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

Holly Nishimura, Rose Pollard Kaptchuk, Ismail Mbabali, Jeremiah Mulamba, Neema Nakyanjo, Aggrey Anok, Maria J. Wawer, Caitlin E. Kennedy, Gertrude Nakigozi, Larry W. Chang, K. Rivet Amico, Heidi Hutton

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)491-499
Number of pages9
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume36
Issue number4
DOIs
StatePublished - 2024

Keywords

  • HIV
  • Uganda
  • community health workers
  • motivational interviewing

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health
  • Social Psychology

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