Lay Counsellor-Based Risk Reduction Intervention with HIV Negative Diagnosed Patients at HIV Counselling and Testing Sites in a Rural South African Setting

Abstract

The study evaluated the feasibility, fidelity, and effectiveness of a human immunodeficiency virus (HIV) prevention intervention delivered to HIV-uninfected patients by lay counsellors during routine HIV counselling and testing (HCT) service in Mpumalanga, South Africa. Participants were 543 HIV negative diagnosed persons (males=383, females=163, age range=18–68). They were assessed at baseline, received a single 60-minute session motivational/skills-building HIV risk reduction counselling intervention and followed-up at 4-months with 75% retention. Measures included descriptive information (demographics, substance use, and HIV risk history), Information Motivation Behavioural Skills (IMB) constructs, and sexual behaviour. Analyses tested for differences between baseline and follow-up using Paired samples t-tests for continuous variables and McNemar Chi-square tests for categorical variables. The 60-minute motivational/skills risk reduction counselling demonstrated significantly greater risk reduction practices, lower rates of multiple partners, unprotected intercourse, alcohol or drug use in the context of sex, transactional sex and greater likelihood of reduction of alcohol use and abuse. Brief theory-based HIV prevention counselling may significantly reduce HIV risk behaviours for HIV-uninfected patients at HIV counselling and testing sites in South Africa. Further research is needed to validate the findings.