Review of HIV counselling and testing studies in South Africa
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Several authors have emphasised the importance of the quality of counselling (to client-centered counselling standards) (Holtgrave & McGuire, 2007), in particular for HIV positive individuals good-quality counselling and particularly intensive counselling for couples together when one is positive, seems likely to result in behaviour change (Shelton, 2008). On the other hand, Chersich and Temmerman (2008) argue for increased emphasis on group pre-test information given during health talks, especially in antenatal and child health clinics. Brief individual pre-test sessions would then only be for confirming information was comprehended. Little evidence supports effectiveness of behaviour change counselling for HIV-negatives. Consequently, more abbreviated and focused post-test information (or printed leaflets) could be given for those testing negative. Conversely, substantial evidence shows post-test counselling for HIV-positives is effective, and should be prioritised and meet pre-set standards of quality. Though attention is needed to ensure high-quality interventions before and after testing, simplifying pre-test information and post-test information for negatives could facilitate a rapid increase in testing coverage and frequency.