Marseille 2007
| Abstract #429 - HIV counselling as a local, subjective and interactive practice - Anthropological approach of breastfeeding prevention of HIV in south India | ||||
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Session: 38.6: Counselling and Therapy (Parallel) on Tuesday @ 14.00-16.00 in CP Chaired by Barbara Hedge, Michael Blank Authors: Presenting Author: Mrs Mary-ashley Ouvrier - CreCSS/universit Paul Cezanne, France |
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| Additional Authors: Dr Patrice Cohen, | ||||
| Aim: Even though HIV counselling is based on an international definition and strategy supported by WHO, it might be define and practice differently depending on the cultural and economic context in which it is organised. In deed, counselling refers in each country to specific strategies and practices related to the institutions (public, private, NGOs) and the actors (counsellors, doctors, nurses, health managers) involved in HIV treatment and prevention. This paper intends to bring an anthropological analysis of the diversity of counselling practices with regard breastfeeding prevention in South India | ||||
| Method / Issue: This research is part of an anthropological study of mother to child transmission of HIV through breastfeeding that took place in Chennai (India) in 2005. It is based on observations and qualitiative interviews conducted whith several key actors in the breastfeeding prevention in Chennai such as health managers, NGO managers, counsellors, nurses and doctors. This study has been jointly conducted by an indo-french partnership between GRIS (Rouen, France), IFP (Pondicherry, India) and YRG CARE (Chennai,India). The project has been funded by Sidaction, France. | ||||
| Results / Comments: Analysis shows that breastfeeding and PMTCT counselling is varying according to factors related to the institution in which the prevention is organized, counsellors skills and knowledge, his interaction with the patient and his own identity and culture. This communication will show how counsellors interviewed in Chennai are using various strategies in counselling breast-feeding mothers, depending on the place where the counselling is offered, his own perception of risk and the local public and private recommendations regarding HIV transmission through breastfeeding. More specifically, the analysis will show how counsellors dicourse leads to the local dilemma regarding the management of breastfeeding prevention of HIV (exclusive formula feeding versus exclusive breastfeeding), the position of counselling in the health system and their personal every day ethical decisions. | ||||
| Discussion: This interpretative approach of counselling brings a reflection on the local, subjective and interactive applications of an international and standardised concept that is a core element of HIV prevention and clinical management. Focusing on PMTCT counselling the study proposes to open up discussions on other forms of counselling (pre-test counselling, post test counselling, adherence counselling) and to think about the specific issues faced by counsellors in southern countries. | ||||
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