Increasing HIV testing among male partners. The Prenahtest ANRS 12127 multi-country randomised trial

aUniversity Bordeaux, ISPED, Centre Inserm U897- Epidemiologie-Biostatistique, F-33000 Bordeaux, France bINSERM, ISPED, Centre Inserm U897- Epidemiologie-Biostatistique, F-33000 Bordeaux, France cLaboratoire d'Epidémiologie et de Santé Publique, Centre Pasteur du Cameroun, Yaoundé, Cameroun dCentro Nacional de Investigaciones en Salud Materno Infantil, Santo Domingo, Dominican Republic ePrayas Health Group, Prayas, Pune, India fMaternal and Child Care Union, Neoclinic, Tbilisi, Georgia gInstitut de Recherche pour le Développement, UMR 912 IRD-INSERM-U2, Marseille, France hInstitut de Recherche pour le Développement, CEPED UMR Sorbonne Paris Descartes -INED-IRD, Paris, France iRéseau International des Instituts Pasteurs, Paris, France.
AIDS (London, England) (Impact Factor: 6.56). 01/2013; 27(7). DOI: 10.1097/QAD.0b013e32835f1d8c
Source: PubMed

ABSTRACT OBJECTIVE:: Couple-oriented post-test HIV counselling (COC) provides pregnant women with tools and strategies to invite her partner to HIV counselling and testing. We conducted a randomised trial of the efficacy of COC on partner HIV testing in low/medium HIV prevalence settings (Cameroon, Dominican Republic, Georgia, India). METHODS:: Pregnant women were randomised to receive standard post-test HIV counselling (SC) or COC and followed until six months postpartum. Partner HIV testing events were notified by site laboratories, self-reported by women or both combined. Impact of COC on partner HIV testing was measured in intention-to-treat analysis. Socio-behavioural factors associated with partner HIV testing were evaluated using multivariable logistic regression. RESULTS:: Among 1943 pregnant women enrolled, partner HIV testing rates (combined indicator) were 24.7% among women from COC group vs 14.3% in SC group in Cameroon (Odds Ratio [OR] = 2.0 95%CI [1.2-3.1]), 23.1% vs 20.3% in Dominican Republic (OR = 1.2 [0.8-1.8]), 26.8% vs 1.2% in Georgia (OR = 29.6 [9.1-95.6]) and 35.4% vs 26.6% in India (OR = 1.5 [1.0-2.2]). Women having received COC did not report more conjugal violence or union break-ups than in the SC group. The main factors associated with partner HIV testing were a history of HIV testing among men in Cameroon, Dominican Republic and Georgia and the existence of couple communication around HIV testing in Georgia and India. CONCLUSION:: A simple prenatal intervention taking into account the couple relationship increases the uptake of HIV testing among men in different socio-cultural settings. COC could contribute to the efforts towards eliminating mother-to-child transmission of HIV.

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