Adaptation and delivery of a motivational interviewing-based counseling program for persons acutely infected with HIV in Malawi: Implementation and lessons learned.
Catherine A Grodensky, Carol E Golin, Allison P Pack and 6 others
PMID 29519656WHAT IT FOUND
Counselors and people with acute HIV found topic choice and goal setting useful; rating importance and confidence often produced uniformly high answers and did not open discussion about barriers.
Key findings
01Counselors reported that participants especially liked the session where they could choose their own topic.
02One counselor reported that importance and confidence ratings were uniformly high and that the questions felt leading.
03Counselors said goal setting was helpful, but starting it on diagnosis day and reviewing it three days later was sometimes too soon.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 14 intervention participants and 2 counselors were analysed, so these are small pilot implementation impressions. The paper did not formally code MI session quality, so it cannot show whether counselors delivered MI as intended. Effectiveness and primary outcomes were reported elsewhere; this manuscript does not test whether risk behavior changed. The importance and confidence finding rests on one counselor's perceptions and the authors' suspicion, not a formal participant analysis. The paper says retention was high but does not give dropout numbers. The intervention depends on identifying acute HIV infection, and the paper says barriers exist to making diagnostic tools widely available in this setting.
Declared interests
No author conflicts of interest are declared in the supplied text. The supplied publication types include NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not conclude that Uphungu Wanga reduced HIV risk behavior or transmission. This paper reports implementation perceptions from 14 intervention participants and 2 counselors, not effectiveness results. Participants in the Uphungu Wanga arm also received brief education, so the contribution of MI alone cannot be separated.