AEGiS-10IAC: HIV counselling skills used by health care workers in Zambia.

10th International AIDS Conference

Yokohama, Japan — Aug 7-12, 1994

HIV counselling skills used by health care workers in Zambia.

Int Conf AIDS 1994 Aug 7-12; 10:390 (abstract no. PD0743)
Baxter P, Campbell T; Kare Counselling & Training Trust, Lusaka, Zambia.

OBJECTIVES: Kara Counselling and Training Trust has a 2 stage counselling skills programme. There is an introductory five day course (stage 1) followed after three months by another five day course (stage 2). This study identified (1) The counselling skills health and education workers (HEW's) had found useful from stage 1 and (2) The counselling skills they were using in their work.

METHOD: 12 HEW's trained at stage 1 completed a questionnaire at the beginning of stage 2. There were 8 women (5 nurses, 2 clinical officers and 1 teacher) and 4 men (3 clinical officers and 1 counsellor).

RESULTS: Helpful skills learned at stage 1 were identified by the respondents and included specific counselling skills eg active listening, developing rapport, awareness of the counselling context eg confidentiality, time factors and giving information about HIV. Skills used in pre-test counselling in the previous month included active listening (12/12), taking the clients sexual history (11/12), giving accurate information about HIV/AIDS (10/12) and checking that the information had been understood (12/12). Regarding pre-test counselling objectives, 69.2% of the responses identified giving information/education and 23% identified changing risky behaviour. Regarding post-test counselling objectives 28.5% of responses identified behaviour change, and 57.1% identified giving information about health. The majority of respondents rated pre and post-test counselling as important. 75% rated pre-test counselling as very important in helping clients make an informed decision. 33% rated post-test counselling as very important in helping clients change risky sexual behaviour. Pre-test and post-test counselling sessions lasted from 1-2 hours. Only 50% of respondents engaged in post-test counselling. Attendance rates for post-test counselling were generally low.

CONCLUSIONS: 1. Even though the sample size is small this study highlights counselling techniques by HEW's. 2. Counselling skills taught at stage 1 are being used appropriately with clients with HIV concerns. 3. There is a strong emphasis on getting a clear idea of clients's sexual history, delivering accurate information and checking that it has been understood. 4. Both pre- and post-test counselling are considered very important. However, only 50% of HEW's had experience of post-test counselling in part reflecting low clients return rates. Reasons for this are unclear but need to be explored. 5. There is not a strong emphasis on behaviour change at post-test. This may reflect lack of knowledge or skill.

Keywords: AEGIS, Counseling, Health Personnel, Acquired Immunodeficiency Syndrome, Attitude to Health, HIV Infections, HIV Seropositivity, HIV Seroprevalence, Confidentiality, HIV-1, Zambia, HIV, HIV Seronegativity, Human, Female, Male, utilization, immunology, ICA10
940807
PD0743