From questionnaire to conversation: a structural intervention to improve HIV test counseling

Area of Science:

• Public Health
• Behavioral Science
• Clinical Psychology

Background:

• HIV testing counseling quality is crucial for men who have sex with men (MSM).
• Previous interventions often lacked structural support for effective counseling.
• Optimizing client-counselor interaction is key for accurate risk assessment.

Purpose of the Study:

• To evaluate a structural intervention designed to enhance HIV test counseling quality for MSM.
• To assess the impact of the intervention on the interaction dynamics between counselors and clients.
• To determine if the intervention improves the accuracy of client risk data.

Main Methods:

• Audio recordings of 28 HIV rapid test sessions were analyzed.
• Sessions were collected in two phases: pre- and post-intervention.
• Sequence maps visualized and compared counseling, information delivery, data collection, and sample collection activities.

Main Results:

• Before the intervention, data collection on client risk resembled a survey.
• Post-intervention, risk questions were integrated into discussions of clients' life circumstances.
• This shift improved the collaborative orientation to tasks during counseling sessions.

Conclusions:

• Direct observation using sequence maps effectively reveals task-oriented interactions.
• The structural intervention successfully improved counseling quality and risk data accuracy.
• The intervention is feasible, requiring no additional session time or counselor training.