Antenatal couple counseling increases uptake of interventions to prevent HIV-1 transmission.
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.
Farquhar
Carey
C
Department of Medicine, University of Washington, Seattle, WA 98104-249, USA. cfarq@u.washington.edu
Kiarie
James N
JN
Richardson
Barbra A
BA
Kabura
Marjory N
MN
John
Francis N
FN
Nduati
Ruth W
RW
Mbori-Ngacha
Dorothy A
DA
John-Stewart
Grace C
GC
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
D019380:Anti-HIV Agents; D018894:Reverse Transcriptase Inhibitors; D019829:Nevirapine