title: Predictors of first follow-up HIV testing for couples' voluntary HIV counseling and testing in Ndola, Zambia.
abstract: BACKGROUND
  We describe predictors of first follow-up testing for concordant negative and discordant couples seeking joint voluntary HIV counseling and testing in Ndola, Zambia, where cohabiting couples account for an estimated two-thirds of incident HIV infections.
  
  
  METHODS
  Demographic and serostatus data were collected from couples' voluntary HIV testing and counseling and follow-up testing services implemented in government clinics. We calculated follow-up testing rates by serostatus and compared rates before and after the introduction of a Good Health Package (GHP).
  
  
  RESULTS
  The follow-up testing rate from May 2011 to December 2012 was 12.2% for concordant negative (M-F-) couples and 24.5% for discordant (M+F- or M-F+) couples. Significant predictors of follow-up testing in multivariate analyses included increasing age of the man [adjusted odds ratio (aOR) = 1.02 per year] and the woman (aOR = 1.02 per year), and either partner being HIV+ (aOR = 2.57 for HIV+ man, aOR = 1.89 for HIV+ woman). The man (aOR = 1.29) and the couple (aOR = 1.22) having been previously tested for HIV were predictive of follow-up testing among concordant negative couples. Introduction of a GHP increased follow-up testing among discordant (aOR = 2.93) and concordant negative (aOR = 2.06) couples.
  
  
  CONCLUSIONS
  A low-cost GHP, including prevention, screening, and treatment for common causes of morbidity and mortality resulted in increased follow-up testing rates among HIV discordant and concordant negative couples. Overall follow-up testing rates remain low, and efforts to increase these rates are necessary to ensure linkage to combination prevention, reduce HIV transmission within couples, and identify seroconversions promptly. Further investigation of low-cost sustainable incentives and other factors influencing follow-up HIV testing for couples is needed.
authors: *Rwanda Zambia HIV Research Group, Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, GA; †Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA; and ‡HIV/AIDS Tuberculosis Global Program, Program for Appropriate Technology in Health (PATH), Washington, DC.
authors: Nancy L
authors: NL
authors: Czaicki
authors: Jonathan
authors: J
authors: Davitte
authors: Bella
authors: B
authors: Siangonya
authors: Randee
authors: R
authors: Kastner
authors: Nurilign
authors: N
authors: Ahmed
authors: Naw Htee
authors: NH
authors: Khu
authors: Wan Hsuan
authors: WH
authors: Kuo
authors: Joseph
authors: J
authors: Abdallah
authors: Kristin M
authors: KM
authors: Wall
authors: Amanda
authors: A
authors: Tichacek
authors: Mubiana
authors: M
authors: Inambao
authors: Kakungu
authors: K
authors: Simpungwe
authors: Julie
authors: J
authors: Pulerwitz
authors: Ibou
authors: I
authors: Thior
authors: Susan
authors: S
authors: Allen
mesh_terms: D000293:Adolescent; D000328:Adult; D003376:Counseling / Q000706:statistics & numerical data; D005191:Family Characteristics; D005260:Female; D015658:HIV Infections / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D012747:Sexual Partners; D055815:Young Adult; D015024:Zambia