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Infectious disease outpatient clinic

Infection disease outpatient clinic
In my job as an infectious disease specialist I quite often have to counsel people with a newly diagnosed HIV infection. So, they come and I have to tell them that their HIV test was positive. There is a big difference if you talk to one of the major risk groups in Germany, who basically all know about the impacts of an HIV infection. They have friends who are treated already and they know it can be treated. They have made experiences that their colleagues or their friends can continue living a normal life.
Of course they are not happy about the diagnosis, but most of them are not really deeply depressed. They are usually quite well informed and know about the basic implications of the disease. When you talk to - for example - a Somali, who just came across the Mediterranean Sea and is now, after all his journey, confronted with such a problem, in his experience this is a death sentence. He may know from his own experience at home, that family members got the diagnosis and they died within a few month in agony. There is a lot of stigma around this disease in different countries and in their point of view this is the end to a normal life.
They do not expect to have a family, they do not expect to have a professional career and this puts them into a deep depression. And what you have to do in this situation is to counsel them well. So in my experience it is good to ask them first, “What do you know about the disease? What is your experience?”, and then I can answer and relate to their experience and tell them that the situation in our country is different than in their home country. And tell them there is always a good chance to live a normal life.
From our point of view as doctors, we always focus on the disease, but we must know that in the reality of the patient other things might be much more important. He might have family at home he left, which are still in danger, there are administrative problems, he is afraid of getting deported.
Maybe he has no money to travel to our clinic to get checked again. All these things make it difficult for the patient to be compliant to our medication and to come to our appointments on the regular time.

After the briefing with the Head of Department and reading a bit more about refugees’ right to health, Sarah joins Dr Uwe Ziegler at the Infectious disease outpatient clinic and observes how he provides counselling to a patient that may be infected with HIV.

HIV is a serious and chronic disease, but with adherence to effective treatment, patients can expect to live fairly normal lives. In this interview infectious disease specialist Dr Uwe Ziegler talks about the importance of exploring the patient’s understanding of the disease he/she is diagnosed with.

Lack of knowledge, myths and misconceptions may make patients worried about things that health personnel do not realize cause concern. After listening to Dr Ziegler, Sarah appreciates that it is important to ask open-ended questions to patients about what concerns they have in order to provide appropriate reassurance and information.

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