title: Behaviour change counselling for ARV adherence support within primary health care facilities in the Western Cape, South Africa.
abstract: Health care systems have been described as ideal settings for behaviour change counselling interventions. There is little research evaluating the feasibility of implementing such interventions in routine practice in primary care facilities. We implemented an intervention called Options for Health within routine adherence counselling practice in 20 antiretroviral facilities in Cape Town, South Africa. Lay counsellors were trained to use Options to help clients to optimise ARV adherence and reduce sexual risk behaviour. Counsellors delivered the intervention to 9% of eligible patients over 12 months. Interviews with counsellors revealed barriers to implementation including a lack of counselling space, time pressure and patient resistance to counselling. Counsellors felt that Options was not appropriate for use with all patients and adherence problems, and used parts of the intervention as it suited their needs. Findings revealed weaknesses in the current adherence counselling system that have implications for the feasibility of behaviour change counselling within this context.
authors: Health Systems Research Unit, Medical Research Council, P.O. Box 19070, Cape Town, Tygerberg 7505, South Africa. sarahdewing@gmail.com
authors: S
authors: S
authors: Dewing
authors: C
authors: C
authors: Mathews
authors: N
authors: N
authors: Schaay
authors: A
authors: A
authors: Cloete
authors: J
authors: J
authors: Louw
authors: L
authors: L
authors: Simbayi
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D003695:Delivery of Health Care; D037001:Directive Counseling / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006268:Health Facilities / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D009042:Motivation; D010342:Patient Acceptance of Health Care; D011320:Primary Health Care; D011369:Professional-Patient Relations; D040242:Risk Reduction Behavior; D012725:Sexual Behavior / Q000523:psychology* / Q000706:statistics & numerical data; D013019:South Africa / Q000453:epidemiology; D016903:Drug Monitoring
chemical_list: D019380:Anti-HIV Agents