Evaluation of a Training Intervention for Couples' HIV Counseling and Testing Counselors in Copperbelt Province, Zambia Open Access

Abstract

With the expansion of couples' voluntary HIV counseling and testing (CVCT) in urban Zambia, there has been a growing need to evaluate CVCT trainings to ensure that couples are receiving quality counseling and care. Zambia-Emory HIV Research Project (ZEHRP) has been providing CVCT counseling, laboratory testing, and data management trainings in the Copperbelt Province since 2008. The objective of this study was to answer two questions regarding the CVCT trainings held by ZEHRP: (1) Were the training programs successful in improving knowledge of relevant facts and procedures? (2) Was the knowledge among non-medical "lay" counselors comparable to that of medically trained counselors before and after the trainings? This study evaluated 1,283 counselors, rapid HIV testing staff ("laboratory"), and data managers. Each of the trainings was quantitatively measured in a pre-post test design based mainly on true/false questions. The tests covered topics including the cause of HIV infection, modes of transmission, the basics of couples' counseling, and the counseling of discordant results. Following training, the overall average score increased from 68.8% at baseline to 83.8% (p < 0.001). Average scores across covariates, including years of experience, education, and medical background also resulted in statistically significant improvement during the post-test (p < 0.001). 98.4% of data management and laboratory testing trainees passed their post-training test with at least an 80%. In contrast, the average post-training score for counselor trainees was below 80% in some groups including men, those over the age of 50, those trained before 2011, and those with less than a college education or a non-medical background. Counselors in two of the four cities had average post training scores greater than 80%. Most of these factors remained predictive of post-test scores in multivariate analyses, with significant interactions occurring between several variables. Systematic pre and post-test assessments are critical to ensure quality services and to highlight training components that must be repeated until passing scores are achieved, particularly as task-shifting from medical to lay staff becomes more common.

Table of Contents

ABSTRACT

1

INTRODUCTION

2

METHODS

5

RESULTS

7

DISCUSSION

10

CONCLUSION

12

REFERENCES

13

TABLES

16

APPENDIX A: Formation of the pre-test ANCOVA model

20

APPENDIX B: Formation of the post-test ANCOVA model

21

APPENDIX C: IRB letter of approval

23

About this Master's Thesis

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Global Epidemiology - MPH & MSPH
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	sub-Saharan Africa HIV counseling and testing CVCT Training intervention Task shifting Lay counselors
Committee Chair / Thesis Advisor	Allen, Susan A, Emory University
Partnering Agencies	International Non-governmental organization (e.g., CARE, Inc.)

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