title: Promotion of couples' voluntary counselling and testing for HIV through influential networks in two African capital cities.
abstract: BACKGROUND
  Most new HIV infections in Africa are acquired from cohabiting heterosexual partners. Couples' Voluntary Counselling and Testing (CVCT) is an effective prevention strategy for this group. We present our experience with a community-based program for the promotion of CVCT in Kigali, Rwanda and Lusaka, Zambia.
  
  
  METHODS
  Influence Network Agents (INAs) from the health, religious, non-governmental, and private sectors were trained to invite couples for CVCT. Predictors of successful promotion were identified using a multi-level hierarchical analysis.
  
  
  RESULTS
  In 4 months, 9,900 invitations were distributed by 61 INAs, with 1,411 (14.3%) couples requesting CVCT. INAs in Rwanda distributed fewer invitations (2,680 vs. 7,220) and had higher response rates (26.9% vs. 9.6%), than INAs in Zambia. Context of the invitation event, including a discreet location such as the INA's home (OR 3.3-3.4), delivery of the invitation to both partners in the couple (OR 1.6-1.7) or to someone known to the INA (OR 1.7-1.8), and use of public endorsement (OR 1.7-1.8) were stronger predictors of success than INA or couple-level characteristics.
  
  
  CONCLUSIONS
  Predictors of successful CVCT promotion included strategies that can be easily implemented in Africa. As new resources become available for Africans with HIV, CVCT should be broadly implemented as a point of entry for prevention, care and support.
authors: The Rwanda-Zambia HIV Research Group, 1520 Clifton Road, Emory University, Atlanta, GA 30322, USA. sallen5@sph.emory.edu
authors: Susan
authors: S
authors: Allen
authors: Etienne
authors: E
authors: Karita
authors: Elwyn
authors: E
authors: Chomba
authors: David L
authors: DL
authors: Roth
authors: Joseph
authors: J
authors: Telfair
authors: Isaac
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authors: Zulu
authors: Leslie
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authors: Clark
authors: Nzali
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authors: Kancheya
authors: Martha
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authors: Conkling
authors: Rob
authors: R
authors: Stephenson
authors: Brigitte
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authors: Bekan
authors: Katherine
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authors: Kimbrell
authors: Steven
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authors: Dunham
authors: Faith
authors: F
authors: Henderson
authors: Moses
authors: M
authors: Sinkala
authors: Michel
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authors: Carael
authors: Alan
authors: A
authors: Haworth
mesh_terms: D000328:Adult; D003376:Counseling; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000517:prevention & control* / Q000523:psychology; D006293:Health Promotion / Q000379:methods*; D020010:Heterosexuality; D006801:Humans; D008297:Male; D015397:Program Evaluation; D011446:Prospective Studies; D012432:Rwanda / Q000453:epidemiology; D021841:Safe Sex; D012737:Sex Factors; D012747:Sexual Partners / Q000523:psychology*; D012944:Social Support; D014504:Urban Health; D035141:Voluntary Programs; D015024:Zambia / Q000453:epidemiology