AEGiS-15IAC: Antenatal couple counseling increases uptake of interventions to prevent HIV-1 transmission.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Antenatal couple counseling increases uptake of interventions to prevent HIV-1 transmission.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. ThOrC1415)

Farquhar C, Kiarie JN, Richardson BA, Kabura MN, John FN, Nduati RW, Mbori-Ngacha DA, John-Stewart GC
University of Washington, Seattle, United States

BACKGROUND: Women who learn that they are HIV-infected often do not implement interventions to prevent vertical HIV-1 transmission. Conducting voluntary HIV counseling and testing (VCT) for pregnant women together with partners may improve maternal access to mother-to-child HIV-1 prevention interventions by facilitating partner notification and increasing their participation in the decision making process.

METHODS: Pregnant women presenting to a Nairobi antenatal clinic were offered individual or couple VCT and followed prospectively. At enrollment, women were encouraged to return with their partners within 1 week for VCT. Women and partners were given the choice between post-test counseling as a couple or individually. Nevirapine was provided to HIV-1 infected women and condoms were distributed to all participants.

RESULTS: Among 2104 women accepting testing, 314 (15%) were HIV-1-seropositive and 308 (15%) had partners participate in VCT, of whom 116 (38%) were counseled as a couple. HIV-1-seropositive women whose partners came were 3-fold more likely to return for nevirapine (P=0.02) and report administering nevirapine at delivery (P=0.009). Nevirapine use was reported by 88% of HIV-infected women who were couple counseled, 67% whose partners came but were not couple counseled, and 45% whose partners did not come for VCT (P for trend=0.006). Among HIV-1-seropositive women, those receiving couple counseling were 5-fold more likely to avoid breastfeeding (P=0.03) compared to those receiving individual counseling. Partner notification of HIV-1-positive test results was reported by 138 (64%) women and associated with a 4-fold increased likelihood of condom use (P=0.004).

CONCLUSIONS: Partner participation in VCT and couple counseling increased uptake of interventions to prevent HIV-1 transmission. These data support antenatal couple counseling as a strategy to reduce perinatal HIV-1 infection risk in developing countries.

Keywords: AEGIS, HIV-1, Counseling, Disease Transmission, Vertical, Nevirapine, HIV Seropositivity, Acquired Immunodeficiency Syndrome, Condoms, Developing Countries, Humans, Female, Child, Pregnancy, transmission, prevention & control, therapy, organization & administration

040711
ThOrC1415