Couple-oriented prenatal HIV counseling for HIV primary prevention: an acceptability study

Joanna Orne-Gliemann, Patrice T Tchendjou, Marija Miric, Mukta Gadgil, Maia Butsashvili, Fred Eboko, Eddy Perez-Then, Shrinivas Darak, Sanjeevani Kulkarni, George Kamkamidze, Eric Balestre, Annabel Desgrées du Loû, Francois Dabis, Joanna Orne-Gliemann, Patrice T Tchendjou, Marija Miric, Mukta Gadgil, Maia Butsashvili, Fred Eboko, Eddy Perez-Then, Shrinivas Darak, Sanjeevani Kulkarni, George Kamkamidze, Eric Balestre, Annabel Desgrées du Loû, Francois Dabis

Abstract

Background: A large proportion of the 2.5 million new adult HIV infections that occurred worldwide in 2007 were in stable couples. Feasible and acceptable strategies to improve HIV prevention in a conjugal context are scarce. In the preparatory phase of the ANRS 12127 Prenahtest multi-site HIV prevention trial, we assessed the acceptability of couple-oriented post-test HIV counseling (COC) and men's involvement within prenatal care services, among pregnant women, male partners and health care workers in Cameroon, Dominican Republic, Georgia and India.

Methods: Quantitative and qualitative research methods were used: direct observations of health services; in-depth interviews with women, men and health care workers; monitoring of the COC intervention and exit interviews with COC participants.

Results: In-depth interviews conducted with 92 key informants across the four sites indicated that men rarely participated in antenatal care (ANC) services, mainly because these are traditionally and programmatically a woman's domain. However men's involvement was reported to be acceptable and needed in order to improve ANC and HIV prevention services. COC was considered by the respondents to be a feasible and acceptable strategy to actively encourage men to participate in prenatal HIV counseling and testing and overall in reproductive health services.

Conclusions: One of the keys to men's involvement within prenatal HIV counseling and testing is the better understanding of couple relationships, attitudes and communication patterns between men and women, in terms of HIV and sexual and reproductive health; this conjugal context should be taken into account in the provision of quality prenatal HIV counseling, which aims at integrated PMTCT and primary prevention of HIV.

References

    1. UNAIDS. AIDS Epidemic Update - December 2007. Geneva: UNAIDS; 2007.
    1. World Health Organisation. Towards Universal access. Scaling up priority HIV/AIDS interventions in the health sector. Progress report 2008. Geneva: World Health Organisation; 2008.
    1. de Walque D. Sero-discordant couples in five African countries: implications for prevention strategies. Population and development review. 2007;33(3):501–523. doi: 10.1111/j.1728-4457.2007.00182.x.
    1. World Health Organisation. HIV/AIDS in the South-East Asia region. New Delhi: WHO Regional Office for South-East Asia; 2007.
    1. Becker S. Couples and reproductive health: a review of couple studies. Studies in Family Planning. 1996;27(6):291–306. doi: 10.2307/2138025.
    1. Painter TM. Voluntary counseling and testing for couples: a high-leverage intervention for HIV/AIDS prevention in sub-Saharan Africa. Soc Sci Med. 2001;53(11):1397–1411. doi: 10.1016/S0277-9536(00)00427-5.
    1. Farquhar C, Kiarie JN, Richardson BA, Kabura MN, John FN, Nduati RW, Mbori-Ngacha DA, John-Stewart GC. Antenatal couple counseling increases uptake of interventions to prevent HIV-1 transmission. J Acquir Immune Defic Syndr. 2004;37(5):1620–1626. doi: 10.1097/00126334-200412150-00016.
    1. Semrau K, Kuhn L, Vwalika C, Kasonde P, Sinkala M, Kankasa C, Shutes E, Aldrovandi G, Thea DM. Women in couples antenatal HIV counseling and testing are not more likely to report adverse social events. AIDS. 2005;19(6):603–609. doi: 10.1097/01.aids.0000163937.07026.a0.
    1. World Health Organisation. Strategic approaches to the prevention of HIV infection in infants. Report of a WHO meeting, Morges (Switzerland), 20-22 March 2002. Geneva: World Health Organisation; 2003. p. 22.
    1. Chomba E, Allen S, Kanweka W, Tichacek A, Cox G, Shutes E, Zulu I, Kancheya N, Sinkala M, Stephenson R. Evolution of Couples' Voluntary Counseling and Testing for HIV in Lusaka, Zambia. J Acquir Immune Defic Syndr. 2008;47(1):108–115. doi: 10.1097/QAI.0b013e31815b2d67.
    1. Allen S, Karita E, Chomba E, Roth DL, Telfair J, Zulu I, Clark L, Kancheya N, Conkling M, Stephenson R. Promotion of couples' voluntary counselling and testing through inflential networks in two African capital cities. BMC Public Health. 2007;7(349)
    1. World Health Organisation, Centres for Disease Control and Prevention. Prevention of mother-to-child transmission of HIV infection generic training package. Participant manual. Geneva: World Health Organisation; 2004.
    1. Rosenstock I, Strecher V, Becker M. In: Preventing AIDS: Theories and Methods of Behavioral Interventions. DiClemente RJ, Peterson JL, editor. New York: Plenum Press; 1994. The Health Belief Model and HIV risk behavior change; pp. 5–24.
    1. Orne-Gliemann J, Tchendjou P, Miric M, Gadgil M, Butsashvili M, Eboko F, Perez-Then E, Darak S, Kulkarni S, Kamkamidze G. Evaluating the feasibility and impact of couple-oriented prenatal HIV counselling and testing in low and medium HIV prevalence countries. XVII International AIDS Conference: 2008; Mexico City (Mexico), 3-8 August. 2008.
    1. Institut National de la Statistique, Ministère de la Planification, de la Programmation du Développement et de l'Aménagement du Territoire, ORC Macro International Inc. Enquête Démographique et de Santé, Cameroun. Calverton, Mayland, USA: Institut National de la Statistique et Macro International Inc; 2004.
    1. CESDEM, USAID, COPRESIDA, World Bank, CERSS, Macro International. República Dominicana: Encuesta Demográfica y de Salud 2007. Informe preliminar. Santo Domingo: Centro de Estudios Sociales y Demográficos (CESDEM), Macro International; 2007.
    1. Molina Achécar M, Ramírez N, Polanco JJ, Quiterio G. Encuesta Demográfica y de Salud. República Dominicana 2007. Santo Domingo: Centro de Estudios Sociales y Demográficos (CESDEM), Macro International; 2007.
    1. UNAIDS. Epidemiological Fact Sheet on HIV and AIDS - Georgia - 2008 update.
    1. National Institute of Health and Family Welfare, National AIDS Control Organisation. Annual HIV Sentinel Surveillance Country Report 2006. New Dehli: National Institute of Health and Family Welfare and National AIDS Control Organisation; 2006.
    1. Altheide DL. Ethnographic content analysis. Qual Sociol. 1987;10(1):65–77. doi: 10.1007/BF00988269.
    1. Strauss A, Corbin J. Basics of qualitative research. Techniques and procedures for developing grounded theory. Newbury Park, CA: Sage Publications, Inc; 1990.
    1. Barnett-Page E, Thomas J. Methods for the synthesis of qualitative research: a critical review. BMC Med Res Methodol. 2009;9:59. doi: 10.1186/1471-2288-9-59.
    1. Wilson D, Halperin DT. "Know your epidemic, know your response": a useful approach, if we get it right. Lancet. 2008;372(9637):423–426. doi: 10.1016/S0140-6736(08)60883-1.
    1. Misiri HE, Tadesse E, Muula AS. Are public antenatal clinics in Blantyre, Malawi, ready to offer services for the prevention of vertical transmission of HIV? Afr J Reprod Health. 2004;8(2):64–70. doi: 10.2307/3583179.
    1. Kim YM, Odallo D, Thuo M, Kols A. Client participation and provider communication in family planning counseling: transcript analysis in Kenya. Health Commun. 1999;11(1):1–19. doi: 10.1207/s15327027hc1101_1.
    1. Murira N, Lutzen K, Lindmark G, Christensson K. Communication patterns between health care providers and their clients at an antenatal clinic in Zimbabwe. Health Care Women Int. 2003;24(2):83–92.
    1. World Health Organisation, UNAIDS. Guidance on provider-initiated HIV testing and counselling in health facilities. May 2007. Geneva: World Health Organisation; 2007. p. 56.
    1. Treloar C, Graham ID. Multidisciplinary cross-national studies: a commentary on issues of collaboration, methodology, analysis, and publication. Qual Health Res. 2003;13(7):924–932. doi: 10.1177/1049732303253518.
    1. Piot P, Bartos M, Larson H, Zewdie D, Mane P. HIV prevention 6 - Coming to terms with complexity: a call to action for HIV prevention. Lancet. 2008;372(9641):845–859. doi: 10.1016/S0140-6736(08)60888-0.
    1. Desgrées-du-Loû A, Orne-Gliemann J. Couple-centred testing and counselling for HIV serodiscordant heterosexual couples in sub-Saharan Africa. Reprod Health Matters. 2008;16(32):151–161. doi: 10.1016/S0968-8080(08)32407-0.
    1. Coates TJ, Richter L, Caceres C. HIV Prevention 3 - Behavioural strategies to reduce HIV transmission: how to make them work better. Lancet. 2008;372(9639):669–684. doi: 10.1016/S0140-6736(08)60886-7.

Source: PubMed

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