Counseling Script - Male

MOH/CDC/WHO Viral Persistence Study Counseling Scripts
Talking points-MEN
We do not yet know if there is any possibility of passing Ebola to another person through semen, rectal
fluids, sweat, tears, urine, or saliva. We believe the risk is very low, but we do not know for certain.
Pre-Test
Semen











Greet the participant:
o Remember to express empathy and happiness that they survived Ebola.
o Ask how they are doing since they have recovered and if they have any questions.
Discuss the purpose of the visit:
o Give information to [the client] about the testing we will do to detect if pieces of the Ebola
virus are in their semen.
o You will also talk with them about things you can do in your life to reduce the risk of
passing Ebola to a person you have sex with.
Talk about confidentiality and possible discomfort:
o Let the participant know that anything they tell you will be confidential.
o Let the client know that if they feel uncomfortable at any time, they can tell you and you
will move on.
o Inform the client that receiving test results is optional and the choice is entirely up to
them.
o Ask if they would like you to help them strategize how to tell their partner or family
members about their test results.
Tell the survivor it is important that he monitors his health:
o These tests for Ebola virus pieces are very reliable, however it may be possible that
virus could still be present in the body but not able to be found in body fluids.
o There have been a very small number of survivors who became seriously ill after they
recovered, and so we would like to ensure that you are well even after finishing the
study.
o If you feel unwell contact Dr Sesay or Dr Massaquoi, the medical doctors at the 34
Military Survivor Clinic.
Talk with client about their relationships and their sexual behavior, condom use, condom
negotiation, abstinence. Give client condom demonstration and condoms.
Offer HIV test

Other Fluids: Rectal, Sweat, Tears, Urine, Saliva




Greet the participant:
o Remember to express empathy and happiness that they survived Ebola.
o Ask how they are doing since they have recovered and if they have any questions.
Discuss the purpose of the visit:
o Give information to [the client] about the testing we will do to detect if pieces of the Ebola
virus are in their fluids.

1











Tell participants that at pre-test they do not need to do anything differently right now. If the test
does detect pieces of Ebola in any bodily fluid, you will give her more information when you go
over the test result with them.
Talk about confidentiality and possible discomfort:
o Let the participant know that anything they tell you will be confidential.
o Let the client know that if they feel uncomfortable at any time, they can tell you and you
will move on.
o Inform the client that receiving test results is optional and the choice is entirely up to
them.
o Ask if they would like you to help them strategize how to tell their partner or family
members about their test results.
Tell the survivor it is important that she monitor her health:
o Inform participants that even though the RT-PCR tests are reliable, it may be possible
that virus could still be present in the body but not able to be found in body fluids.
o There have been a small number of survivors who became seriously ill after they
recovered, and so we may ask to follow up with the participant after the study ends to
ensure they are well even after finishing the study.
o Ask participants who feel unwell to call Dr. Sesay or Dr. Massaquoi for further help.
Inform participant that condoms can help prevent against HIV, STIs and unwanted pregnancy.
Give client condom demonstration and condoms and discuss condom negotiation.
Offer HIV test
Refer participants with medical or psychological problems to Dr. Sesay or Dr. Massaquoi.

2

Delivery of Results
Semen, Rectal, Sweat, Tears, Saliva, Urine
Positive:






Explain the results:
o Explain that the RT-PCR test detected pieces of the Ebola virus in the sample that they
provided.
o Explain that because of these results, it is possible that they may be able to pass Ebola
to a person who has contact with their [FLUID] through activity like vaginal, anal, oral, or
manual sex.
Tell the survivor it is important that they monitor their health:
o There have been a small number of survivors who became seriously ill after they
recovered, and so we may ask to follow up with the participant after the study ends to
ensure they are well even after finishing the study.
o Ask participants who feel unwell to call Dr. Sesay or Dr. Massaquoi for further help.
Encourage participant to continue with the study until they get two negative test results in a
row.

Indeterminate:






Explain the results:
o Explain that the RT-PCR test could not tell if pieces of the Ebola virus are in the sample
that she provided because it was on the border of detected and not detected.
o Explain that because of these results, it is possible that they may be able to pass Ebola
to a person who has contact with their [FLUID] through activity like vaginal, anal, oral, or
manual sex.
Tell the survivor it is important that they monitor their health:
o Inform participants that even though the RT-PCR tests are reliable, it may be possible
that virus could still be present in the body but not able to be found in body fluids.
o There have been a small number of survivors who became seriously ill after they
recovered, and so we may ask to follow up with the participant after the study ends to
ensure they are well even after finishing the study.
o Ask participants who feel unwell to call Dr. Sesay or Dr. Massaquoi for further help.
Encourage participant to continue with the study until they get two negative test results in a
row.

1st Negative:




Explain the results:
o Explain that the RT-PCR test did not detect pieces of the Ebola virus in the sample that
they provided.
o Explain that we would like to test them again to make sure pieces of Ebola is not
detected in their fluids.
Tell the survivor it is important that they monitor their health:
o Inform participants that even though the RT-PCR tests are reliable, it may be possible
that virus could still be present in the body but not able to be found in body fluids.

3

o



There have been a small number of survivors who became seriously ill after they
recovered, and so we propose to follow with the participant at 3 and 6 months after they
had 2 consecutive negative tests, to ensure they are well even after finishing the study.
o Ask participants who feel unwell to call Dr. Sesay or Dr. Massaquoi for further help.
Encourage participant to continue with the study until they get two negative test results in a
row.

Second Negative RT-PCR Test:



Inform participation is stopped for now, and the participant is welcome to the 3 and 6 months
follow up visits.
Discharge participant from the study.

4

Post-Test Counseling
Semen, Rectal, Sweat, Tears, Saliva, Urine
Positive/Indeterminate/1st Negative:



Explain results again, ask if participant has any questions.
Explain to participants that there are basic good health habit he will need to follow to make sure
the risk of transmitting Ebola through any positive fluid is as low as possible until they get two
negative RT-PCR results in a row.
o Saliva:
 Avoid spitting in places that others could come into contact with saliva (on the
street)
 Do not share eating utensils with others without washing them with soap and
water, and do not share food that you have been eating with others
 Wipe your mouth with a clean tissue and throw that tissue in a lined dust bin and
then wash your hands immediately with soap and water.
 Wash your hands often with soap and water. Try not to touch your eyes, nose,
and mouth with unwashed hands.
 Do not share your toothbrush or other personal care items with others.


Avoid deep kissing or oral sex (mouth to genital contact).



Use a condom if you engage in manual, oral, vaginal, or anal sex or choose
abstinence.

o

Tears:
 Wash your hands often with soap and water.
 Wipe your eyes with a clean tissue and throw that tissue in a lined dust bin and
then wash your hands immediately with soap and water.
 Try not to touch your eyes, nose, and mouth with unwashed hands.

o

Semen:


o

Use a condom if you engage in manual, oral, vaginal, or anal sex or choose
abstinence.

Urine:
 Do not urinate in places where others can come into contact with your urine (on
the street, into sewers). Urinating in pit latrines or toilets is ok.
 Wash your hands with soap and water each and every time you use the toilet.
 Try not to touch your eyes, nose, and mouth with unwashed hands.
 If urine comes in contact with eyes, nose, mouth, wash the areas very well with
water.
 If urine comes in contact with open skin (skin with cuts, wounds), rinse with water
very well and clean with soap.
 In the home, regularly clean toilet areas with water that has bleach in it.
5


o

Use a condom if you engage in manual, oral, vaginal, or anal sex or choose
abstinence.

Sweat:
 Wash your hands often with soap and water.
 Try not to touch your eyes, nose, and mouth with unwashed hands.
 Do not share your personal care items with others
 Do not share your unwashed clothing with others.


Wash personal clothing separately from items that belong to others



Avoid close skin to skin contact with other people












Use a condom if you engage in manual, oral, vaginal, or anal sex or choose
abstinence.
Explain to participants that he may be able to pass Ebola to a person who has contact with
[fluid] through activity like vaginal, anal, oral, or manual sex until he gets two negative test
results in a row.
Tell the survivor it is important that he monitors his health:
o Inform participants that even though the RT-PCR tests are reliable, it may be possible
that virus could still be present in the body but not able to be found in body fluids.
o There have been a small number of survivors who became seriously ill after they
recovered, and so we propose to follow with the participant at 3 and 6 months after they
had 2 consecutive negative tests, to ensure they are well even after finishing the study.
o Ask participants who feel unwell to call Dr. Sesay or Dr. Massaquoi for furth er help.
Talk with client about their relationships and their sexual behavior, condom use, condom
negotiation, abstinence.
Give client condom demonstration and condoms.
Refer participants with medical or psychological problems to Dr. Sesay or Dr. Massaquoi.
Encourage client to continue until they get two negative RT-PCR test results in a row.

6