title: Knowledge and perceptions of couples' voluntary counseling and testing in urban Rwanda and Zambia: a cross-sectional household survey.
abstract: BACKGROUND
  Most incident HIV infections in sub-Saharan Africa occur between cohabiting, discordant, heterosexual couples. Though couples' voluntary HIV counseling and testing (CVCT) is an effective, well-studied intervention in Africa, <1% of couples have been jointly tested.
  
  
  METHODS
  We conducted cross-sectional household surveys in Kigali, Rwanda (n = 600) and Lusaka, Zambia (n = 603) to ascertain knowledge, perceptions, and barriers to use of CVCT.
  
  
  RESULTS
  Compared to Lusaka, Kigali respondents were significantly more aware of HIV testing sites (79% vs. 56%); had greater knowledge of HIV serodiscordance between couples (83% vs. 43%); believed CVCT is good (96% vs. 72%); and were willing to test jointly (91% vs. 47%). Stigma, fear of partner reaction, and distance/cost/logistics were CVCT barriers.
  
  
  CONCLUSIONS
  Though most respondents had positive attitudes toward CVCT, the majority were unaware that serodiscordance between cohabiting couples is possible. Future messages should target gaps in knowledge about serodiscordance, provide logistical information about CVCT services, and aim to reduce stigma and fear.
authors.affiliation: Project San Francisco, Rwanda Zambia HIV Research Group, Kigali, Rwanda.
authors.forename: April L
authors.initials: AL
authors.lastname: Kelley
authors.forename: Etienne
authors.initials: E
authors.lastname: Karita
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Sullivan
authors.forename: Francois
authors.initials: F
authors.lastname: Katangulia
authors.forename: Elwyn
authors.initials: E
authors.lastname: Chomba
authors.forename: Michel
authors.initials: M
authors.lastname: Carael
authors.forename: Joseph
authors.initials: J
authors.lastname: Telfair
authors.forename: Steve M
authors.initials: SM
authors.lastname: Dunham
authors.forename: Cheswa M
authors.initials: CM
authors.lastname: Vwalika
authors.forename: Michele G
authors.initials: MG
authors.lastname: Kautzman
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Wall
authors.forename: Susan A
authors.initials: SA
authors.lastname: Allen
mesh_terms: D000293:Adolescent; D000328:Adult; D002947:Cities; D003376:Counseling / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology; D019538:Health Care Surveys / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D012432:Rwanda / Q000453:epidemiology; D055815:Young Adult; D015024:Zambia / Q000453:epidemiology