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Poverty and InequalitySexual and Reproductive HealthFamily, Maternal & Child HealthMethodology

Comparing Couples' and Individual Voluntary Counseling and Testing for HIV at Antenatal Clinics in Tanzania: A Randomized Trial

TitleComparing Couples' and Individual Voluntary Counseling and Testing for HIV at Antenatal Clinics in Tanzania: A Randomized Trial
Publication TypeJournal Article
Year of Publication2010
AuthorsBecker, S, Mlay, R, Schwandt, HM, Lyamuya, E
JournalAIDS and behavior
Volume14
Pagination558-566
Date PublishedJun
ISBN Number1573-3254; 1090-7165
Accession Number19763813
Keywords*Family Characteristics, *HIV Infections/diagnosis/drug therapy/epidemiology/virology, *Pregnancy Complications, Infectious/diagnosis/drug therapy/epidemiology/virology, *Prenatal Care, Adult, AIDS Serodiagnosis/*methods, Anti-HIV Agents/therapeutic use, Counseling/*methods, Female, HIV-1, Humans, Infectious Disease Transmission, Vertical/prevention & control, Male, Nevirapine/therapeutic use, Patient Acceptance of Health Care, Pregnancy, Reverse Transcriptase Inhibitors/therapeutic use, Tanzania/epidemiology, Treatment Outcome, Young Adult
Abstract

Voluntary counseling and testing (VCT) for couples (CVCT) is an important HIV-prevention effort in sub-Saharan Africa where a substantial proportion of HIV transmission occurs within stable partnerships. This study aimed to determine the acceptance and effectiveness of CVCT as compared to individual VCT (IVCT). 1,521 women attending three antenatal clinics in Dar es Salaam were randomized to receive IVCT during that visit or CVCT with their husbands at a subsequent visit. The proportion of women receiving test results in the CVCT arm was significantly lower than in the IVCT arm (39 vs. 71%). HIV prevalence overall was 10%. In a subgroup analysis of HIV-positive women, those who received CVCT were more likely to use preventive measures against transmission (90 vs. 60%) and to receive nevirapine for themselves (55 vs. 24%) and their infants (55 vs. 22%) as compared to women randomized to IVCT. Uptake of CVCT is low in the antenatal clinic setting. Community mobilization and couple-friendly clinics are needed to promote CVCT.