| Summary: | Includes bibliographical references. === The challenges of communication in the multilingual and multicultural South African health care context are exacerbated by the complexities and demands introduced by HIV/AIDS. Despite the wealth of information on aspects related to the doctor-patient relationship, communication in HIV/AIDS care settings has received very little attention in the literature. South Africa leads the HIV/AlDS pandemic in numbers, yet almost no locally relevant information is available on the nature of communication in HIV/AIDS care settings. The study has aimed to address this need. A qualitative research design within an interpretive paradigm was followed. The primary aim of the study was to describe and explain communication in a paediatric outpatient HIV I AIDS clinic from the multiple perspectives of caregivers, counsellors and doctors. Semi-structured interviews with 11 caregivers of HIV positive children, four NGO trained HIVI AIDS counsellors and four doc1Drs were conducted. A phenomenological data analysis procedure was followed. Rich descriptions of the communication experiences of the three groups of participants were constructed and five central themes were identified. Communication in the clinic meant sharing meaning across differences. The language and cultural divide between caregivers and doc1Drs could be successfully bridged by a doctor facilitative conversational style and the participation of counsellors in communication. Effective communication was dependant on systemic support and infrastructure. Communication in the clinic involved more 1I1an words, was shaped by context, required the collective effort of all role players, and was transactional in nature and powerful to affect the lives of caregivers, counsellors and doctors. Recommendations regarding practice and education were made.
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