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Author Notes:

Corresponding Author: Kristin M. Wall, Department of Epidemiology, School of Public Health, Emory University, 1518 Clifton Road NE, 3rd Floor, Atlanta, GA 30322, Phone: (512) 785-4779, kmwall@emory.edu

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Research Funding:

This work was supported by funding from the NIMH RO1 66767, with contribution from the AIDS International Training and Research Program (AITRP) FIC D43 TW001042, the Social & Behavioral Core of the Emory Center for AIDS Research P30 AI050409, R01 AI40951, R01 AI51231, NICHD R01 40125, and the International AIDS Vaccine Initiative.

Keywords:

  • Community Workers
  • Couples’ Voluntary Counseling and Testing
  • HIV
  • Rwanda

INFLUENCE NETWORK AGENT EFFECTIVENESS IN PROMOTING COUPLES' HIV COUNSELING AND TESTING IN KIGALI, RWANDA

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Journal Title:

AIDS

Volume:

Volume 26, Number 2

Publisher:

, Pages 217-227

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Objective To identify predictors of promotion of couples’ voluntary counseling and testing (CVCT) in Kigali, Rwanda Design Analysis of CVCT promotional agent (influential network leaders, INLs; influential network agents, INAs), and couple/invitation-level predictors of CVCT uptake. Methods Number of invitations and couples tested were evaluated by INL, INA, and couple/contextual factors. Multivariable logistic regression accounting for two-level clustering analyzed factors predictive of couples’ testing. Results 26 INLs recruited and mentored 118 INAs who delivered 24,991 invitations. 4,513 couples sought CVCT services after invitation. INAs distributed an average of 212 invitations resulting in an average of 38 couples tested/agent. Characteristics predictive of CVCT in multivariate analyses included the invitee and INA being socially acquainted (aOR=1.4;95%CI:1.2–1.6); invitations delivered after public endorsement (aOR=1.3;95%CI:1.1–1.5); and presence of a mobile testing unit (aOR=1.4;95%CI:1.0–2.0). In stratified analyses, predictors significant among cohabiting couples included invitation delivery to the couple (aOR=1.2;95%CI:1.0–1.4) in the home (aOR=1.3;95%CI:1.1–1.4), while among non-cohabiting couples predictors included invitations given by unemployed INAs (aOR=1.7;95%CI:1.1–2.7). Cohabiting couples with older men were more likely to test, while younger age was associated with testing among men in non-cohabiting unions. Conclusions Invitations distributed by influential people were successful in prompting couples to seek joint HIV testing, particularly if the invitation was given in the home to someone known to the INA, and accompanied by a public endorsement of CVCT. Mobile units also increased the number of couples tested. Country-specific strategies to promote CVCT programs are needed to reduce HIV transmission among those at highest risk for HIV in sub-Saharan Africa.

Copyright information:

© 2012 Lippincott Williams & Wilkins, Inc.

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