DiscoverCounselor Toolbox PodcastHepatitis and Blood Borne Pathogens
Hepatitis and Blood Borne Pathogens

Hepatitis and Blood Borne Pathogens

Update: 2020-08-05


TIP 37: Substance Abuse Treatment for Persons with HIV/AIDS

Dr. Dawn-Elise Snipes, PhD, LMHC

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• Review current information about the prevention, transmission and treatment of HIV, Hepatitis and Blood Borne Pathogens

• Review current information about hepatitis transmission, symptoms and treatment.


• 650,000 to 900,000 in the U.S. with HIV

• Approximately 3.2 million people in the US are living with Hepatitis B or C

• Hepatitis A is spread by close personal contact with people or things contaminated with feces

• HIV & Hepatitis B & C are most easily transmitted by contaminated blood and body fluids

• The incidence of hepatitis C among people who are heavy consumers of alcohol (e.g. men that consume 4-5 alcoholic drinks a day) is 7x higher than in the general population.

• Vaccines exist for Hepatitis A & B


• Alcoholic hepatitis is caused by drinking too much alcohol and occurs in 20% of alcoholics or approximately 3 million people

• Severe alcoholic hepatitis can develop suddenly and quickly lead to liver failure and death.

Viral Hepatitis Symptoms

• Viral hepatitis symptoms are similar no matter which type of hepatitis you have. Symptoms include:

◦ Jaundice

◦ Fever

◦ Loss of appetite

◦ Fatigue

◦ Dark urine

◦ Joint and abdominal pain

◦ Diarrhea, nausea, and vomiting.

• Incubation period 15-180 days

Risk-Reduction Counseling

• Clinician’s goals

◦ Help and support understanding need for behavior change

◦ Assist addressing cultural practices, beliefs contributing to resisting change

◦ Assist skills development to sustain behavior change

Counseling and Testing

• Pre- and posttest counseling by a trained HIV and Blood borne pathogens clinician

• Counseling should:

◦ Explain limitations of tests (i.e. incubation period and false +/-)

◦ Help clients assess risks

◦ Encourage, reinforce behavior change

◦ Refer infected clients for medical care

Factors for Noncompliance

• Addiction or mental health relapse

• Living in an institution

• Side effects

• Affordability

Increasing Compliance

• Write instructions

• Use timer, ensuring proper dosing

• Use check-sheet, notating dosage

• Provide positive feedback

• Empathize / Advocate regarding medication side effects

• Visual cues for persons with impaired language/cognitive abilities

Avoiding Drug Resistance

Take all medications as prescribed

Drug Interactions

◦ General drug interaction checker

LEARN Sensitivity

• Listen with empathy and understanding

• Elicit cultural information

• Acknowledge and discuss cultural differences and similarities

• Recommend action, treatment, intervention incorporating cultural knowledge

• Negotiate agreements and differences with client

Relapse Prevention

• Events which may initiate client relapse:

◦ Taking an HIV/Hepatitis test

◦ Receiving test results

◦ Experiencing first symptoms of the disease

◦ Experiencing first disease-related hospitalization

◦ Being diagnosed with AIDS or liver cancer / liver failure

◦ Friend or significant other dying from AIDS or hepatitis

◦ Beginning medication regimen for the disease

◦ Experiencing little or no response to various medications

◦ Decreasing CD4+ T cell count or increasing viral load

Relapse Prevention Interventions

• Nutrition (H)

• Relaxation and stress management (A)

• Grief management (A)

• Recreation (A/L)

• Peer support (L)

• Family Counseling (L)

• Sleep (T)

• Medical intervention for pain

Group Therapy









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Hepatitis and Blood Borne Pathogens

Hepatitis and Blood Borne Pathogens

Charles Snipes