5th Conference on Retroviruses and Opportunistic Infections Chicago, IL - February 1-5, 1998

Conf Retroviruses Opportunistic Infect 1998 Feb 1-5; 5th:82 (abstract no. 16)

Coates TJ; University of California, San Francisco, CA.

OBJECTIVE: To determine the impact of voluntary HIV counseling and testing (C&T) on behavior change among individuals and couples seeking such service in Nairobi (Kenya); Dar Es Salaam (Tanzania) and Port-of-Spain, (Trinidad).

METHODS: Randomized controlled trial, in which individual or couple participants were assigned to receive either HIV C&T or basic health information (HI). The C&T was client-centered and included a minimum of one pre and one posttest counseling session. The HI intervention consisted of a videotape with culturally appropriate information on HIV. All participants received the assigned intervention at baseline and were seen again as part of study follow-up at six and 12 months. At the 6 months visit sexually transmitted infection data were collected from all participants to corroborate self reported behavior and at this time participants in the Hl group were offered C&T.

RESULTS: A total of 4297 individuals were recruited in the three sites (1514 in Kenya, 1432 in Tanzania, and 1351 in Trinidad). Retention rates of more than 75% have been achieved in the 3 sites at six-month follow-up and 68% of the study participants returned for their 12 months visit at each site. The overall prevalence OF HIV at baseline was 21% in Kenya and Tanzania and 7% in Trinidad. Approximately one third of the sample reported unprotected intercourse with casual partners in the previous 6 months at baseline. At the 6 month follow-up, those randomized to the CT group reported significant decreases in the number of episodes of unprotected intercourse and in the number of unprotected intercourse partners relative to those assigned to HI. The percentage of individuals reporting unprotected intercourse with non-primary partners also decreased significantly in the CT group relative to the HI group. Couples did not report greater changes than individuals, and males and females did not differ in the observed changes. There were no differences between the two groups in psychological status or social stigma. Data on incident STDs in the two group will be available for presentation at the time of the meeting.

CONCLUSION: This is the first randomized trial on HIV counseling and testing in developing countries and the impact was tested on males and females and on individuals and couples. These data support the efficacy of CT in promoting behavior change in developing countries, and suggest that policies favoring expenditures of funds for CT become a high priority.

1998-02-01
16

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