Perceptions of the appropriate HIV/AIDS counsellor in Arusha and Kilimanjaro regions of Tanzania: implications for hospital counselling.

The objective of the study is to identify key characteristics of an HIV/AIDS counsellor who would prove to be culturally acceptable for the particular problems associated with HIV/AIDS in Arusha and Kilimanjaro, Tanzania. HIV/AIDS counselling in the hospitals is recommended by the Tanzanian Ministry of Health and by WHO. There was a need to check whether theories of counselling, developed in Western societies, would be valid in an African context. Few research reports exist on counselling in Africa. No previous studies have been conducted to identify locally important characteristics relevant for the Tanzanian HIV/AIDS hospital counsellor. A qualitative research approach is used. Methods of data collection are interviews and focus groups. A phenomenological and hermeneutical mode of analysing the data is utilized. In spite of differences in the cultural context, the data fit Western theories on client-centred counselling. Informants were more concerned with the social consequences of the disease than with the technical facts of AIDS. Stigma and fear of rejection are seen as major problems of HIV/AIDS. The findings indicate that confidentiality is central and that hospital counsellors must balance the fact-giving approach with a person-centred approach, exploring the client's problem conception and identifying who in the client's network can give the further necessary psycho-social support.