most effective HIV prevention intervention for cohabitating couples in Africa, the largest group at risk for HIV infection in the world. very few couples in high-prevalence areas have been tested together. couples will come together for testing if financial and logistical obstacles are overcome. VCT is becoming increasingly available with the advent of perinatal prevention efforts and antiretroviral medication provision programs, but these programs prioritize the individual and generally do not accommodate couples
IN KIGALI, RWANDA, HIV TESTING FOR COUPLES FIRST BEGAN IN 1988 AS PART OF PROJET SAN FRANCISCO, A RESEARCH PROJECT EVIDENCE OF REDUCED HIV, STI, AND UNPLANNED PREGNANCY WAS PUBLISHED AS EARLY AS 1991-1993, WITH SIMILAR PUBLICATIONS FROM GROUPS IN OTHER AFRICAN COUNTRIES.
Stepping back, couples’ testing was successful early on, prior to availability of any PMTCT drug regimens: in both Kigali and Lusaka, our World AIDS Foundation program was able to train counselors to provide HIV testing for women during the week and with their partners on weekends. The publication detailing the findings is available, but of note on this slide are the couples with HIV+ men and HIV- women; these couples contribute to 85% of the new infections that occur in pregnant and breastfeeding women.
Lack of trained staff to promote and deliver couples counseling
HIV testing for couples William Kilembe MD MSc Rwanda Zambia HIV Research Group 19 July 2010
Successfully implemented in 2001 in 2 ANC clinics in Lusaka and 2 clinics in Kigali
No HIV testing was available at the outset, within 8 months >2000 women were tested alone during the week and >1600 women with partners on weekends
World AIDS Foundation HIV testing Program in antenatal clinics-2001 8 months in 2001 KIGALI LUSAKA RWANDA ZAMBIA Singles N 193 91 HIV+ 21% 22% Married F tested alone 791 931 14% 27% Couples N 956 663 HIV + M / HIV + F 8% 18% HIV - M / HIV + F 5% 9% HIV + M / HIV - F 4% 8% HIV - M / HIV - F 83% 64%