AEGiS-13IAC: HIV counselling and testing amongst antenatal women using lay community volunteers: Experience from urban Zimbabwe.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

HIV counselling and testing amongst antenatal women using lay community volunteers: Experience from urban Zimbabwe.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. TuOrC309)

Mhazo M, Moyo S, Von Lieven A, Maponga C, Bassett MT
M. Mhazo, Zimbabwe AIDS Prevention Project, 103 Rotten Row, Kopje, Harare, Zimbabwe, Tel.: +263 4 770 610, Fax: +263 4 749 865, E-mail: miriam@zappuz.co.zw

ISSUES: Lower cost anti-retroviral regimens may make feasible government programmes for reduction of mother to child HIV transmission in poor countries, but expansion of HIV counselling and testing poses a substantial challenge. Use of community lay volunteers may offer an alternative to creation of a new professional cadre that many health systems cannot afford. Can lay volunteers offer reliable, confidential, quality services?

DESCRIPTION: Volunteers were recruited from church groups, the Red Cross and PLHIV/AIDS support groups in Chitungwiza, a working class urban area. All counsellors were >25 years, literate in English and committed to 4 hours counselling per week plus weekly Friday staff meetings. Incentives included a uniform and badge and $US 20 monthly stipend. A two week course reviewed AIDS facts, systemic counselling approach and practical counselling techniques using scripts and role play. Local politicians officiated at a pledging of confidentiality ceremony. 19 of 20 completed training. Over six months they were present for 146 hours/week with only 6 hours missed. A total of 247 clients have been pre-test counselled, 171 counselled for test results, 40 more than once. Discussion: Counsellors maintained a high professional standard of promptness and confidentiality. They handled challenging family situations (examples will be given) and most often requested medical facts, not counselling advice, to answer client questions. Weekly supervision with professional counsellors was essential to quality and morale. Counsellors noted improved communication at home. Use of lay counsellors appears effective, low cost and may contribute to the community response to the epidemic.

Keywords: AEGIS, Counseling, HIV Infections, HIV Seropositivity, Voluntary Workers, Research Design, Zimbabwe, Acquired Immunodeficiency Syndrome, Self-Help Groups, Confidentiality, Human, Female, Child, utilization
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TuOrC309