Any advice for an HIV positive client

[RedFox]

I have an HIV positive client that is in good health (other than the HIV). I gave her a medium pressure massage today and she would like to come back about once a week. She said her doctor said it was fine to get massage. She has also had heart surgery a year ago. Does anyone have any advice for massage on HIV clients? Things I should avoid or things I should do? Should I get WRITTEN approval for massage from the doctor?

 

[johnny fettcakes]

I'll be more concerned that she's fine after her heart surgery. Remember, you're increasing her circulation and the heart must pump it through so just touch base with her that she has no problems with edema, low or high uncontrolled b/p, etc. As far as HIVp goes, half the people on your table could be HIVp and not know it. You should treat everyone as if they are positive, meaning, good handwashing, proper cleaning of linen, wiping down face cradle/bed after each client, you know. Having saiid all that, you are doing the best medicine for this person by your caring touch!!  

 

[El Chahusitle]

Get ok from her Dr.  If she is otherwise "healthy", proceed as normal.This population can benefit from touch in a profound way....the emotional aspect alone is monumental.  We are still a HIV phobic society so I am sure she faces prejudices everyday.She is probably touch starved.Use your head and universal precautions.If it's red or wet and it "ain't yours" don't touch it.Also, if you are sick AT ALL...please reschedule her.  Make sure she is comfortable (maybe have an extra padding((soft))) for her chest(heart surgery).Robyn

 

[corinthians]

I fully agree with the above statements...  I am a Medical MT certified in treating patients with life altering illnesses.  For her sake: have her get the ok in writing, not just a verbal ok, from her cardiologist due to the added strain, and make sure her WBC count is at a decent level before getting a massage.  Schedule her either the last client before lunch or the last client of the day.  Make sure that there is a cushion of time before and after her appointment so that she doesn't have to risk encountering your other clients germs especially if you have a pre-natal client that she might encounter (since they are hosts for a lot of germs, due to lack of being able to medicate themselves), and DO NOT WORK ON HER IF YOU ARE SICK AT ALL!!! and make sure that you have good hand washing techniques and clean off all serfaces and oil bottles before you treat her.  For your sake: make sure to wash your hands well, and if she has any pimples, boils, odd appearing marks on her body, let her know that they are present, and avoid them just in case they ooze out any body fluids.And most of all, thank you for working with this client, and you might end up getting other referrals because of your willingness to work with her.  So many people are afraid to work with them or touch them for fear of harm to you or to them.  Thank you for opening up your heart and seeing her need and welcoming her.  That is what we are here for to support you so that you can make her feel better and not alienated.  Good luck!

 

[Melissa J]

Any advice for an HIV positive client

Thanks for the advice. I will make sure to get approval form her cardiologist before she makes her next appointment. I was sure to do medium work on her today and nothing deep. She was my last appointment today. I appriciate the help. Thanks!

 

[waldey524]

Hello.I know an HIV individual who has been recieving treatment by a therapist for a few years now.  She mentioned that her T-Cells have been increasing every since getting the massage work, which is apparantly pretty deep work (in case that matters).  They (T-cells)have gone from about 500 to about 1500.  The client has been on meds for a lot more years than that... so she is attributing this to the massage specifically.Hope the info helps.

 

[Annie]

Any advice for an HIV positive client

I haven't had pathology in school, yet, but from what I understand, a T-cell count going from 500 up to 1500 is excellent, right? Isn't a normal T-cell count around 1000, and AIDS is detected when it drops to below 200?I have read that some studies have linked massage with very postive results in people with AIDS. In Ruth Werner's "A Massage Therapists Guide to Pathology", pg 318, it says the following about massage indications for HIV:HIV-positive clients who are asymptomatic are fine candidates for massage. Although in advanced seforum.xxxes of AIDS opportunistic diseases can make circulatory massage problematic, other types of work may reduce stress, which in turn strengthens the immune system. It can be a very appropriate treatment option and an important source of support and comfort for people who are often rejected, ignored, or actively persecuted by society.

 

[Hannah G]

Any advice for an HIV positive client

I called her today to check in and make sure was was OK and to see how she was feeling. She said she felt great and loved the massage. Thanks for all the great information. I know she gets her T-cell counts regularly. I'll have to see as we go on if this makes a difference.

 

[ironside]

Any advice for an HIV positive client

Thanks for sharing with us, 911gal. I'm glad your client enjoyed her massage, feels great, and. . .that you are lovingly caring for her.Please keep us informed. ~Samantha

 

[WinterNights]

911gal,The best thing you can do is treat them with respect, which I'm sure your'e doing.  We had a guy come into our class that is HIV positive and he gets massage every week and his Tcell count is extremely high.  He just talked about what his life was like and how people treat him and then we all had a ton of questions, he is the nicest guy.  Diane

 

[Adri]

In school they talked about a study from the Touch Research Institute in Miami that showed that T-Cell count increases by 25% in HIV+ people after a one hour full body massage.  If anybody has any information on that study, it would be nice to see it.Allure magazine has a little blurb this month (pg. 156) about women with early seforum.xxxes of breast cancer having an increase in "natural killer" cells and lymphocytes after receiving three 1/2-hour massages per week for five weeks.  This information was also from a TRI study.Katykangaroo

 

[Ellis Bontellis]

Any advice for an HIV positive client

You may want to have a look at this article from Positive Nation - the UK's HIV and sexual health magazine. It is published by the UKC - the UK Coalition of People Living with HIV and AIDS.This issue has a specific article summarising the benefits of massage for those who are HIV+.Foz xx

 

[Bride2be]

Any advice for an HIV positive client

911 - thanks for asking this question and special thanks for taking on the caring and loving responsibility of admiting this person into your life. You are doing a truly wonderful thing.Thanks also to everyone's responses. As part of my graduating requirements, I plan on doing @ least 30 hours @ massage for a HIV resident program. To reiterate what has been said: if you even suspect you have a cold, flu, etc., DO NOT on your client. There's more likelihood of you making them sick instead of them making you sick.Foz - thanks for the link. Plan on visiting it and reading it.

 

[Oliver]

Any advice for an HIV positive client

Get ok from her Dr.  

If she is otherwise "healthy", proceed as normal.

Use your head and universal precautions.

If it's red or wet and it "ain't yours" don't touch it.

Also, if you are sick AT ALL...please reschedule her.  

Make sure she is comfortable (maybe have an extra padding((soft))) for her chest(heart surgery).

Robyn

Great stuff Robyn, just wanted to expand on one aspect "universal precautions" since it's not always taught to MT's (believe it or not).  When doing a massage for HIV+/AIDS clients you should wear gloves!  Hold on!  I'm not phobic - I have HIV+ clients....IT'S FOR THE CLIENT'S PROTECTION.  The client has more to fear from you than you do from her/him.  Even if you wash your hands well with anti-bacterial soap, you are still likely to be carrying germs.  Use gloves to keep your client safe and let them know it's for their protection.  If your client just can't handle the idea of you wearing gloves then use a product like Derma Sheild after washing your hands.  Also, invest in latex finger cots in the event you have a cut on your fingers.  They work better than a band-aid when lotion or oil is used.

Ben Crabtree, RMT, MTI, CNMT

San Antonio, Texas
http://www.massagebyben.com

 

[deep blue2]

If hands are washed PROPERLY before and after massage, and there are no cuts on either the client or the therapist, there is no need to use gloves.  HIV+ people need normal human touch, just like everyone else.  I'm shocked to see that you recommend gloves for every known HIV+ client.  Not everyone discloses that information, or even knows they are infected with the disease.  In that case, you should wear gloves when working with all your clients.  If they are otherwise healthy, and you know you're healthy, and your hands and table and linens are clean, give your clients the dignity of being treated like human beings...touch them...they deserve it, and need it.  

 

[Pompal 09.]

Any advice for an HIV positive client

If hands are washed PROPERLY before and after massage, and there are no cuts on either the client or the therapist, there is no need to use gloves.  HIV+ people need normal human touch, just like everyone else.  I'm shocked to see that you recommend gloves for every known HIV+ client.  Not everyone discloses that information, or even knows they are infected with the disease.  In that case, you should wear gloves when working with all your clients.  If they are otherwise healthy, and you know you're healthy, and your hands and table and linens are clean, give your clients the dignity of being treated like human beings...touch them...they deserve it, and need it.  

+1

 

[sandhillkar]

Any advice for an HIV positive client

If hands are washed PROPERLY before and after massage, and there are no cuts on either the client or the therapist, there is no need to use gloves.  HIV+ people need normal human touch, just like everyone else.  I'm shocked to see that you recommend gloves for every known HIV+ client.  Not everyone discloses that information, or even knows they are infected with the disease.  In that case, you should wear gloves when working with all your clients.  If they are otherwise healthy, and you know you're healthy, and your hands and table and linens are clean, give your clients the dignity of being treated like human beings...touch them...they deserve it, and need it.  

Well said.

There are some volunteer centres near me that offer free massage to people suffering a range of life limiting / threatening illnesses - HIV / AIDS one of them. They do not require gloves to be worn, I have to admit this is the first time I have come across this suggestion and i think my HIV+ friends would find it very offensive.

Mat xx

 

[Monkey Lover]

If hands are washed PROPERLY before and after massage, and there are no cuts on either the client or the therapist, there is no need to use gloves.  HIV+ people need normal human touch, just like everyone else.  I'm shocked to see that you recommend gloves for every known HIV+ client.  Not everyone discloses that information, or even knows they are infected with the disease.  In that case, you should wear gloves when working with all your clients.  If they are otherwise healthy, and you know you're healthy, and your hands and table and linens are clean, give your clients the dignity of being treated like human beings...touch them...they deserve it, and need it.

Ditto.I realize there may be times that gloves are essential. However, there's nothing like skin to skin contact.Years ago premie babies were kept in isolated units and were only touched via gloves to change diapers or feed them. My mother was a new nurse working in a premie unit where the babies had a high mortality rate and those that did live, were slow to gain weight. The head nurse was injured in a serious accident and my mother was asked to take over. Although it was against the rules to take the babies out of their incubator and hold them, for fear that they'd get an infection, she instintively felt they needed to be held, cuddled and touched - skin to skin. So, when no one was around during late night hours, she'd take the babies out one by one to cuddle and rub them. Surprise. . . all the babies started to gain weight and the mortality rate significantly dropped. Hers is only one of many stories of the healing power of skin-to-skin touch.

 

[danielle Z]

There was brief mention in one of the above entries that "sometimes they don't disclose it on the intake form". I gotta say that's pretty dangerous and irresponsible. It's so common for us therapists to use OTC or prescription drugs to mask the symptoms of illness, that on any given day we might be the only one who knows we're sick.  Even with proper hand washing, there's the possibility that we could pass on something which might adversely affect someone with an other-than-normal immune system.  Sometimes we need to know, so that we can determine wether or not the current state of our health is a contraindication for the HIV+ client.

 

[Alex S]

Any advice for an HIV positive client

There was brief mention in one of the above entries that "sometimes they don't disclose it on the intake form". I gotta say that's pretty dangerous and irresponsible.

Uh, er, like how irresponsible of them to assume that we would  perform massage while masking communicable disease?

or..how dangerous of them to fail to risk disclosure to a new therapist (of unproven ethical standards) one of the most emotionally charged, potentially socially poisonous disclosures that one can make?  

How about lets allow just a tad bit of respect for the terror and fear of this particular dx that the US culture has inflicted upon those living with this disease.  Its presents no risk to the therapist.

Seems just based upon some of the more lively discussions on this board, there are obviously some "other" bodyworkers who are not quite up the ethical bar on stuff way easier to be ethical on than this one.   :-/

I do think it sucks that people have to be afraid of revealing their HIV+ ...but i believe that fear is still well founded. I think that measure of trust is earned, not granted preemptorily, and I don't think that I as the new bodyworker in their life have done anything to earn the necessary trust until the work has been done.  

Rob

...its a wonder I can think at all