Increasing HIV testing among male partners.

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Global Health

Background:

• Preventing mother-to-child HIV transmission (PMTCT) is a global health priority.
• Partner HIV testing is crucial for reducing HIV transmission within couples and preventing vertical transmission.
• Couple-oriented counselling strategies may enhance male partner engagement in HIV testing during pregnancy.

Purpose of the Study:

• To evaluate the efficacy of couple-oriented posttest HIV counselling (COC) in increasing partner HIV testing rates.
• To assess the impact of COC on partner HIV testing in low/medium HIV prevalence settings.
• To identify socio-behavioural factors associated with partner HIV testing.

Main Methods:

• A randomized trial involving 1943 pregnant women in Cameroon, Dominican Republic, Georgia, and India.
• Participants were randomized to receive standard posttest HIV counselling or COC.
• Partner HIV testing was tracked via laboratory reports and self-reporting, analyzed using intention-to-treat and multivariable logistic regression.

Main Results:

• COC significantly increased partner HIV testing rates in Cameroon (24.7% vs 14.3%), Georgia (26.8% vs 1.2%), and India (35.4% vs 26.6%).
• No increase in conjugal violence or union break-ups was reported in the COC group.
• Key factors for partner testing included prior male HIV testing and couple communication about HIV.

Conclusions:

• A simple prenatal intervention focusing on the couple relationship effectively increases male partner HIV testing uptake.
• Couple-oriented posttest HIV counselling is a viable strategy for PMTCT efforts.
• The intervention shows promise across diverse socio-cultural contexts.