Comparing couples' and individual voluntary counseling and testing for HIV at antenatal clinics in Tanzania: A randomized trial

Stan Becker; Rose Mlay; Hilary M. Schwandt; Eligius Lyamuya

doi:10.1007/s10461-009-9607-1

Comparing couples' and individual voluntary counseling and testing for HIV at antenatal clinics in Tanzania: A randomized trial

Stan Becker, Rose Mlay, Hilary M. Schwandt, Eligius Lyamuya

Bloomberg School of Public Health

Research output: Contribution to journal › Article › peer-review

116 Scopus citations

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.

Original language	English (US)
Pages (from-to)	558-566
Number of pages	9
Journal	AIDS and behavior
Volume	14
Issue number	3
DOIs	https://doi.org/10.1007/s10461-009-9607-1
State	Published - Jun 2010

Keywords

Antenatal care
Couples
HIV
Tanzania
Voluntary counseling and testing

ASJC Scopus subject areas

Social Psychology
Public Health, Environmental and Occupational Health
Infectious Diseases

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10.1007/s10461-009-9607-1

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title = "Comparing couples' and individual voluntary counseling and testing for HIV at antenatal clinics in Tanzania: A randomized trial",

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.",

keywords = "Antenatal care, Couples, HIV, Tanzania, Voluntary counseling and testing",

author = "Stan Becker and Rose Mlay and Schwandt, {Hilary M.} and Eligius Lyamuya",

note = "Funding Information: Acknowledgments This research was funded by the Center for AIDS Research of Johns Hopkins University. Analyses were supported by the Bill and Melinda Gates Institute for Population and Reproductive Health and the Hopkins Population Center, also of Johns Hopkins University. We also thank Professor Ron Gray of Johns Hopkins University, Dr. Godfrey Kigozi of the Rakai Health Sciences Program, and Dr. Jessie Mbwambo of Muhimbili University College of Health Sciences, for serving on the Data Safety and Monitoring Board for the project. We are grateful to Professor Suzanne Maman of the University of North Carolina for helpful suggestions as we designed the study. We thank the Temeke District Authority for assisting in the identification of study clinics. We extend our sincere appreciation to the counselors, interviewers, data processing staff, and laboratory staff, as well as the women and men who participated in the study. Copyright: Copyright 2010 Elsevier B.V., All rights reserved.",

year = "2010",

month = jun,

doi = "10.1007/s10461-009-9607-1",

language = "English (US)",

volume = "14",

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AU - Schwandt, Hilary M.

AU - Lyamuya, Eligius

N1 - Funding Information: Acknowledgments This research was funded by the Center for AIDS Research of Johns Hopkins University. Analyses were supported by the Bill and Melinda Gates Institute for Population and Reproductive Health and the Hopkins Population Center, also of Johns Hopkins University. We also thank Professor Ron Gray of Johns Hopkins University, Dr. Godfrey Kigozi of the Rakai Health Sciences Program, and Dr. Jessie Mbwambo of Muhimbili University College of Health Sciences, for serving on the Data Safety and Monitoring Board for the project. We are grateful to Professor Suzanne Maman of the University of North Carolina for helpful suggestions as we designed the study. We thank the Temeke District Authority for assisting in the identification of study clinics. We extend our sincere appreciation to the counselors, interviewers, data processing staff, and laboratory staff, as well as the women and men who participated in the study. Copyright: Copyright 2010 Elsevier B.V., All rights reserved.

PY - 2010/6

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N2 - 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.

AB - 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.

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Comparing couples' and individual voluntary counseling and testing for HIV at antenatal clinics in Tanzania: A randomized trial

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