Effect of serotesting with counselling on condom use and seroconversion among HIV discordant couples in Africa.
OBJECTIVE
To determine whether HIV testing and counselling increased condom use and decreased heterosexual transmission of HIV in discordant couples.


METHODS
Prospective study.


METHODS
Kigali, the capital of Rwanda.


METHODS
Cohabiting couples with discordant HIV serology results.


METHODS
Condom use in the couple and HIV seroconversion in the negative partners.


RESULTS
60 HIV discordant couples were identified, of whom 53 were followed for an average of 2.2 years. The proportion of discordant couples using condoms increased from 4% to 57% after one year of follow up. During follow up two of the 23 HIV negative men and six of the 30 HIV negative women seroconverted (seroconversion rates of 4 and 9 per 100 person years). The rate among women was less than half that estimated for similar women in discordant couples whose partners had not been serotested. Condom use was less common among those who seroconverted (100% v 5%, p = 0.01 in men; 67% v 25%, p = 0.14 in women).


CONCLUSIONS
Roughly one in seven cohabiting couples in Kigali have discordant HIV serological results. Confidential HIV serotesting with counselling caused a large increase in condom use and was associated with a lower rate of new HIV infections. HIV testing is a promising intervention for preventing the spread of HIV in African cities.
Allen
S
S
Department of Pathology, University of California, San Francisco.
Tice
J
J
Van de Perre
P
P
Serufilira
A
A
Hudes
E
E
Nsengumuremyi
F
F
Bogaerts
J
J
Lindan
C
C
Hulley
S
S
D015492:AIDS Serodiagnosis; D000328:Adult; D003275:Contraceptive Devices, Male / Q000706:statistics & numerical data*; D003376:Counseling; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000523:psychology; D006679:HIV Seropositivity / Q000453:epidemiology; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012432:Rwanda / Q000453:epidemiology; D012737:Sex Factors; D012725:Sexual Behavior