Promotion of couples' voluntary counselling and testing for HIV through influential networks in two African capital cities

Susan Allen, Etienne Karita, Elwyn Chomba, David L. Roth, Joseph Telfair, Isaac Zulu, Leslie Clark, Nzali Kancheya, Martha Conkling, Rob Stephenson, Brigitte Bekan, Katherine Kimbrell, Steven Dunham, Faith Henderson, Moses Sinkala, Michel Carael, Alan Haworth

Research output: Contribution to journalArticlepeer-review

86 Scopus citations


Background. Most new HIV infections in Africa are acquired from cohabiting heterosexual partners. Couples' Voluntary Counselling and Testing (CVCT) is an effective prevention strategy for this group. We present our experience with a community-based program for the promotion of CVCT in Kigali, Rwanda and Lusaka, Zambia. Methods. Influence Network Agents (INAs) from the health, religious, non-governmental, and private sectors were trained to invite couples for CVCT. Predictors of successful promotion were identified using a multi-level hierarchical analysis. Results. In 4 months, 9,900 invitations were distributed by 61 INAs, with 1,411 (14.3%) couples requesting CVCT. INAs in Rwanda distributed fewer invitations (2,680 vs. 7,220) and had higher response rates (26.9% vs. 9.6%), than INAs in Zambia. Context of the invitation event, including a discreet location such as the INA's home (OR 3.3-3.4), delivery of the invitation to both partners in the couple (OR 1.6-1.7) or to someone known to the INA (OR 1.7-1.8), and use of public endorsement (OR 1.7-1.8) were stronger predictors of success than INA or couple-level characteristics. Conclusion. Predictors of successful CVCT promotion included strategies that can be easily implemented in Africa. As new resources become available for Africans with HIV, CVCT should be broadly implemented as a point of entry for prevention, care and support.

Original languageEnglish (US)
Article number349
JournalBMC public health
StatePublished - 2007
Externally publishedYes

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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