MIV/VIGS-berading in 'n Suid-Afrikaanse gemeenskap : 'n kritiese beskouing

[摘要] ENGLISH ABSTRACT:The human immune deficiency virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) havealready reached a magnitude in Southern Africa which can hardly be addressed by the existing structures.HIV counselling is considered to be an important preventative and supportive strategy in the battle againstHIV. In recent years therefore, urgent attempts have been made to provide HIV/AIDS counsellingservices throughout South Africa. The researcher had a firsthand experience of such an attempt asmanager of HIV counselling services for a NGO working in a peri-urban community. She realised thatalthough the ideal outcome and aims of HIV counselling have been widely documented, very littleresearch has been done on the implementation of these principles in health systems with limitedresources. It was thought that a meaningful contribution could be made to the development of HIVcounselling services in a specific South African community by critically exploring current HIVcounselling services in such a community. This exploration entailed the following:• reviewing the literature on HIV counselling;• clarifying the goal of HIV counselling;• clarifying behaviour change as an outcome of HIV counselling;• exploring the influence of the Stellenbosch context on the content and outcome of HIV counselling;and;• exploring to what extent the goals of HIV counselling (as prescribed by international and nationalliterature) are pursued in the Stellenbosch context.The ecological model and an action research method were used to direct this study. The researcher usedher position and experience as manager of the HIV counselling services within a non-governmentalorganisation to access sources of information. Direct and participatory observations were utilised togather information regarding the implementation of HIV counselling services in the community. Themodel of Raeburn and Seymour (1979) and specifically the overview phase have been used as aframework to organise the data and to describe the HIV counselling system in the specific community.The researcher concluded that the theoretical principles that were identified as prerequisites for effectiveHIV counselling services were often irreconcilable with the management skills, context, infrastructureand aims of the primary health services within the district. It was highlighted that a systemicunderstanding of the impact of the environment should be considered when future models and outcomesare formulated and implemented. Finally, alternative suggestions for the management, the formulation ofoutcomes and the utilisation of personnel in HIV counselling in this specific community were discussed.

[发布机构] Stellenbosch University