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Patient Educ Couns. 2018 Jun;101(6):1103-1109. doi: 10.1016/j.pec.2018.02.004. Epub 2018 Feb 7.

Adaptation and delivery of a motivational interviewing-based counseling program for persons acutely infected with HIV in Malawi: Implementation and lessons learned.

Author information

1
Department of Medicine, Institute of Global Health and Infectious Disease, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Center for AIDS Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
2
Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Center for AIDS Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Department of Health Behavior, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States. Electronic address: carol_golin@med.unc.edu.
3
Center for AIDS Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Department of Health Behavior, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
4
Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
5
Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, United States.
6
UNC Project Lilongwe, Lilongwe, Malawi.
7
Department of Social, Behavioral, and Health Sciences, FHI 360, Durham, NC, United States(1); Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States.

Abstract

OBJECTIVE:

Individuals diagnosed with acute HIV infection (AHI) are highly infectious and require immediate HIV prevention efforts to minimize their likelihood of transmitting HIV to others. We sought to explore the relevance of Motivational Interviewing (MI), an evidence-based counseling method, for Malawians with AHI.

METHODS:

We designed a MI-based intervention called "Uphungu Wanga" to support risk reduction efforts immediately after AHI diagnosis. It was adapted from Options and SafeTalk interventions, and refined through formative research and input from Malawian team members and training participants. We conducted qualitative interviews with counselors and participants to explore the relevance of MI in this context.

RESULTS:

Intervention adaptation required careful consideration of Malawian cultural context and the needs of people with AHI. Uphungu Wanga's content was relevant and key MI techniques of topic selection and goal setting were viewed positively by counselors and participants. However, rating levels of importance and confidence did not appear to help participants to explore behavior change as intended.

CONCLUSION:

Uphungu Wanga may have provided some added benefits beyond "brief education" standard of care counseling for Malawians with AHI.

PRACTICE IMPLICATIONS:

MI techniques of topic selection and goal setting may enhance prevention education and counseling for Malawians with AHI.

KEYWORDS:

Acute infection; Adaptation; Counseling; HIV; Motivational interviewing; Sub-Saharan Africa

PMID:
29519656
PMCID:
PMC6003622
[Available on 2019-06-01]
DOI:
10.1016/j.pec.2018.02.004
[Indexed for MEDLINE]

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