Abstract
Early identification of people living with HIV (PLHIV) and subsequent engagement into HIV treatment is a key to reducing HIV-related illness, HIV-related deaths, and HIV transmission through universal test and treat approaches. With the scale-up of antiretroviral therapy (ART) programmes, counselling that is provided immediately after the diagnosis of HIV (post-test counselling) is well placed to facilitate linkage to care and ART initiation. We sought to assess whether the current delivery of post-test counselling in a routine HIV programme was aligned with the goals of universal test and treat as articulated in local and international HIV testing service guidelines. We analysed transcripts of 40 post-test counselling sessions for HIV-positive clients, performed by 34 counsellors in ten public sector health facilities in the Ekurhuleni District of South Africa. We used thematic analysis to identify key aspects of counselling techniques and content provided to the client. We identified five key themes of counselling messages: (1) specific behaviour changes that are required to maintain or improve health when living with HIV, (2) the benefits of ART, (3) behaviour changes required for ART to be effective, (4) the need for clients to disclose their HIV status, and (5) a need for caution with ART due to a wide range of severe side effects. The counselling sessions were highly didactic, which limited the opportunities for clients to express concerns or counsellors to address client's needs during the counselling session. Based on our observations, a substantial re-adjustment is needed to deliver best-practice counselling. This may include a combination of digital media-based counselling, counselling scripts, and truly client-centred counselling for a sub-set of individuals who are at risk of not linking to care, or not initiated ART within a specified period.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
