5 Clinical and Support Services
Intervention from three months post-trauma
• Assess for mental health problems and manage according to mhGAP.
• If survivor has post-traumatic stress disorder, arrange for appropriate therapy.
5.8 Mental health
Mental well-being makes up an integral part of any individual’ s capacity to lead a fulfilling life. Mental health and overall well-being are influenced not only by individual attributes, but also by the social circumstances in which people find themselves and the environment in which they live. Sex workers may be particularly vulnerable to mental health problems, because of poverty, criminalization, marginalization, discrimination or violence.
Poor mental health may be a barrier to seeking testing or treatment for HIV, and to continuing in care for those who are HIV-positive. Programmes should monitor for and address the obstacles to mental health created by HIV service providers who are unskilled in recognizing mental health problems or who actively stigmatize sex workers with such problems.
The WHO mhGAP Intervention Guide provides guidance in evidence-based interventions to identify and manage a number of priority conditions, including depression, psychosis, bipolar disorders, alcohol-use disorders, drug-use disorders, self-harm, suicidal ideation and other emotional or medically unexplained conditions.
5.9 Resources and further reading
WHO guidance relevant to voluntary HIV testing and counselling WHO has issued guidance on HIV testing services since 1988, soon after the first tests were developed. The most recent guidance documents are:
1. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infections: recommendations for a public health approach. Geneva: World Health Organization, 2013. http:// www. who. int / hiv / pub / guidelines / arv2013 / en /
2. Handbook for improving HIV testing and counselling services. Geneva: World Health Organization, 2010. http:// www. who. int / hiv / pub / vct / 9789241500463 / en / index. html
3. Service delivery approaches to HIV testing and counselling( HTC): a strategic policy framework. Geneva: World Health Organization, 2012. http:// www. who. int / hiv / pub / vct / htc _ framework / en /
4. Guidance on couples HIV testing and counselling including antiretroviral therapy for treatment and prevention in serodiscordant couples: recommendations for a public health approach. Geneva: World Health Organization, 2012. http:// www. who. int / hiv / pub / guidelines / 9789241501972 / en /
5. Delivering HIV test results and messages for re-testing and counselling in adults. Geneva: World Health Organization, 2010. http:// www. who. int / hiv / pub / vct / hiv _ re _ testing / en /
6. Guidance on provider-initiated HIV testing and counselling in health facilities. Geneva: World Health Organization, 2007. http:// www. who. int / hiv / pub / vct / pitc2007 / en /
7. Handbook for improving HIV testing and counselling services: field-test version. Geneva: World Health Organization, 2010. http:// www. who. int / hiv / pub / vct / 9789241500463 / en /
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