Exploring the extent of mental health practice: Content and cluster analysis of techniques used in HIV Testing and Counselling sessions in Uganda

Faith Martin, Eleanor Clowes, Winifred Nalukenge, Cain Clark, Oucul Lazarus, Josephine Birungi, Janet Seeley

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    There is an urgent need for greater provision of mental health services to people living with HIV. HIV testing and counselling (HTC) sessions diagnose HIV and offer appropriate psychosocial support and behavioural messages to support people to link into HIV care. It is not known to what extent HTC currently addresses mental health. We examined transcriptions of 116 audio-recorded HTC sessions delivered in Uganda against a checklist of mental health techniques. Hierarchical cluster analysis explored co-occurrence of techniques. Core counselling skills were very commonly present, and co-occurred. Assessment techniques were not commonly seen. Specific therapy techniques to treat anxiety or depression were not present. HTC staff are a resource for delivering mental health care for people with HIV, owing to their strong fundamental counselling skills. However, training is needed in assessment and evidence-based therapies. Provision of fuller assessment and interventions may increase detection and signposting for mental health and alcohol use, both of which may affect linkage into care. HTC staff have fundamental skills that could also be developed to train and supervise other staff to provide much needed mental health support to people living with HIV. Future research should develop brief mental health interventions for delivery by HTC staff.

    Original languageEnglish
    Pages (from-to)191-197
    Number of pages7
    JournalAIDS Care
    Issue number2
    Early online date22 May 2022
    Publication statusPublished - 1 Feb 2023

    Bibliographical note

    This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-ncnd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.


    This work as supported by the British Academy / Leverhulme Small Grants Fund under Grant SG142741. We would like to thank the staff and service users at TASO who participated in data collection, in addition to the research assistants who supported the data collection. Publisher Copyright: © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.


    • HIV
    • mental health
    • Uganda
    • care continuum
    • testing and counselling


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