The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #70335

Michelle Heerey, MPH¹, Young Mi Kim, EdD¹, Dieneba Ouedraogou, PhD², Marian Amoa, MA¹, Claudia Vondrasek, MPH³, and Koudaogo Ouedraogo⁴. (1) Center for Communication Programs, The Johns Hopkins University, 111 Market Place, Suite 310, Baltimore, MD 21202, 410-659-6367, mheerey@jhuccp.org, (2) Consultant, 22 B.P. 1356, Pres du Lycee Francais, Ougadougou, Burkina Faso, (3) Projet Santé Familiale et Prévention du SIDA, (SFPS), VILLA 1112 - Riviera III, Près du Lycée Français Blaise Pascal, 22 B.P. 1356, Abidjan 22, Ivory Coast, (4) Johns Hopkins University, Center for Communication Programs, 22 B.P. 1356, Pres du Lycee Francais, Ougadougou, Burkina Faso

While integrating STI/HIV/AIDS prevention and referral is considered a necessary component for quality family planning counseling, STI/HIV/AIDS counseling rarely addresses clients' contraceptive needs. This study presents impact of a program aimed at improving overall quality of STI/HIV/AIDS counseling in Cameroon - with a particular emphasis on promotion of dual protection for risk reduction of both STI/HIV/AIDS and unwanted pregnancy. Interventions included provider training and introduction of a communication aid to improve: 1) client-provider discussion of risk assessment and risk reduction and 2) client communication post consultation related to implementing their risk reduction plan.

The study sample includes 180 clients, 20 from each of 9 matched facilities purposely assigned to three experimental conditions: 1) providers trained; 2) providers trained plus use of communication aid and 3) control. Observations follow the same client through pre- and post-test counseling as well as follow-up approximately six weeks later. Analysis compared baseline and post-intervention rounds of data collected, as well as between the control and intervention groups. To assess impact on provider skills, audiotapes were coded for technical content and interpersonal communication behaviors using the Roter Interaction Analysis System. Impact on client knowledge and behavior were assessed via client interview data. Baseline data show an overemphasis on clients' general knowledge of STI/HIV/AIDS, with little discussion of testing and its implications. Also rare were a systematic review of the three primary means of preventing sexual transmission and discussion of dual protection. Impact data will be examined to see whether the interventions corrected these weaknesses.

Learning Objectives:

At the conclusion of the presentation, session participants will be able to:
• describe advantages/disadvantages of integrating family planning into STI/HIV/AIDS services in settings with low prevalence of STI/HIV/AIDS and low CPR;
• articulate challenges and lessons-learned regarding inclusion of dual protection messages in STI/HIV/AIDS counseling; and
• design more effective interventions for improving quality of STI/HIV/AIDS counseling.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.