However lacking engagement in counselling, it is unlikely that such clients would receive HIV prevention. Table 1 , summarises a number of empirically informed recommendations for counsellors to reduce CBCs and ameliorate the integration of HIV prevention in substance abuse counselling with men who have sex with men. Transcripts of hearings are also made available on the website. It was also discovered that levels of sexual satisfaction were shown to be higher among women and men in the experimental group who had attended premarital sexual counselling education than the women and men in the control group. By creating distance, Clara signalled a lack of interest and potentially reduced the likelihood that he will talk to her about HIV in the future. Other CBCs may exist and those ought to be studied further to reveal how they hinder counselling. Second, we will describe how these manifestations hamper the integration of HIV prevention into counselling. You could say that something has changed. The following CBCs will be explored:
Also, a counsellor would need to assess for any risks of domestic or partner violence. Therefore, Clara should inform Kris that she has a duty to warn and allow him to determine how to proceed. Clara revealed that she held biases toward Kris for not being responsible and telling his wife that he had tested positive. Finally, the avoidance of certain topics refers to overlooking sexual matters or deliberately diverting conversations away from sexual practices or pleasure. The following CBCs will be explored: The Victims Access Line provides information, referral and support to victims of crime. Therefore, growing up in a society that is both homophobic and heterosexist impacts all individuals, including counsellors. Since the above case illustration was conceived by the authors, it does not reflect an actual interaction, but rather highlights salient concepts in order to emphasise the CBCs discussed in this paper. However, culture-based countertransferences CBCs may hamper this effort. The most important thing is that she protects herself and that you continue to work on your marriage. This is an example of how assumptions reveal biases and curtail candid discussion of sex and HIV transmission. It is thought that an intervention plan prepared within the framework of the Information, Motivation, Behavioural Skills theoretical model will help nurses guide recently-married couples to greater sexual satisfaction. Clients who have positive experiences remain in treatment longer and are more likely to reduce HIV risk. Without such information, counsellors cannot intervene to help clients prevent HIV transmission. Rather we are demonstrating how counsellors may use this model, which happens to be grounded in a psychodynamic theory, to understand their own behaviour. Third, we will make recommendations for reducing these manifestations and for promoting HIV prevention with men who have sex with men in treatment for substance abuse. Approval rates for sexual myths in the pre-test were The interaction highlighted is not meant to cast a negative light upon counsellors, but to illustrate the points made above. These perceptions can limit objectivity and effectiveness Forrest Rural and urban substance-use counsellors were compared and exhibited similar attitudes toward and knowledge about men who have sex with men Eliason and Hughes , despite the fact that urban counsellors reported more training and education about sexual diversity. Has anything changed this the last time we saw each other? Counsellors who hold this belief may marginalise same-sex relationships. Counsellors may discuss program rules and policies excessively or offer unsolicited advice to clients in an effort to prevent the client from speaking about same-sex sexual practices or relationships. In fact, Kris initiated the conversation with the counsellor as a preliminary preparatory step to talking about his HIV status with his wife and others in his life. Distancing Clara suggested that Kris attend more support groups in response to his assertion that he is at risk of relapse. Men who have sex with men are at heightened risk for substance use disorders US Department of Health and Human Services due to stigma and discrimination McKirnan and Peterson ; Melendez and Pinto , stress and depression Hughes and Eliason and shame around same sex sexual practices Diaz et al. Clara ought to assess for the threat of any violence or retaliation if Kris discloses his status.
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