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‘It is just the way it was in the past before I went to test’: a qualitative study to explore responses to HIV prevention counselling in rural Tanzania

Overview of attention for article published in BMC Public Health, June 2016
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Title
‘It is just the way it was in the past before I went to test’: a qualitative study to explore responses to HIV prevention counselling in rural Tanzania
Published in
BMC Public Health, June 2016
DOI 10.1186/s12889-016-3109-7
Pubmed ID
Authors

Caoimhe Cawley, Alison Wringe, Joyce Wamoyi, Shelley Lees, Mark Urassa

Abstract

Voluntary counselling and testing (VCT) for HIV first evolved in Western settings, with one aim being to promote behaviours which lower the risk of onward transmission or acquisition of HIV. However, although quantitative studies have shown that the impact of VCT on sexual behaviour change has been limited in African settings, there is a lack of qualitative research exploring perceptions of HIV prevention counselling messages, particularly among clients testing HIV-negative. We conducted a qualitative study to explore healthcare worker, community and both HIV-negative and HIV-positive clients' perceptions of HIV prevention counselling messages in rural Tanzania. This study was carried out within the context of an ongoing community HIV cohort study in Kisesa, northwest Tanzania. Nine group sessions incorporating participatory learning and action (PLA) activities were conducted in order to gain general community perspectives of HIV testing and counselling (HTC) services. Thirty in-depth interviews (IDIs) with HIV-negative and HIV-positive service users explored individual perceptions of HIV prevention counselling messages, while five IDIs were carried out with nurses or counsellors offering HTC in order to explore provider perspectives. Two key themes revolving around socio-cultural and contextual factors emerged in understanding responses to HIV prevention counselling messages. The first included constraints to client-counsellor interactions, which were impeded as a result of difficulties discussing private sexual behaviours during counselling sessions, a hierarchical relationship between healthcare providers and clients, insufficient levels of training and support for counsellors, and client concerns about confidentiality. The second theme related to imbalanced gender-power dynamics, which constrained the extent to which women felt able to control their HIV-related risk. Within the broader social context of a rural African setting, HIV prevention counselling based on a Western model of individual-level agency seems unlikely to make a significant contribution to sexual behaviour change until there is greater recognition by counsellors of the ways in which power dynamics within many relationships influence behaviour change. More culturally relevant counselling strategies and messages and infrastructural improvements such as additional training for counsellors and counselling rooms which ensure privacy and confidentiality, may lead to better outcomes in terms of sexual risk reduction.

Twitter Demographics

The data shown below were collected from the profiles of 3 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 58 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 2%
Unknown 57 98%

Demographic breakdown

Readers by professional status Count As %
Student > Master 11 19%
Student > Ph. D. Student 7 12%
Student > Bachelor 6 10%
Student > Doctoral Student 5 9%
Researcher 4 7%
Other 10 17%
Unknown 15 26%
Readers by discipline Count As %
Medicine and Dentistry 12 21%
Social Sciences 11 19%
Nursing and Health Professions 11 19%
Psychology 2 3%
Mathematics 1 2%
Other 4 7%
Unknown 17 29%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 July 2016.
All research outputs
#5,760,077
of 7,974,292 outputs
Outputs from BMC Public Health
#5,652
of 6,850 outputs
Outputs of similar age
#171,941
of 268,795 outputs
Outputs of similar age from BMC Public Health
#204
of 234 outputs
Altmetric has tracked 7,974,292 research outputs across all sources so far. This one is in the 24th percentile – i.e., 24% of other outputs scored the same or lower than it.
So far Altmetric has tracked 6,850 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.8. This one is in the 13th percentile – i.e., 13% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 268,795 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 30th percentile – i.e., 30% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 234 others from the same source and published within six weeks on either side of this one. This one is in the 11th percentile – i.e., 11% of its contemporaries scored the same or lower than it.