Implementation of couples’ voluntary HIV counseling and testing services in Durban, South Africa

BMC Public Health

Research Article

Mark Brockman¹  Mammekwa Mokgoro²  Miriam Kamusoko²  Thumbi Ndung’u³  Tarylee Reddy⁴  Annie Mwaanga⁵  William Kilembe⁵  Jean Sakulanda⁵  Hilda Phiri⁵  Jonathan Davitte⁵  Elisabeth Dissen⁵  Kristin M. Wall⁶  Susan Allen⁷ 

[1] Faculty of Health Sciences and Faculty of Science, Department of Molecular Biology and Biochemistry, Simon Fraser University, British Columbia, Canada;HIV Pathogenesis Programme, Doris Duke Medical Research Institute, University of Kwa Zulu Natal, Durban, South Africa;HIV Pathogenesis Programme, Doris Duke Medical Research Institute, University of Kwa Zulu Natal, Durban, South Africa;KwaZulu-Natal Research Institute for Tuberculosis and HIV (K-RITH), University of KwaZulu-Natal, Durban, South Africa;Medical Research Council, Biostatistics unit, Durban, South Africa;Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine, Emory University, Atlanta, GA, USA;Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine, Emory University, Atlanta, GA, USA;Department of Epidemiology, School of Public Health, Emory University, 1518 Clifton Road NE, 4011, 30322, Atlanta, GA, USA;Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine, Emory University, Atlanta, GA, USA;Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA;

关键词: Heterosexual couples;    Couples’ HIV voluntary counseling and testing;    South Africa;    HIV prevention;    Implementation science;   

DOI  :  10.1186/s12889-015-1959-z

 received in 2015-01-06, accepted in 2015-06-22,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundCouples’ voluntary HIV counseling and testing (CVCT) is an evidence-based intervention that significantly reduces HIV incidence in couples. Despite the high prevalence of HIV and HIV couple serodiscordance in South Africa, there are few CVCT services.MethodsFrom February-June 2013, The Rwanda Zambia HIV Research Group provided support, training, and technical assistance for local counselors and promoters to pilot CVCT services in five hospital-based clinics in Durban, South Africa. Client-level data (age, gender, years cohabiting, pregnancy status, previous testing, antiretroviral treatment (ART) status, neighborhood, and test site) collected as a component of routine CVCT service operation is presented stratified by couple serostatus.ResultsTwenty counselors and 28 promoters completed training. Of 907 couples (1,814 individuals) that underwent CVCT, prevalence of HIV was 41.8 % and prevalence of HIV serodiscordance was 29.5 % (19.3 % M-F+, 10.3 % M + F-). Most participants were 25–34 years of age, and this group had the highest prevalence. Previous individual HIV testing was low (50 % for men, 63 % for women). Only 4 % of couples reported previous CVCT. Most (75 %) HIV+ partners were not on ART, and HIV+ individuals in discordant couples were more likely to be on ART than those in concordant positive couples. Pregnancy among HIV+ women was not associated with previous HIV testing or ART use.ConclusionsImplementation of standard CVCT services was found to be feasible in Durban. The burden of HIV and couple serodiscordance in Durban was extremely high. CVCT would greatly benefit couples in Durban as an HIV prevention strategy.

【 授权许可】

Unknown   
© Kilembe et al. 2015. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.