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Abstract

Counseling provided by trained professionals can make a profound impact on the lives of individuals, families and communities. This service helps people navigate difficult life situations, to better understand the reasons why patients default from antiretroviral treatment (ART) programmes while they are being counselled, to help design interventions that improve treatment retention and ultimately, patient outcomes through professional counseling in order to promote change that improves the quality of life for not only their clients, but the public, Hampered in part by lack of empirical evidence for quality of life, which is affecting immune system exposing clients to opportunistic infections.

There is high rate of clients stopping taking the drug that assist them in suppressing an HIV Virus called Ante retroviral drugs despite available counseling services at their clinics. Therefore a research was conducted to determine the relationship between professional counseling and HIV treatment default, AIDS as a disease carries stigma because of the way it is acquired by the people .Traditionally, our society view AIDS affected people as promiscuous and tend to isolate them as bad mannered It is against this background that professional counselling needs to come in to help these people to heal psychologically. Counseling as a profession is supported by quality assurance structures , implemented by an expert group or government body , that mandate the specific knowledge and skills necessary to be a professional counsellor.

Prospective cohort study at two treatment sites in Southern Malawi, Queen Elizabeth Central Hospital) and Chiradzulu district hospital followed by qualitative interviews with patients on treatment and that had defaulted ,deductive and inductive approach had been used, deductive in the sense that the research used the existing theories and models, the study was limited to public hospitals which have well established ART clinics . The research was designed to use cross sectional explorative research. Quantitative data was collected using questionnaires, observations to achieve objectives. Counselling process was used to study the relationship of the parameters. Correlation of default rate to the practice of standard counselling to prove professionalism which is Comparison of adherence to treatment and counsellors qualification. Correlation regression analysis was done.

Respondents overwhelmingly defaulted there treatment, Counsellors were unable to conduct the proper counselling process due to the infrastructure ,no special rooms for counselling ,compromised competency of counsellors. Components had strong positive correlation between default rate and professional counselling. With a better understanding of the reasons for defaulting, interventions can be designed that improve treatment retention and ultimately, patient outcomes. This study argues for introduction of professional counseling cadres in Anteretroviral treatment Clinics of Malawi and policy changes designed to reduce the financial and time burden for follow up of lost to follow up clients , tie burden of HIV profession Counseling and reduce logistic barriers, Privacy has to be addressed and adopting extended and weekend clinic, more awareness on effects of treatment default and community sensitization in reducing stigma.

Keywords: World Health Organisation; Counseling; Couples Counseling; Hiv