIDS increased at around 50-60% per year; between 1988 and 1989, however, the rate of growth fell to 6%. The percentage of papers discussing the aetiology of AIDS fell from 25 to 3% between 1983 and 1990. During the same period, papers concerned with HIV increased from 2 to 37% of the HIV/AIDS total. Research into drug therapy also accounted for an increasing proportion of indexed papers during the decade. The percentage of papers dealing with prevention and control rose to 18% in 1988, but had declined to 12% by 1990. Priorities for the 1990s should include a renewed interest in aetiology and a sustained emphasis on prevention. Furthermore, countries that have so far been neglected should be granted priority in future research.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Changing patterns in the workload of a district HIV/AIDS counselling unit 1987-90.

OBJECTIVES: To describe the changing workload of an HIV/AIDS counselling unit between 1987 and 1990. DESIGN: Retrospective examination of data collected by the HIV/AIDS counselling unit between 1987-90 on the number of counselling sessions with patients, family members and staff. SETTING: An HIV/AIDS counselling unit established in 1987 in a London teaching hospital. MAIN OUTCOME MEASURES: Number of new referrals to the HIV/AIDS counselling unit and the number of follow-up sessions. Number of counselling sessions with family members, hospital staff and people making telephone contact with the unit. RESULTS: New referrals to the HIV/AIDS counselling unit increased from 117 (1987-88) to 926 (1989-90). Follow-up appointments increased from 403 to 2016 in the same period. Telephone counselling sessions increased five-fold, and counselling sessions with family members nearly ten-fold over the three year period. Staff consultations doubled. CONCLUSION: The increase in the HIV/AIDS counselling unit's workload may be partly attributable to the rising incidence of AIDS in the community, reflecting earlier patterns of HIV infection. In addition, new HIV/AIDS services were developed in the hospital between 1987 and 1990. These included the establishment of a same-day HIV test and result clinic; integrated management of patients with HIV/AIDS, with an emphasis on early intervention in HIV infection; specialist services for families, antenatal clinic attenders and others affected by HIV; and the appointment of a designated HIV/AIDS consultant. New approaches to counselling and training health care providers in counselling skills will assume increasing importance in meeting future demand for HIV/AIDS counselling.

AIDS Serodiagnosis↗
PubMed1991

Evaluation of an intensive 'train-the-trainer' course in AIDS counselling in Zimbabwe.

The anticipated increase in the number of people with HIV infection and AIDS in Zimbabwe, together with those who have associated worries, will place extra demands upon clinical and counselling services in the coming decade. To meet these demands, a wide range of health care staff will have to acquire specialist counselling skills. For this reason, an intensive two-day HIV/AIDS train-the-trainer counselling course was run at the Family Counselling Unit (FCU), Harare, in April 1990. The aim was to teach training and supervision skills in AIDS counselling so that those professionals with experience could confidently teach others counselling skills for people with HIV/AIDS. The structure, content and evaluation of the course are presented here. Overall, the course was positively evaluated by the 42 trainees who came from Harare and other towns in Zimbabwe. The different teaching activities (role play, discussion) and course objectives (to develop specialist skills, address diverse problems) were especially well thought of. However, a few trainees were critical of the teaching format and lack of time available for teaching. This training experience may help others in establishing courses for the training of trainers in AIDS counselling elsewhere.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Interactional problems of addressing 'dreaded issues' in HIV-counselling.

Addressing the patient's fears about the future is an essential task in HIV counselling. The paper examines with conversation analytical methods the interactional dynamics of such discussions in video- and audio-taped counselling sessions with patients coming for an HIV test and others diagnosed as HIV antibody positive. Two communication formats were found to be used in the sessions, one based on information delivery made by the counsellor and the other on interviewing the patient. The interactional tasks in the use of the interview format include persuading the patient to produce his/her own views of the future and moving from mere expression of troubles towards their management.

Communication↗
PubMed1990

New initiatives in a district AIDS counselling unit, 1988-89.

This paper describes the workload of the AIDS Counselling Unit in Hampstead District Health Authority during its second year of service. Between April 1988 and March 1989, the average number of patients seen each month by the Unit doubled. It is anticipated that the caseload in the district will continue to increase, both among those with human immunodeficiency virus (HIV) infection and those without. New initiatives were developed within the district during the year. These included a new inpatient facility for patients with the acquired immunodeficiency syndrome (AIDS), the appointment of a designated HIV/AIDS consultant, and counselling services for people attending the antenatal clinic as well as those entering drug trials. Appropriate counselling services will need to be established in other health districts to meet local demand.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Developing AIDS counselling services: problems and problem-solving.

AIDS counselling is vitally important in the prevention of HIV transmission. It is also widely used in the context of patient management. Culturally sensitive counselling approaches need to be developed for the African setting. Establishing counselling services requires problem-solving, managerial interventions and interpersonal skills, much the same as an AIDS counselling interview. A framework for problem-solving is described in this paper.

Acquired Immunodeficiency Syndrome↗