Motivational interviewing experiences from a community health worker-led HIV prevention and care intervention in rural Uganda: a qualitative study

Motivational Interviewing (MI) and Community Health Workers (CHWs) are increasingly utilized in global settings to improve HIV outcomes, yet research exploring implementation strategies using MI and CHWs is lacking. We examined the experiences of CHWs and their clients in a counseling intervention w...

Full description

Saved in:
Bibliographic Details
Published in:AIDS care 2024-04, Vol.36 (4), p.491-499
Main Authors: Nishimura, Holly, Kaptchuk, Rose Pollard, Mbabali, Ismail, Mulamba, Jeremiah, Nakyanjo, Neema, Anok, Aggrey, Wawer, Maria J., Kennedy, Caitlin E., Nakigozi, Gertrude, Chang, Larry W., Amico, K. Rivet, Hutton, Heidi
Format: Article
Language:English
Subjects:
Behavior change
Clients
Community health workers
Community Health Workers - psychology
Counseling
Disease prevention
Fishing
Fishing communities
HIV
HIV Infections - epidemiology
HIV Infections - prevention & control
Human immunodeficiency virus
Humans
Intervention
Interviews
Medical personnel
Motivational Interviewing
Power-sharing
Prevention
Prevention programs
Preventive medicine
Qualitative Research
Rural communities
Uganda
Uganda - epidemiology
Uptake
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Motivational Interviewing (MI) and Community Health Workers (CHWs) are increasingly utilized in global settings to improve HIV outcomes, yet research exploring implementation strategies using MI and CHWs is lacking. We examined the experiences of CHWs and their clients in a counseling intervention which used MI-informed counseling to increase engagement in HIV prevention and treatment. This study was nested within the mLAKE cluster-randomized trial in a high HIV prevalence fishing community in rural Rakai District, Uganda. We conducted in-depth interviews with purposively-sampled CHWs (n = 8) and clients (n = 51). Transcripts were analyzed thematically to characterize CHWs' implementation of the intervention. Main themes identified included use of specific MI strategies (including evocation, guidance towards positive behavior change, active listening, and open-ended questions), and MI spirit (including collaboration, power-sharing, trust, and non-judgmental relationship building). Through these specific MI mechanisms, CHWs supported client behavior change to facilitate engagement with HIV services. This study provides evidence from a low-resource setting that CHWs with no previous experience in MI can successfully implement MI-informed counseling that is well-received by clients. CHW-led MI-informed counseling appears to be a feasible and effective approach to increase uptake of HIV prevention and care services in low-resource, HIV endemic regions.
ISSN:0954-0121
1360-0451
1360-0451
DOI:10.1080/09540121.2023.2253504