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How Follow-Up Counselling Increases Linkage to Care Among HIV-Positive Persons Identified Through Home-Based HIV Counselling and Testing: A Qualitative Study in Uganda

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  • Dominic Bukenya
  • Janet Seeley
  • Grace Tumwekwase
  • Elizabeth Kabunga
  • Eugene Ruzagira

Abstract

We investigated how follow-up counselling had increased linkage to HIV care in a trial of referral to care and follow-up counseling, compared to referral to care only, for participants diagnosed as HIV-positive through home-based HIV counseling and testing. We carried out a cross-sectional qualitative study. Using random stratified sampling, we selected 43 trial participants (26 [60%] in the intervention arm). Sample stratification was by sex, distance to an ART facility, linkage, and nonlinkage to HIV care. Twenty-six in-depth interviews were conducted with participants in the intervention arm: 17 people who had linked to HIV care and 9 who had not linked after 6 months of follow-up. Home-based follow-up counseling helped to overcome worries resulting from an HIV-positive test result. In addition, the counseling offered an opportunity to address questions on HIV treatment side effects, share experiences of intimate partner violence or threats, and general problems linking to care. The counselling encouraged early linkage to HIV care and use of biomedical medicines, discouraging alternative medicine usage. Home-based follow-up counseling also helped to promote HIV sero-status disclosure, facilitating linkage to, retention in and adherence to HIV care and treatment. This study successfully demonstrated that home-based follow-up counselling increased linkage to care through encouragement to seek care, provision of accurate information about HIV care services and supporting the person living with HIV to disclose and manage stigma.

Suggested Citation

  • Dominic Bukenya & Janet Seeley & Grace Tumwekwase & Elizabeth Kabunga & Eugene Ruzagira, 2020. "How Follow-Up Counselling Increases Linkage to Care Among HIV-Positive Persons Identified Through Home-Based HIV Counselling and Testing: A Qualitative Study in Uganda," SAGE Open, , vol. 10(1), pages 21582440199, January.
    • Handle: RePEc:sae:sagope:v:10:y:2020:i:1:p:2158244019900166
    DOI: 10.1177/2158244019900166
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    References listed on IDEAS

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    1. Fylkesnes, Knut & Sandøy, Ingvild Fossgard & Jürgensen, Marte & Chipimo, Peter J. & Mwangala, Sheila & Michelo, Charles, 2013. "Strong effects of home-based voluntary HIV counselling and testing on acceptance and equity: A cluster randomised trial in Zambia," Social Science & Medicine, Elsevier, vol. 86(C), pages 9-16.
    2. Kalpana Sabapathy & Rafael Van den Bergh & Sarah Fidler & Richard Hayes & Nathan Ford, 2012. "Uptake of Home-Based Voluntary HIV Testing in Sub-Saharan Africa: A Systematic Review and Meta-Analysis," PLOS Medicine, Public Library of Science, vol. 9(12), pages 1-14, December.
    3. Monisha Sharma & Roger Ying & Gillian Tarr & Ruanne Barnabas, 2015. "Systematic review and meta-analysis of community and facility-based HIV testing to address linkage to care gaps in sub-Saharan Africa," Nature, Nature, vol. 528(7580), pages 77-85, December.
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