OBJECTIVE: We describe the effects of structural intervention to enhance the quality of HIV test counseling interaction with men who have sex with men (MSM) in San Francisco. METHODS: Audio recordings of 28 rapid HIV test sessions by seven counselors were collected in two phases: before and after implementation of a waiting room intervention prior to the session. The sessions were analyzed using sequence maps to visualize and compare the sequence and distribution of four activities: counseling, information delivery, data collection, and sample collection. RESULTS: Prior to the intervention, counselors and clients often oriented to data collection about the client's past risk as if it were a survey. In sessions recorded after the intervention, questions about past risk were dispersed throughout the session and embedded within an elaborated discussion of the client's particular life circumstances. CONCLUSION: Direct observation with the aid of sequence maps illuminates the ways that counselors and clients collaboratively orient to various tasks. PRACTICE IMPLICATIONS: We demonstrated the feasibility of a structural intervention that improved the quality of both counseling and the accuracy of client risk data without requiring additional session time or counselor training.
OBJECTIVE: We describe the effects of structural intervention to enhance the quality of HIV test counseling interaction with men who have sex with men (MSM) in San Francisco. METHODS: Audio recordings of 28 rapid HIV test sessions by seven counselors were collected in two phases: before and after implementation of a waiting room intervention prior to the session. The sessions were analyzed using sequence maps to visualize and compare the sequence and distribution of four activities: counseling, information delivery, data collection, and sample collection. RESULTS: Prior to the intervention, counselors and clients often oriented to data collection about the client's past risk as if it were a survey. In sessions recorded after the intervention, questions about past risk were dispersed throughout the session and embedded within an elaborated discussion of the client's particular life circumstances. CONCLUSION: Direct observation with the aid of sequence maps illuminates the ways that counselors and clients collaboratively orient to various tasks. PRACTICE IMPLICATIONS: We demonstrated the feasibility of a structural intervention that improved the quality of both counseling and the accuracy of client risk data without requiring additional session time or counselor training.
Authors: Susan E Fernyak; Kimberly Page-Shafer; Timothy A Kellogg; William McFarland; Mitchell H Katz Journal: J Acquir Immune Defic Syndr Date: 2002-09-01 Impact factor: 3.731
Authors: T A Kellogg; W McFarland; J L Perlman; H Weinstock; S Bock; M H Katz; J L Gerberding; D R Bangsberg Journal: J Acquir Immune Defic Syndr Date: 2001-09-01 Impact factor: 3.731
Authors: Matthew E Levy; Leo Wilton; Gregory Phillips; Sara Nelson Glick; Irene Kuo; Russell A Brewer; Ayana Elliott; Christopher Watson; Manya Magnus Journal: AIDS Behav Date: 2014-05