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PYC2605/202/2/2015

Tutorial letter 202/2/2015

HIV/Aids care and counselling


PYC2605

Semester 2

Department of Psychology

Feedback on Assignment 02.


1 INTRODUCTION

Dear Student,
We hope that you are enjoying your module in HIV/Aids care and counselling. If you find the
course helpful, please tell your friends and colleagues about it. Remember, it is possible for
students to enrol only for this one module for non-degree purposes, if they wish to do so.
The only prerequisite for the course is matric (Standard 10/Grade 12). It may also interest
you to know that almost 6 000 students enrol for the HIV/Aids care and counselling course
(PYC2605) per year!
The main purpose of this tutorial letter is to give feedback on Assignment 01. However,
before we do so, lets address some other issues first.

Assignment issues

In the previous semester, many students did not get examination admission because (a)
their assignments were never received by Unisa; (b) the assignments reached Unisa after
the closing date; and (c) the assignments were submitted in the wrong semester. Please
note that it is your own responsibility to make sure that Unisa has received and marked your
assignments. Please check myUnisa regularly to see if your assignment has been received
and marked. If you check the system regularly and it seems that your assignment was not
received or marked, please direct your enquiries to the Students Assessment and
Assignment Department. Please do not contact your lecturers to find out what happened to
your assignments. Your multiple choice assignments go directly to the Assignment section to
be marked by computer. Unfortunately, lecturers do not see your multiple choice
assignments at all.
Please note that you have to submit both Assignments 01 and 02 to gain examination
admission. Together the two assignments contribute 20% to your final year mark.
Please take careful note of your assignment closing dates. In each semester there are
two compulsory multiple choice assignments each with a specific closing date and
unique number.
Make sure that you know exactly if you are registered for the first or for the second
semester. Use the assignment closing date and unique number of that specific semester
ONLY on your mark reading sheet. If you are registered for the 2nd semester, please do not
submit your assignments for the 1st semester closing dates or use the 1st semester unique
numbers. Your assignment will NOT be registered on the system and it will get lost.

The Study Guide and CD-ROM

Do you enjoy your study guide? We surely had a lot of fun writing it! Some students find the
study guide a bit daunting but keep in mind that the purpose of the guide is only to guide you
through the prescribed book and to challenge you to think differently about HIV and Aids and
to motivate you to do things in your communities. There will be no examination questions on
the content of the guide directly. The examination questions are based on your prescribed
book only, but the guide will tell you what to study in your prescribed book (in the READ
sections) and it will explain some of the more difficult material to you. The CD-ROM is
material for further enrichment, and there will definitely not be exam questions on that.

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Declaration Letters

As discussed in Tutorial Letter 101/2015, you will automatically receive a Declaration Letter
after successful completion of this module. Please note that we cannot re-issue this Letter of
Declaration if you do not receive it the first time or lose it. Please make sure that you receive
your Declaration Letter by following three simple steps:
(a) Make sure that Unisa has your most recent postal address. We will send your
Declaration Letter to the address that you registered with Unisa. If your address
changed, please notify Unisa (not the Psychology Department) to change your address
on the student system (fill in the form at the back of my Studies @ Unisa and send it
to The Registrar (Academic), PO Box 392, UNISA 0003). You can also change your
details by logging into myUnisa.
(b) Please make sure that all outstanding fees are paid. If your study fees are in arrears,
Unisa will unfortunately not release your exam results, and we will not be able to issue
the Declaration Letter either.
(c) Return all your library books that are outstanding. Unisa will not release your exam
results if you still have library books in your possession.
Note: We do NOT print or issue the letters of declaration in our offices in the Department of
Psychology. Please do not visit us on campus to issue the letters because we are not able to
do so.

The examination paper

Tutorial Letter 103 contains a practice examination paper to familiarise you with what to
expect in the examinations. Please make use of the opportunity to see if you can complete it
(without your prescribed book) within the two hours allowed for the paper. DO NOT send
your answers to Unisa to be marked. You will find the answers at the back of the tutorial
letter for you to mark your own paper. Old examination papers for this module are available
on myUnisa.

Feedback on Assignment 02

The purpose of this assignment was to help you to assess where you are in terms of your
HIV and Aids reading and comprehension skills, knowledge and attitudes at this early stage
of your studies. Use your assignment mark and our feedback to sensitise you to possible
problems in your learning.Table 1 gives a summary of the correct answers to Assignment 02.

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Table 1. Correct answers to Assignment 02.

Question Assignment 2 Question Assignment 2


correct answer correct answer
1 2 11 3
2 2 12 2
3 3 13 2
4 1 14 4
5 3 15 2
6 2 16 3
7 1 17 1
8 1 18 4
9 4 19 2
10 2 20 3

In the remainder of this Tutorial Letter I will provide you with each question, the right answer
and either a short explanation with the relevant page number in the prescribed book, or
only the relevant page number in the prescribed book. Please read these sections and
make sure you understand why the indicated answer is the correct one. This process will
guide you towards a better understanding of the sections in which you did not perform well.

QUESTION 1
What feature of the HI virus makes it so effective and so difficult for the immune system to
kill?

(1) Although it is a very fragile virus, it has the ability to survive harsh conditions and
environments.
(2) The important defensive cells of the human immune system (i.e. the CD4 cells) have no
way of defending themselves against the HI virus.
(3) The fact that the HI virus reproduces inside the human body.
(4) The reproduction rate of the virus is too quick for the immune system to be able to kill it.

Feedback on Question 1
The correct answer is 2. Consult your prescribed book, p. 31 (the last paragraph of the
section The uniqueness of HIV that starts on p. 29), for more clarity.
QUESTION 2
How do the macrophages warn the lymphocytes (B and T-cells) that they should mobilise to
protect the body against an organic invader such as a virus? The macrophages
(1) swallow the virus and then carry it to the lymphocytes, which then destroy both the
macrophages and the virus.
(2) surround the virus, grab an antigen from it and display it like a banner of war in order
to mobilise the lymphocytes.
(3) surround the virus and render it inactive until the lymphocytes find it and kill it.
(4) swallow the virus and, when the macrophages die, the virus dies with them, thus
warning lymphocytes about the presence of the foreign antigens in the process.
Feedback on Question 2
The correct answer is 2.
Read the paragraph Warning of the Special Forces or T cells on p. 24.

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Question based on Chapter 3.


QUESTION 3
Jacob is a teenage boy who has heard a lot about HIV transmission from his friends.
However, because there are so many myths about how HIV is transmitted, it is difficult for
him to distinguish between fact and myth. As a health-care worker, you ask him to compile
examples of facts and myths about transmission. Jacob gave a correct answer by stating
that transmission of HIV through (a) ____ is a fact, while transmission of HIV through (b)
____ is a myth.
(1) (a) coughing or sneezing (b) handshaking or hugging
(2) (a) unprotected sex (b) breastmilk
(3) (a) contact with infected blood (b) mosquito bites
(4) (a) swimming pools (b) blood transfusions
Feedback on Question 3
The correct answer is 3. HIV cannot be transmitted through coughing or sneezing,
handshaking and hugging, mosquito bites, and nor through swimming pools (p. 51).
Questions based on Chapter 4.

QUESTION 4
The health status of an HIV infected person can be predicted by
(1) doing a CD4 cell count. The lower the CD4 cell count, the sicker the person will be and
the higher the possibility of opportunistic infections.
(2) measuring the viral load in the persons blood. The lower the viral count, the sicker the
person will be.
(3) counting the number of opportunistic infections the person had over the last four
weeks. More opportunistic infections are an indication of an inadequately functioning
immune system.
(4) testing the patient for tuberculosis.
Feedback on Question 4
The correct answer is 1. A poor health status is related to a higher viral load in the body
(Answer 2). Opportunistic infections and TB (Answers 3 and 4) are the results of a poor
health status, but the CD 4 cell count is a predictive value (Answer 1). (Consult p. 62).
QUESTION 5
The treatment of STIs (sexually transmitted infections) in Africa is based on either the
diagnostic or the syndromic management approach. The following are some of the
advantages of syndromic case management:
(a) It does not require laboratory support.
(b) It is impossible to over-treat patients by giving them more drugs than they actually
need.
(c) It does not require highly trained STI specialists.
(d) A definite diagnosis of the STI can be established by identifying the organism that
causes it.
The correct answer is:
(1) (d)
(2) (b) and (d)
(3) (a) and (c)
(4) (a), (b), (c) and (d)

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Feedback on Question 5
The correct answer is 3. In the syndromic approach health care workers, who do not have to
be highly trained STI specialists, look at the clinical signs and symptoms the patient
experience to base their treatment on. No precise diagnosis is made based on results of
laboratory tests that looked for specific organisms. Therefore it is also possible to over-treat
the patient. (Consult p. 87).

Questions based on Chapter 5.

QUESTION 6
If you were a health care worker in a remote rural clinic where only Rapid HIV antibody tests
are available, which procedures would you follow to eliminate possible false negative or false
positive test results?

(a) Making sure that the tests are stored at the correct temperature.
(b) Always using the tests within two weeks of receiving them.
(c) Confirming all positive results with a second Rapid test from the same batch of tests.
(d) Confirming all positive results with a second Rapid test from a different batch of tests.
(e) Always retesting an HIV positive person with a p24 antigen test.

The correct answer is:


(1) (a) and (b)
(2) (a) and (d)
(3) (a), (b) and (e)
(4) (b) and (c)

Feedback on Question 6
The correct answer is 2. The tests have to be used before the expiry date. To control for a
possible defective Rapid test, a confirmation test cannot be made from the same batch of
tests as all the tests in that batch may be defective. Retesting with a p24 antigen test is for
early detection and requires a laboratory that will not be available in a remote area.
(Consult p. 100).

Question based on Chapter 6.

QUESTION 7
What are some of the disadvantages of antiretroviral therapy?
(a) Some antiretrovirals have very negative side-effects on some patients.
(b) Antiretroviral therapy may prolong the life of the patient.
(c) Antiretroviral therapy involves a strict and complex medication regime which is often
difficult for patients to follow.
(d) Antiretrovirals has to be taken every day throughout a person's life.

The correct answer is:

(1) (a), (c) and (d)


(2) (a), (b) and (d)
(3) (c) and (d)
(4) (b) and (c)

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Feedback on Question 7
The correct answer is 1. To prolong the life of the patient is the aim of ART and is therefore
not a disadvantage. (An understanding of Chapter 6 make it possible to correctly answer this
question).

QUESTION 8
It is widely accepted in the scientific community that an adherence level of (a)____ % is
necessary to suppress the virus sufficiently to avoid the risk of (b)____ and to prevent
(c)____.

(1) (a) at least 90%; (b) mutation; (c) development of drug-resistant strains
(2) (a) 100%; (b) drug failure; (c) opportunistic infections
(3) (a) 95%; (b) opportunistic infections; (c) development of drug-resistant strains
(4) (a) at least 90%; (b) wild-type viruses gaining fitness; (c) drug failure

Feedback on Question 8
The correct answer is 1. This statement is based on research and agreement within the
scientific community. (Consult p. 121).
Questions based on Chapter 7.

QUESTION 9
One of the principles of behaviour change is that the counsellor should be absolutely specific
about the behaviour that needs to be changed. It is therefore important to identify the action,
target, context and time of the behaviour that you want to change. The important conceptual
difference between casual sex once a week and casual sex once a year refers to the _____
of the behaviour.

(1) action
(2) target
(3) context
(4) time

Feedback on Question 9
The correct answer is 4. Time refers to how often the behavior occurs. (Consult p. 138).

QUESTION 10
According to the health locus of control theory, people with an external locus of control

(1) will be more inclined to change their sexual behaviour, because they believe in their
ability to carry out the required behaviour in order to promote their own health.
(2) believe that they have no control over their own health, and will be less inclined to
change their sexual behaviour in order to prevent illness.
(3) will not change their sexual behaviour, because they feel so self-assured that they do
not realise the need to change their behaviour in the first place.
(4) believe that they have external control over their own health, and that they will be able
to change their sexual behaviour whenever they want to.

Feedback on Question 10
The correct answer is 2. In Answers 1, 3 and 4 the people see that their ability (or decision)
to change their behaviour comes from within. It is a decision to be made and ability they
possess. The person in Answer 2 do not see that he/she has control over his/her behaviour
and therefore has an external locus of control. (Consult p. 141).

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QUESTION 11
An important principle of stages of change theories is that

(1) one intervention plan fits all individuals so it is an easy model to use for behaviour
change.
(2) behaviour change moves in a linear fashion through the various stages.
(3) the Aids educator firstly have to establish in which stage of change a person is before
an appropriate behaviour change intervention can be planned.
(4) change is an individual process and the individuals needs must be taken into account
when planning a behaviour change intervention.

Feedback on Question 11
The correct answer is 3. For a clear overview of the stages of change theory and its
principles consult p. 143.

QUESTION 12
A negative attitude to members of a group, based solely on their membership of that group,
is called

(1) a stereotype.
(2) prejudice.
(3) a misconception.
(4) discrimination.

Feedback on Question 12
The correct answer is 2. A negative attitude can be based on a misconception but is not a
misconception in itself. To clearly distinguish between a stereotype, a prejudice and
discrimination consult p. 154.
Questions based on Chapter 9.
QUESTION 13
The femidome or female condom empowers women by giving them control over their sex
lives. What are the some of the advantages of the female condom?
(a) Because it is made of latex, it requires no special storage.
(b) It can be used with water- and oil-based lubricants such as Vaseline, KY-Gel, baby oil
and cooking oil.
(c) It can be inserted an hour or so before intercourse.
(d) It can be used by a woman without her male partner knowing about it.
The correct answer is:
(1) (c)
(2) (b) and (c)
(3) (a) and (d)
(4) (a), (b), (c) and (d)
Feedback on Question 13
The correct answer is 2. The female condom is made of polyurethane plastic or nitrile and
therefore it does not have special storage requirements. It is very unlikely that her male
partner will not know about the condom because of the external ring. (Consult p. 170).

Question based on Chapter 11.

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QUESTION 14
The collective existence of traditional Africans should be kept in mind by AIDS educators
when they work in Africa. What is meant by the concept collective existence?

(1) Collective existence is based on the unity of the person with his or her community, with
the emphasis on the self.
(2) Collective existence is based on principles such as the interest of the group,
independence and individualism.
(3) Collective existence is based on values such as the interests of the group, survival of
the community and total control and power over nature.
(4) Collective existence is based on the notion that the traditional African cannot exist
alone and that his or her identity is totally embedded in the community or tribe.

Feedback on Question 14
The correct answer is 4. A collective existence does not promote emphasis on the self,
independence, and individualism. It also does not promote total control and power over
nature but believes in unity with nature. (Consult p. 227).

Questions based on Chapter 12.

QUESTION 15
The counselling process can be divided into four phases. The goal of the relationship
building phase is to (a) ___, while the goal of the phase that involves helping the client to tell
his or her story is to (b)___.

(1) (a) get to know the client well


(b) set goals and to decide on methods of achieving them
(2) (a) establish an open relationship
(b) get insight into the client's context
(3) (a) set goals and to decide on methods of achieving them
(b) get to know the client well
(4) (a) get insight into the client's context
(b) facilitate self-exploration and clarify feelings

Feedback on Question 15
The correct answer is 2. Get clarity on the phases of counselling and the goals of the various
phases you can consult pp. 240 247.

QUESTION 16
During the counselling session, your client Pete discloses to you that he is HIV positive and
explains that the reason for not telling you before was because he feared your response.
How would you, as the counsellor, respond with a view to demonstrating basic empathy?

(1) You remain silent after Petes disclosure because you are not sure what to say and you
think that silence would be better than a brief response.
(2) You match Petes emotional tone, even if it means you are not being yourself in that
moment.
(3) You name the relevant emotion expressed by Pete and refer to the relevant experience
that gave rise to his feelings.
(4) You appreciate the importance of Petes disclosure and therefore use the standard
response recommended by Egan for client's self-disclosure, rather than your own
words.

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Feedback on Question 16
The correct answer is 3. In this case you have recognized and acknowledge Petes feelings
but did not experience the same emotions. (Consult p. 251).

QUESTION 17
In which one of the following would you have conveyed advanced empathy in response to
Pete telling you that he does not want to disclose his HIV positive status to his wife?

(1) Maybe you feel guilty about what happened and fear your wifes response?
(2) You feel that your wife was the unfaithful one.
(3) Do I understand you correctly if I say that you do not want to tell your wife at this stage
that you are HIV positive?
(4) I know that your wife will forgive you.

Feedback on Question 17
The correct answer is 1. In this case you have focused on the message behind the clients
message. (Consult p. 255).

QUESTION 18
According to Egan (1998), probing involves statements and questions from the counsellor
that enable clients to explore a relevant issue in their lives more fully. According to Egans
principles, which one of the following questions would best demonstrate this technique?

(1) Is that acceptable to you?


(2) Did you agree with his response?
(3) Does your partner understand your condition?
(4) Could you tell me more about that experience?

Feedback on Question 18
The correct answer is 4. The first three questions will elicit yes/no answers while the fourth
question will enable exploration of the issue. (Consult p. 253).

Questions based on Chapter 13.

QUESTION 19
Suzi is 16 years old and has been sent by her mother for an HIV test. She explains to you
that her mother is convinced that she is already having sex with her boyfriend. She,
however, tells you that she is not sleeping with her boyfriend. On the basis of the above
information, which one of the following actions is the most appropriate for you to take?

(1) You can see that Suzi is telling the truth and you decide to send her for the HIV test
without providing counselling, because you already know that the results are going to
be negative.
(2) You know that 16 is a vulnerable age and so you spend some time getting to know
Suzi, hoping that she will open up more to you as the pre-test counselling continues.
(3) You do not know who is telling the truth and so you send Suzi back home with a letter,
explaining that the reasons for HIV testing must be clear before counselling can
continue.
(4) You do not simply want to believe that Suzi is telling the truth, and so you spend the
pre-test counselling session telling her about the moral implications of sleeping with
ones boyfriend before sending her for the test.

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Feedback on Question 19
The correct answer is 2. It may be difficult for Suzi to share intimate detail with you and
therefore relationship building is important. It will also help to clarify her reasons for being
tested as it will give direction to the pre-test counselling session you conduct.
(Consult p. 270).

Question based on Chapter 14.

QUESTION 20
With the definition of crisis intervention in mind, which one of the following counsellors
provides crisis counselling?

(1) Counsellor A views crisis intervention as a form of emotional first aid to support and
help the client. He therefore takes a passive, non-directive and empathic stance to find
a quick solution for the clients problem.
(2) Counsellor B knows that the only way to help a client through a crisis is to establish a
long-term helping process. He is attentive, non-directive and respectful and makes sure
that his client has access to ongoing therapy.
(3) Counsellor C realises that this is an emergency situation and that his role is to provide
immediate relief for the client. He therefore takes an active role and decides what
should be done to help the client through this crisis.
(4) Counsellor D defines crisis intervention as a form of preventing suicide. She therefore
refers the client to an emergency service, and she also realises that this is the time to
be prescriptive, supportive and passive.

Feedback on Question 20
The correct answer is 3. During crisis intervention the counsellor should be directive and act
immediately. During this process there is room to take decision on behalf of the client as it is
an emotional emergency. Read Crisis intervention on p. 297 to gain a clear understanding of
this process.

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We hope that you have learned more than theory in this assignment and that you are
stimulated to read more about new developments in the HIV and Aids field. Best wishes with
all the work ahead, and make the best of it!

Your lecturers in HIV/Aids care and counselling.

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