A psychological epidemiology of people seeking HIV/AIDS counselling in Kenya: An approach for improving counsellor training: An approach for improving counsellor training

Objective: This study develops a typology of psychological problems reported during HIV/AIDS counselling. This typology provides a framework for training paraprofessional counsellors (PPCs) in East Africa. Design: Study participants included 307 Kenyans tested for HIV at any of six clinics in Nairobi specialising in STDs, tuberculosis and other infectious diseases. Pre-test, post-test, and follow-up counselling was provided by 16 PPCs who are themselves HIV-positive. Data consisted of demographic, physical and psychological information reported by 168 clients who sought follow-up counselling. Methods: Counselling data were coded using an ipsative method; a unique code was assigned to every distinct topic. Factor analysis with a Varimax rotation reduced the original psychological variables into logical groupings. Multivariate analysis examined the relationship of Factors and demographic characteristics. Results: Clients reported 1-10 physical and 1-23 psychological complaints in a single session. Sixty-five percent of female clients reported ≥ eight psychological problems; 49% of males reported ≥ eight psychological problems. Factor analyses allowed the 109 reported psychological events to be assigned to 15 categories of problems. Multivariate analyses explained little of the variance in the relationship between each client's demographic profile and the psychological factors. Conclusions: Training for PPCs should be relevant to problems encountered during counselling. Results indicate that PPCs can expect clients to present one or more of the 15 factors during counselling. Demographic characteristics explained small amounts of variance in the distribution of factor scores. The 15 factors produced in this study, although descriptive and preliminary, could form the basis of a training curriculum for HIV PPCs.