Argumentation and Paralinguistic Strategies in HIV/AIDS Counselling: A Critical Discourse Analysis of Treatment Adherence in Cameroon

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.