Evaluation of a home-care/counselling AIDS programme in Kgatleng district, Botswana

In 1988 a programme for care and follow-up of HIV-positive persons and AIDS patients was implemented by the existing health facilities (district health team and hospital team) of Kgatleng District, Botswana. A survey study in 1991 tried to indicate the effectiveness and bottlenecks of the programme. All advisory nurses (AN) were interviewed via two questionnaires: one pertaining to case management of clients and one on their perceptions of their work. Seventy-two of 109 HIV-infected persons accepted and received counselling. Response of the 72 varied: 26 with a good, 34 with a moderate and 12 with a bad response. Prevention, contact tracing and home visiting were studied, as well as ANs' experiences and opinions of the programme. Some behavioural change by clients was indicated by the results though its extent remains questionable. Programme problems included client migration and refusal of counselling, and discontinuation of HIV-testing facilities. Once a relationship was established, confidentiality, questions and fear of stigmatization posed major problems. One-to-one support of ANs could help them cope better with these problems as well as discuss their own worries.