P09.18 LB
Background: The Ring Study is a Phase III microbicide study, currently enrolling in communities with a culturally-diverse background in Southern and Eastern Africa. The 'person-centred counselling' (PCC) approach, which stimulates probing, is used by Research Centre (RC) counsellors. Participants and counsellors alike are diverse in ethnicity, cultural background and education. Culture can be described as the blue print for who we are. It includes patterns, beliefs, values, expectations and symbols for how people behave, think and feel in a certain social group. PCC aims at improving retention to study visits and adherence to study product.
Methods:
• The following counselling is conducted during The Ring Study: ring use adherence; HIV pre- and post-test counselling; risk reduction; contraception and visit adherence counselling.
• RC staff attended informal training sessions on understanding and implementing the PCC approach.
• Regular assessments are conducted to get feedback on the implementation of the approach; e.g. visiting RCs; engaging with counsellors and nurses who conduct counselling on site.
• Additional feedback on adherence is obtained subjectively via questionnaire feedback.
Results:
1. Participants differ and decisions are influenced by cultural norms (e.g. partner, family, friends and community).
2. Cultural self-awareness is an important counselling aspect as it allows identification of differences and more empathy and sensitivity in the counselling relationship.
3. Reticence in probing for in-depth PCC answers.
Conclusions: Cultural norms are powerful and can sway a participant from her good intentions, even if the principles of the PCC approach are used effectively. These cultural norms can result in different outcomes with regard to protocol compliance and ring adherence. Further qualitative research is recommended to determine if culture affects counselling in HIV prevention research as this could lead to improved retention and adherence.
