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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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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.

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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.

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Authors and Affiliations

  1. Population, Family, and Reproductive Health Department, Johns Hopkins School of Public Health, 615 North Wolfe Street, E4148, Baltimore, MD, 21205, USA

    Stan Becker & Hilary M. Schwandt

  2. Community Health Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania

    Rose Mlay

  3. Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania

    Eligius Lyamuya

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  1. Stan Becker
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  2. Rose Mlay
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  3. Hilary M. Schwandt
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  4. Eligius Lyamuya
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Correspondence to Stan Becker.

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Becker, S., Mlay, R., Schwandt, H.M. et al. Comparing Couples’ and Individual Voluntary Counseling and Testing for HIV at Antenatal Clinics in Tanzania: A Randomized Trial. AIDS Behav 14, 558–566 (2010). https://doi.org/10.1007/s10461-009-9607-1

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  • DOI: https://doi.org/10.1007/s10461-009-9607-1

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