Dewing S., Mathews C., Schaay N., Cloete A., Louw J., Simbayi L.
Health Systems Research Unit, Medical Research Council, P. O. Box 19070, Tygerberg, Cape Town 7505, South Africa; School of Public Health and Family Medicine, University of Cape Town, Cape Town 7925, South Africa; School of Public Health, University of the Western Cape, Cape Town 7535, South Africa; HIV/AIDS, STIs and TB Research Programme, Human Sciences Research Council, Cape Town 8000, South Africa; Department of Psychology, University of Cape Town, Cape Town 7701, South Africa
Dewing, S., Health Systems Research Unit, Medical Research Council, P. O. Box 19070, Tygerberg, Cape Town 7505, South Africa; Mathews, C., Health Systems Research Unit, Medical Research Council, P. O. Box 19070, Tygerberg, Cape Town 7505, South Africa, School of Public Health and Family Medicine, University of Cape Town, Cape Town 7925, South Africa; Schaay, N., School of Public Health, University of the Western Cape, Cape Town 7535, South Africa; Cloete, A., HIV/AIDS, STIs and TB Research Programme, Human Sciences Research Council, Cape Town 8000, South Africa; Louw, J., Department of Psychology, University of Cape Town, Cape Town 7701, South Africa; Simbayi, L., HIV/AIDS, STIs and TB Research Programme, Human Sciences Research Council, Cape Town 8000, South Africa
There is growing interest in standard care programmes for antiretroviral (ARV) adherence support. In South Africa, individual counselling following ARV initiation is a main strategy for supporting adherence in the public sector. Egan's client-centred "Skilled Helper" counselling model is the predominant model used in HIV counselling in this context. This study evaluated counselling delivered by lay ARV adherence counsellors in Cape Town in terms of adherence to Egan's model. Thirty-eight transcripts of counselling sessions with non-adherent patients were analysed based on the methods of content analysis. These sessions were conducted by 30 counsellors. Generally counsellors' practice adhered neither to Egan's model nor a client-centred approach. Inconsistent with evidence-based approaches to counselling for ARV adherence support, counsellors mainly used information-giving and advice as strategies for addressing clients' non-adherence. Recommendations for improving practice are made. The question as to how appropriate strategies from developed countries are for this setting is also raised. © 2012 Springer Science+Business Media, LLC.
anti human immunodeficiency virus agent; article; directive counseling; evaluation; female; human; Human immunodeficiency virus infection; human relation; male; methodology; motivation; patient attitude; patient care; patient compliance; psychological aspect; South Africa; Anti-HIV Agents; Directive Counseling; Female; HIV Infections; Humans; Male; Medication Adherence; Motivation; Patient Acceptance of Health Care; Patient-Centered Care; Professional-Patient Relations; South Africa