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Potential for abuse in the VCT counselling room

Service provider's perceptions in Kenya

Bibliographic Data

ID11490197
AuthorsC Hamilton (0000-0003-1291-4603), Clive E Hamilton (0000-0001-8945-6490, Liverpool School of Tropical Medicine, corresponding author), D Okoko (LVCT Health), Rachel Tolhurst (0000-0002-3005-6641, Liverpool School of Tropical Medicine), Nduku Kilonzo (LVCT Health), Sally Theobald (0000-0002-9053-211X, Liverpool School of Tropical Medicine), Miriam Taegtmeyer (0000-0002-5377-2536, Liverpool School of Tropical Medicine)
Year2008
Volume23
Issue6
Pages390-396
Publication date2008-08-13
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth Policy and Planning (JOURNAL)
Journal identifiersISSN: 0268-1080 • E-ISSN: 1460-2237
PublisherOxford University Press (PUBLISHER • GB)
DOI10.1093/heapol/czn029
PMID18701551
OpenAlexW2167929016
LanguageEN
Citations received2
References cited19

The rapid scale-up of HIV counselling and testing programmes in Kenya has led to quality concerns, including the potential for abuse within the private, confidential setting of client-initiated voluntary counselling and testing (VCT). A qualitative study was conducted in three provinces of Kenya, involving 26 VCT service providers and 13 key informants. First and second hand accounts of emotional, physical and sexual abuse emerged in all three study sites in spite of measures to mitigate such occurrences. Whilst uncommon, abuse was perceived by service providers to be serious and sufficiently widespread to raise significant concerns. Abuse occurred client to counsellor, from counsellor to client and from counsellor to counsellor. In all cases the person suffering the abuse was female. While the potential for abuse was demonstrated in VCT sites, we argue that experiences of abuse are not confined to VCT and are largely shaped by gender and power relations within the Kenyan cultural context. The international impetus for scale-up of HIV services provides an urgent rationale for the need to address and highlight these difficult issues at multiple levels. International guidelines, policy and methods need adapting in recognition of the potential for abuse. Systems for investigating and deregistering counsellors have been developed in Kenya but require formalizing. Institutions providing VCT should consider unlocked doors, semi-opaque windows and the use of 'mystery clients' as a quality assurance measure.

Business · Developing country · Economic growth · Medical emergency · Perception · Service (business) · Service delivery framework · Service provider · Adolescent Sexual and Reproductive Health · HIV/AIDS Research and Interventions · Homelessness and Social Issues · Marketing · Medicine · Nursing · Psychology

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Unique citing works2
Citations per year0,13
Citation span2011 - 2012 (2)
Citation velocityhistorical
Highly citedNo
Citation typesNeutral: 2
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