Motivational Interviewing in HIV Counseling and Testing : A Basic Training Manual for Community -Based Organizations

The main objective of the manual is to provide a simplified and practical guide to communitypartners who are interested to introduce the Brief Intervention using Motivational Interviewing (MI) approach in their existing programs for high risk populations. MI is a directive, client-centered counseling method developed from experience of alcohol and drug addiction treatment. Listed as one of the best interventions by the US Centers of Disease Control and Prevention, MI has been proven to elicit behavioral change by helping clients to explore and resolve ambivalence across many clinical and non-clinical settings. Previous studies have shown that MI increases uptake of HIV testing and improves health outcomes among high risk populations who struggle with adherence to antiretroviral treatment, depression and risky sexual behaviours.1-9 Particularly, in a randomized controlled trial, participants who received MI were twice as likely to undergo HIV counseling and testing compared to the those in the control group (49 versus 20 percent, x2=17.94, p<0.001). In March 2017, the Centre of Excellence for Research in AIDS (CERiA) of Faculty of Medicine, University Malaya, embarked on a study to introduce and evaluate an MI approach into the existing HIV case management program or MSM in Malaysia. In this study, a total of 112 participants received the brief intervention using MI principles. After the brief intervention, 87 (77.7 percent) agreed and underwent HIV testing. Participants took a short survey before and after the brief intervention with MI. All specific concerns prior to HIV testing were significantly reduced after the brief intervention. At the post-MI survey, a majority of the participants (90 percent) agreed that they were satisfied with the MI intervention while 27 percent felt that they were being lectured and 9 percent felt pressured in the conversation. Furthermore, case workers from KLASS reported high levels of satisfaction in delivering MI as it helps build trust and rapport with their clients.