title: Willingness to use couples HIV testing and discussion of sexual agreements among heterosexuals.
abstract: Couples HIV Testing and Counseling (CHTC) has been used as an HIV prevention strategy in Africa for over 20 years where the HIV epidemic is largely concentrated among sexually active heterosexuals. In recent years, CHTC has been adapted for men who have sex with men (MSM) in the US. A central element of the CHTC intervention as adapted for male couples in the US is the discussion of sexual agreements by the dyad during the CHTC session. Given the success of CHTC for heterosexual couples in Africa, it seems appropriate that CHTC could also be provided to heterosexual couples in the US. However, little is known about heterosexual's willingness to utilize CHTC services including discussion of sexual agreements. This small, preliminary qualitative study sheds new light on the potential for CHTC adoption among heterosexuals in the US. Four focus groups were conducted with heterosexual men and women attending a publicly-funded STI clinic, to explore the potential feasibility and acceptability of CHTC with heterosexuals. The results are similar to those seen for MSM: high levels of willingness to use CHTC, perceptions of the advantages of using CHTC, and willingness to discuss sexual agreements; all necessary conditions for the successful roll-out of CHTC. Further work is now needed with larger samples of high-risk heterosexuals to more completely understand the typologies of sexual agreements and the common language used for sexual agreements in heterosexual relationships. These early data show great promise that CHTC can achieve the same levels of willingness, fit, and acceptability among heterosexual couples as currently experienced by male couples in the US.
authors.affiliation: Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI 48109 USA.
authors.forename: Rob
authors.initials: R
authors.lastname: Stephenson
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322 USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Finneran
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322 USA.
authors.forename: Tamar
authors.initials: T
authors.lastname: Goldenberg
authors.affiliation: Center for Health and Behavioral Training, Infectious Diseases Division, University of Rochester Medical Center, Rochester, NY USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Coury-Doniger
authors.affiliation: Center for Health and Behavioral Training, Infectious Diseases Division, University of Rochester Medical Center, Rochester, NY USA.
authors.forename: Theresa E
authors.initials: TE
authors.lastname: Senn
authors.affiliation: Center for Health and Behavioral Training, Infectious Diseases Division, University of Rochester Medical Center, Rochester, NY USA.
authors.forename: Marguerite
authors.initials: M
authors.lastname: Urban
authors.affiliation: Center for Health and Behavioral Training, Infectious Diseases Division, University of Rochester Medical Center, Rochester, NY USA.
authors.forename: Ann
authors.initials: A
authors.lastname: Schwartz
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322 USA.
authors.forename: Patrick
authors.initials: P
authors.lastname: Sullivan
keywords: Couples; HIV; HIV testing; Heterosexual; Sexual agreements