Advice dilemmas: managing advice against the competing public health and counselling imperatives that shape VCT in South Africa
If you would like to obtain a copy of this Research Output, please contact Hanlie Baudin at firstname.lastname@example.org.
The public health and counselling imperatives that shape VCT create advice dilemmas for counsellors. Public health proponents view the dispensing of advice as important, whilst most contemporary counselling dictates that advice should not be given under any circumstances. Using a qualitative, discursive approach transcripts of twenty-seven videotaped simulated VCT sessions in South Africa were analysed with a view to understanding how counsellors implemented advice in their daily practice and the discursive strategies they used to do so. The results show that counsellors generally struggled to adhere to the dictates of both public health and counselling. In managing their advice-dilemmas, counsellors either tagged an open-ended question to the end of a directive advice statement, or told clients what to do but softened these with client-centred skills. As a dual-identified encounter, the role of advice in VCT needs to be clarified. Key to resolving this issue is an acknowledgement that, whether as counsellor or health adviser, persuasion and influence are central features of the VCT interaction. Clear practice guidelines and tools are required to assist counsellors to distinguish between advice, suggestion or mere confirmation of an intended client action, and the circumstances under which these would be recommended or not.
Related Research Outputs:
- Abstract: Determinants of the use of voluntary counselling and testing services among the sexually active adult population of South Africa
- HIV risk exposure among young children: a study of 2-9 year olds served by public health facilities in the Free State, South Africa
- HIV risk exposure among South African children in public health facilities
- Introduction and overview
- Only skin deep: limitations of public health understanding of male circumcision in South Africa
- A public health evaluation of the implementation of healthy relationships: results from a pilot study
- Working with community based mobilisers (CBMs) to promote community-based voluntary counseling and testing in rural KwaZulu-Natal, South Africa
- Processes, challenges and supervision of VCT lay counsellor in a community based intervention trial
- Fieldwork processes, challenges and lessons of the recruitment of a qualitative cohort
- Voluntary Counselling and Testing (VCT) site-based brief HIV behavioural risk reduction counselling for HIV negative and HIV positive clients at HIV counselling and testing sites in Mpumalanga, South Africa
- Substance use and HIV risk among HIV infected and uninfected Voluntary Counselling and Testing (VCT) clients in Gert Sibande district, South Africa
- Advice-giving difficulties in voluntary counselling and testing: a distinctly moral activity
- Equity in the use of antiretroviral treatment in the public health care system in urban South Africa
- Community-based intervention to increase HIV testing and case detection in people aged 16-32 years in Tanzania, Zimbabwe, and Thailand (NIMH Project Accept, HPTN 043): a randomised study
- Evaluation of voluntary counselling and testing services in a health district, South Africa: service providers' perspectives
- Public health evaluation of the healthy relationships positive prevention programme in four districts of the OR Tambo District in the Eastern Cape, South Africa
- Pride and prejudice: gay men who are HIV-positive fear 'double discrimination'
- Predictors of non-uptake of human immunodeficiency virus testing by tuberculosis public primary patients in three districts, South Africa
- Mobile VCT: reaching men and young people in urban and rural South African pilot studies (NIMH Project Accept, HPTN 043)
- Homophobia and HIV in Africa: contexts of criminalisation, attitudes and implications for public health