title: Antenatal couple counseling increases uptake of interventions to prevent HIV-1 transmission.
abstract: To determine effect of partner involvement and couple counseling on uptake of interventions to prevent HIV-1 transmission, women attending a Nairobi antenatal clinic were encouraged to return with partners for voluntary HIV-1 counseling and testing (VCT) and offered individual or couple posttest counseling. Nevirapine was provided to HIV-1-seropositive women and condoms distributed to all participants. Among 2104 women accepting testing, 308 (15%) had partners participate in VCT, of whom 116 (38%) were couple counseled. Thirty-two (10%) of 314 HIV-1-seropositive women came with partners for VCT; these women were 3-fold more likely to return for nevirapine (P = 0.02) and to report administering nevirapine at delivery (P = 0.009). Nevirapine use was reported by 88% of HIV-infected women who were couple counseled, 67% whose partners came but were not couple counseled, and 45%whose partners did not present for VCT (P for trend = 0.006). HIV-1-seropositive women receiving couple counseling were 5-fold more likely to avoid breast-feeding (P = 0.03) compared with those counseled individually. Partner notification of HIV-1-positive results was reported by 138 women (64%) and was associated with 4-fold greater likelihood of condom use (P = 0.004). Partner participation in VCT and couple counseling increased uptake of nevirapine and formula feeding. Antenatal couple counseling may be a useful strategy to promote HIV-1 prevention interventions.
authors.affiliation: Department of Medicine, University of Washington, Seattle, WA 98104-249, USA. cfarq@u.washington.edu
authors.forename: Carey
authors.initials: C
authors.lastname: Farquhar
authors.forename: James N
authors.initials: JN
authors.lastname: Kiarie
authors.forename: Barbra A
authors.initials: BA
authors.lastname: Richardson
authors.forename: Marjory N
authors.initials: MN
authors.lastname: Kabura
authors.forename: Francis N
authors.initials: FN
authors.lastname: John
authors.forename: Ruth W
authors.initials: RW
authors.lastname: Nduati
authors.forename: Dorothy A
authors.initials: DA
authors.lastname: Mbori-Ngacha
authors.forename: Grace C
authors.initials: GC
authors.lastname: John-Stewart
mesh_terms: D015492:AIDS Serodiagnosis; D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage; D001942:Breast Feeding; D017280:Condoms / Q000706:statistics & numerical data; D016358:Contact Tracing; D003376:Counseling / Q000706:statistics & numerical data*; D005191:Family Characteristics; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008297:Male; D019829:Nevirapine / Q000008:administration & dosage; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control; D011295:Prenatal Care; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage
chemical_list: D019380:Anti-HIV Agents; D018894:Reverse Transcriptase Inhibitors; D019829:Nevirapine