Increasing HIV testing among male partners.
OBJECTIVE
Couple-oriented posttest HIV counselling (COC) provides pregnant women with tools and strategies to invite her partner to HIV counselling and testing. We conducted a randomized trial of the efficacy of COC on partner HIV testing in low/medium HIV prevalence settings (Cameroon, Dominican Republic, Georgia, India).


METHODS
Pregnant women were randomized to receive standard posttest HIV counselling or COC and followed until 6 months postpartum. Partner HIV testing events were notified by site laboratories, self-reported by women or both combined. Impact of COC on partner HIV testing was measured in intention-to-treat analysis. Socio-behavioural factors associated with partner HIV testing were evaluated using multivariable logistic regression.


RESULTS
Among 1943 pregnant women enrolled, partner HIV testing rates (combined indicator) were 24.7% among women from COC group versus 14.3% in standard posttest HIV counselling group in Cameroon [odds ratio (OR) = 2.0 95% CI (1.2-3.1)], 23.1 versus 20.3% in Dominican Republic [OR = 1.2 (0.8-1.8)], 26.8 versus 1.2% in Georgia [OR = 29.6 (9.1-95.6)] and 35.4 versus 26.6% in India [OR = 1.5 (1.0-2.2)]. Women having received COC did not report more conjugal violence or union break-ups than in the standard posttest HIV counselling group. The main factors associated with partner HIV testing were a history of HIV testing among men in Cameroon, Dominican Republic and Georgia and the existence of couple communication around HIV testing in Georgia and India.


CONCLUSIONS
A simple prenatal intervention taking into account the couple relationship increases the uptake of HIV testing among men in different socio-cultural settings. COC could contribute to the efforts towards eliminating mother-to-child transmission of HIV.
INSERM, Centre INSERM U897 Epidémiologie et Biostatistique, Université Bordeaux Segalen, Bordeaux, France. Joanna.Orne-Gliemann@isped.u-bordeaux2.fr
Joanna
J
Orne-Gliemann
Eric
E
Balestre
Patrice
P
Tchendjou
Marija
M
Miric
Shrinivas
S
Darak
Maia
M
Butsashvili
Eddy
E
Perez-Then
Fred
F
Eboko
Melanie
M
Plazy
Sanjeevani
S
Kulkarni
Annabel
A
Desgrées du Loû
François
F
Dabis
D000328:Adult; D002163:Cameroon / Q000453:epidemiology; D037001:Directive Counseling / Q000706:statistics & numerical data*; D004293:Dominican Republic / Q000453:epidemiology; D005260:Female; D005846:Georgia (Republic) / Q000453:epidemiology; D006679:HIV Seropositivity / Q000175:diagnosis / Q000523:psychology / Q000635:transmission*; D006801:Humans; D007194:India / Q000453:epidemiology; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008297:Male; D008403:Mass Screening; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D011295:Prenatal Care; D011320:Primary Health Care; D012725:Sexual Behavior / Q000523:psychology; D012747:Sexual Partners / Q000523:psychology