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Researchers report that HIV testing
and counseling of couples resulted in consistent condom use among
sero-discordant couples in stable relationships in South Africa. The study
determined whether HIV testing and counseling (HTC)—with ongoing counseling and
condom distribution—resulted in reduced unprotected sex in HIV-discordant
couples who are in stable relationships.
Participants were part of the
Partners in Prevention HSV/HIV transmission study to assess acyclovir as a
secondary prophylaxis in HIV/HSV-2 co-infected persons to prevent transmission
to their uninfected partner. The 508 HIV-infected participants self-reported
behavioral data. They were from three South African sites: Gugulethu, Orange
Farm, and Soweto. Most of the couples were in long-term relationships with low
levels of intimate partner violence. The HIV-positive participants were
predominantly female (77 percent), with a mean age of 33 years.
The important factor in the study
was the timing of HTC for the HIV-positive participant: 0?7 days after testing
positive, 8?14, 15–30, and more than 30 days. The primary outcome was
unprotected sex reported by the person with HIV. Predicted probabilities of
unprotected sex in the last month were calculated at baseline, at one month,
and at 12 months. Of the participants, 71 percent who recently learned their
HIV status reported having unprotected sex as compared to 25 percent who knew
their status for a month. One month later, after all the couples had received
HIV testing and counseling and were aware of the discordant relationship, the
proportion of participants reporting unprotected sex was reduced from 71 percent
to 8 percent.
Monthly counseIing for the
sero-positive partner, quarterly individual or couples’ testing, counseling for
the uninfected partner, and condom provision resulted in the couples
maintaining low levels of unprotected sex for one year. The authors conclude
that the findings provide evidence that couples HTC is effective at rapidly
increasing condom uptake, facilitating on-going condom use, and lowering rates
of transmission. They advise caution in generalizing the findings to other than
stable relationships.
The study,” HIV Testing and
Counseling Leads to Immediate Consistent Condom Use Among South African Stable
HIV-Discordant Couples,” was published ahead of print in the Journal of
Acquired Immune Deficiency Syndrome (doi: 10.1097/QAI.0b013e31827971ca).
The Friends of AIDS Foundation is
dedicated to enhancing the quality of life for HIV positive individuals and
empowering people to make healthy choices to prevent the spread of the HIV
virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.
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