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Case StudiesThese case studies are designed to be completed after you have studied the content in each section, but you can complete them any time you feel ready. Case studies allow you to apply what you have learned in this course to real-world situations. Case Study #1:Martina is a 27-year-old woman with HIV. She is pregnant, and her baby is due in a month. During her antenatal visit to the clinic, she mentions that she has heard that breastfeeding could make her baby sick, too. Because of her concern, she has made a major effort to get to the clinic, hitching a ride on a truck and walking about three miles in the heat. She lives in a tiny village that has sporadic access to a safe, clean water supply. She and her husband are subsistence farmers with little disposable income. Breastfeeding is the norm in her community, and she fears everyone will figure out that she has HIV if she does not breastfeed.How do you counsel Martina? Case Study #2:Nelson is a 34-year-old married man who has many sex partners besides his wife. Over the years, he has been infected with gonorrhea and chlamydia, for which he sought treatment promptly and followed through effectively. About a year ago, he found out that Jeremiah, a close childhood friend, is sick with AIDS. He knows that Jeremiah had many sex partners in addition to his wife. When he realized the similarities in their situations, Nelson became concerned that he, too, could get AIDS. He came to the clinic to talk about his concerns. At the clinic, he found out how to use condoms correctly and where to obtain a regular supply. About a month later, he began to use condoms consistently and correctly with all of his partners, except his wife. He has adopted this behavior for more than half a year and intends to continue using condoms.According to the “stages
of change” model, what stage of behavior change is Nelson in? How
can you support him to continue? Case Study #3:Mabel, a 19-year-old unmarried woman, comes to your clinic with a nonspecific complaint about a “problem” in her genital area. She cannot describe any particular symptoms and has no clinical signs of infection. When you engage her in conversation, you realize that she has had unsafe sex with a man whom she does not trust and is terrified that she has gotten infected with HIV.How do you counsel Mabel? Case Study #4:Hope is a family planning counselor at a rural clinic that serves a population with a high rate of STIs, including HIV. Lately, the clinic management has encouraged the staff to promote condoms to prevent HIV/STI transmission, as well as unintended pregnancy. Hope wants to comply with this request, but she personally finds condoms distasteful and, therefore, has difficulty promoting them with a positive attitude. She also is concerned that condoms are not a very good method of family planning. She wonders if women start using condoms instead of more effective contraceptive methods like the pill, will they increase their risk of unintended pregnancy? Will women be offended if she recommends condom use because everyone knows that only sex workers or people having extramarital affairs use condoms?What could the clinic management
say and do to help Hope more effectively promote condoms?
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