Motivational interviewing experiences from a community health worker-led HIV prevention and care intervention in rural Uganda

A qualitative study

Bibliographic Data

ID19440355
AuthorsHolly Nishimura (0000-0001-6572-5473, University of California, San Francisco, corresponding author), Rose Pollard Kaptchuk (0000-0001-9563-0918, Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA), Ismail Mbabali (0000-0003-0054-2136, Rakai Health Sciences Program), Jeremiah Mulamba (0000-0001-5187-9690, Rakai Health Sciences Program), Neema Nakyanjo (0000-0002-1908-7957, Rakai Health Sciences Program), Aggrey Anok (0000-0002-6320-6394, Rakai Health Sciences Program), Maria J Wawer (0000-0002-3601-4469, Rakai Health Sciences Program), Caitlin E Kennedy (0000-0001-6820-063X, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA), Gertrude Nakigozi (0000-0001-6193-2790, Rakai Health Sciences Program), Larry W Chang (0000-0001-7985-4567, Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA), K Rivet Amico (0000-0002-4458-6934, University of Michigan), Heidi E Hutton (0000-0002-0882-4456, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA)
Year2024
Volume36
Issue4
Pages491-499
Publication date2024-04-02
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAIDS Care (JOURNAL)
Journal identifiersISSN: 0954-0121 • E-ISSN: 1360-0451
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09540121.2023.2253504
PMID37713732
OpenAlexW4386762387
LanguageEN
Citations received1
References cited26

Motivational Interviewing (MI) and Community Health Workers (CHWs) are increasingly utilized in global settings to improve HIV outcomes, yet research exploring implementation strategies using MI and CHWs is lacking. We examined the experiences of CHWs and their clients in a counseling intervention which used MI-informed counseling to increase engagement in HIV prevention and treatment. This study was nested within the mLAKE cluster-randomized trial in a high HIV prevalence fishing community in rural Rakai District, Uganda. We conducted in-depth interviews with purposively-sampled CHWs (n = 8) and clients (n = 51). Transcripts were analyzed thematically to characterize CHWs’ implementation of the intervention. Main themes identified included use of specific MI strategies (including evocation, guidance towards positive behavior change, active listening, and open-ended questions), and MI spirit (including collaboration, power-sharing, trust, and non-judgmental relationship building). Through these specific MI mechanisms, CHWs supported client behavior change to facilitate engagement with HIV services. This study provides evidence from a low-resource setting that CHWs with no previous experience in MI can successfully implement MI-informed counseling that is well-received by clients. CHW-led MI-informed counseling appears to be a feasible and effective approach to increase uptake of HIV prevention and care services in low-resource, HIV endemic regions

Community health · Community health workers · Environmental health · Family medicine · Health services · Interview · Motivational interviewing · Population · Public health · Qualitative research · Sociology · Adolescent Sexual and Reproductive Health · Community Health and Development · HIV/AIDS Research and Interventions · Medicine · Nursing · Psychology