A Survey of HIV/AIDS Counselors in Botswana: Satisfaction With Training and Supervision, Self-Perceived Effectiveness and Reactions to Counseling HIV-Positive Clients

Abstract

A total of 181 HIV/AIDS counselors in Botswana, Africa, were surveyed about their satisfaction with their training and supervision, self-perceived clinical effectiveness as counselors, social stigma encountered, emotional and psychological reactions to counseling HIV-positive clients, and barriers to effective counseling. The majority of HIV/AIDS counselors indicated satisfaction with the quality of the training received, perceived themselves as effective counselors, were relatively untroubled by social stigma issues, and perceived few barriers to effective counseling. A large percentage of the counselors received 8 weeks or less of formal training, generally received little or no in-service supervision, and experienced stress and burnout. Many counselors also felt that they had too many clients to be effective and that they had inadequate access to learning materials. Recommendations included the need to provide regular and clinical in-service training experiences, training for clinical supervision, and the development of uniform counseling standards.

KEYWORDS:

• Botswana
• Africa
• counselor
• HIV/AIDS
• counselor training

Acknowledgments

Appreciation is given to staff members of the Institute for Development Management Public Health Unit who conducted the survey on which this article is based. Appreciation is also given to members of the graduate research team who assisted in analyzing the data.

Notes

Note. SD, strongly disagree; D, disagree; A/D, neither agree nor disagree; A, agree; SA, strongly agree. Items numbers reflect the ordering of items on the survey. NA (does not apply) and missing values were omitted resulting in differing n sizes across the items.

Note. Boldface coefficients indicate the highest component loading for each item. Items not loading .5 or higher on one of the four components selected for further analysis are omitted in this table. The four identified components were titled (from 1 to 4, respectively) Satisfaction with Supervision (SUPERVISION), Satisfaction with Basic Skill Training (TRAINING-BASIC), Self-Perceived Effectiveness (EFFECTIVENESS), and Satisfaction with Specialized Skill Training (TRAINING-SPEC).

Note. SUPERVISION, satisfaction with supervision; TRAINING-BASIC, satisfaction with basic skill training; EFFECTIVENESS, self-perceived effectiveness; TRAINING-SPEC, satisfaction with specialized skill training; counseling experience, all types of counseling experience; HIV counseling experience, experience counseling HIV-positive clients; HIV clients per week, average number of HIV clients per week and was coded: 1 = 0–10 clients, 2 = 11–20 clients, 3 = 21–30 clients, 4 = 31–40 clients, and 5 = > 40 clients.

*p < .05, **p < .01.