Argumentation and Paralinguistic Strategies in HIV/AIDS Counselling: A Critical Discourse Analysis of Treatment Adherence in Cameroon
Authors
Assistant Lecturer of English Grammar and Lexicology, Stylistics, Writing Skills and Discourse Analysis, English Department of the Faculty of Arts, Letters and Social Sciences, University of Yaounde 1. (Cameroon)
Senior Contract Officer, Ministry of Communication (Cameroon)
Article Information
DOI: 10.47772/IJRISS.2026.100400071
Subject Category: Education
Volume/Issue: 10/4 | Page No: 981-993
Publication Timeline
Submitted: 2026-03-29
Accepted: 2026-04-03
Published: 2026-04-27
Abstract
HIV treatment adherence remains a major challenge in many parts of Sub-Saharan Africa despite significant advances in antiretroviral therapy. While medical research has extensively examined biomedical and behavioural factors influencing adherence, the role of language in counselling interactions has received comparatively little attention. This study examines the discursive and paralinguistic strategies used in HIV/AIDS counselling sessions to promote treatment adherence and reduce stigma. Drawing on the framework of Critical Discourse Analysis, particularly Ruth Wodak’s Discourse Historical Approach and Teun van Dijk’s socio-cognitive perspective, the study analyses recorded counselling sessions and interviews conducted at the Bamenda Regional Hospital in Cameroon. The data, largely produced in Cameroon Pidgin English, reveal that counsellors employ a variety of argumentative strategies including persuasion, moral appeals, and legitimation to encourage testing, safe sexual behaviour, and adherence to antiretroviral therapy. In addition, paralinguistic features such as tone, laughter, and repetition play a crucial role in easing tension, fostering trust, and facilitating communication between counsellors and patients. The study highlights the importance of language in shaping health behaviour and demonstrates how discourse practices contribute to improving HIV treatment adherence and reducing stigma in clinical contexts.
Keywords
HIV/AIDS, Counselling
Downloads
References
1. Attonito, J. (2014). Antiretroviral treatment adherence as a mediating factor between psychosocial variables and HIV viral load. The journal of the association of nurses in Aids Care: Janac 08 Aug 2014, 25(6):626-637 [Google Scholar] [Crossref]
2. Barki, B. & Mukhopadhyay, B. (1991). Guidance and Counseling A Manual, India Sterling Publisher Pvt. Limited, New Delhi. [Google Scholar] [Crossref]
3. Barnett, T. & Blaikie, P. (1992). AIDS in africa: It’s present and future impact. New York: Guilford Press. [Google Scholar] [Crossref]
4. Beck, A. (1967). Depression: clinical, experimental and theoretical aspects. New York, NY: Hoeber. [Google Scholar] [Crossref]
5. Becker, M. (1990). ‘Theoretical models of adherence and strategies for improving adherence’. In S. Shumaker, E. Schron, J. Ockene, et al., eds. Handbook of Behavior Change. New York: Springer. [Google Scholar] [Crossref]
6. Byrne, S. & Long, L. (1976). A classification for rating the interview style of doctors. Pergamon Press Ltd. [Google Scholar] [Crossref]
7. Cameron, E. (2000). The deafening silence of AIDS. Health and human rights, 5(1), 7-24. [Google Scholar] [Crossref]
8. Cameron, C. (2006). ‘Testing formal theories of political rhetoric’. Vol. 62. Pg. 187-205. [Google Scholar] [Crossref]
9. Cook, G. (2003). Applied Linguistics. Oxford, UK: Oxford University Press. [Google Scholar] [Crossref]
10. Douglas, M. & Wildavsky, A. (1982). Risk and culture: An essay on the selection of technical and environmental dangers. Berkeley, CA: University of California. [Google Scholar] [Crossref]
11. Fairclough, N. (2003). Analysing discourse: Textual analysis for social research. London, Routledge. [Google Scholar] [Crossref]
12. Herek, G. (2000). The social construction of attitudes: Functional consensus and divergence in the US public's reactions to AIDS. In G. Maio & J. Olson (Eds.), Why we evaluate: Functions of attitudes (pp. 325-364). Mahwah, NJ: Lawrence Erlbaum. [Google Scholar] [Crossref]
13. Jones, R. (2014). Health and risk communication. An applied linguistic perspective. Routledge: New York. [Google Scholar] [Crossref]
14. Kalichman, S. & Simbayi, L. (2003). HIV testing attitudes AIDS stigma, and voluntary counseling and testing in a Black township in Cape Town, South Africa. Sexually Transmitted Infections. PubMed; 79:442–447. [Google Scholar] [Crossref]
15. Malcolm, A. et al. (1998). HIV-related stigmatization and discrimination: Its forms and contexts. Critical Public Health. 1998; 9:347–370. [Google Scholar] [Crossref]
16. Reisigl, M. & Wodak, R. (2009) “The discourse-historical approach,” in R. Wodak and M. Meyer (eds) Methods of CDA, London: Sage, pp. 87–121 [Google Scholar] [Crossref]
17. Ten Have, P. (1989). ‘The consultation as a genre. In B. Torode’. (Ed.), Text and talk as social practice: Discourse difference and division in speech and writing (pp. 115-35). Dordrecht: Foris Publications. [Google Scholar] [Crossref]
18. _______________ (1991). ‘Talk and institution: A reconsideration of the ‘asymmetry’ of doctor-patient interaction. In D. Boden and D. H. Zimmerman’. (Eds.), Talk and social structure: Studies in ethnomethodology and conversation analysis (pp. 138-63). Cambridge: Polity Press. [Google Scholar] [Crossref]
19. ________________ (1991). Doing conversation analysis: A practical guide. London: Sage. [Google Scholar] [Crossref]
20. UNAIDS. HIV and AIDS-related stigmatization, discrimination, and denial: Forms, contexts, and determinants. Geneva, Switzerland: 2000. [Google Scholar] [Crossref]
21. Van Dijk, T. (1985). Handbook of discourse analysis. California, Academic Press. [Google Scholar] [Crossref]
22. ________________ (2003). “The Discourse – knowledge interface. In: Weiss, G. and R. Wodak (eds) Multidisciplinary CDA. London, Longman, 85-109 [Google Scholar] [Crossref]
23. Wodak, R. (2001). “The Discourse-Historical Approach,” in R. Wodak and M. Meyer (eds) Methods of CDA, London: Sage, pp. 81–115. [Google Scholar] [Crossref]
Metrics
Views & Downloads
Similar Articles
- Assessment of the Role of Artificial Intelligence in Repositioning TVET for Economic Development in Nigeria
- Teachers’ Use of Assure Model Instructional Design on Learners’ Problem Solving Efficacy in Secondary Schools in Bungoma County, Kenya
- “E-Booksan Ang Kaalaman”: Development, Validation, and Utilization of Electronic Book in Academic Performance of Grade 9 Students in Social Studies
- Analyzing EFL University Students’ Academic Speaking Skills Through Self-Recorded Video Presentation
- Major Findings of The Study on Total Quality Management in Teachers’ Education Institutions (TEIs) In Assam – An Evaluative Study