Acceptability of couples’ voluntary HIV testing among HIV- infected patients in care and their HIV-negative partners in the United States

• Authors: Kristin Wall, Emory University; Lauren Canary, Emory University; Kimberly Workowski, Emory University; Annie Lockard, Emory University; Jeb Jones, Emory University; Patrick Sullivan, Emory University; Katherine Hills, Emory University; Kadija Fofana, Georgia State University; Rob Stephenson, University of Michigan; Susan Allen, Emory University
• Journal Title: Open AIDS Journal
• Volume: Volume 10
• Publisher: Bentham Open | 2016-02-01, Pages 1-13
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.2174/1874613601610010001
• Subjects: Health Sciences, Public Health; Health Sciences, Epidemiology
• Keywords: Acceptability; HIV prevention; United States; combination prevention; couples’ voluntary HIV counseling and testing; discordant couples

Abstract

Introduction: Couples’ voluntary HIV counseling and testing (CHTC) is an HIV risk reduction strategy not widely available in the US. Methods: We assessed willingness to participate in CHTC among US HIV-infected clinic patients via tablet-based survey and among HIV-negative persons with HIV-infected partners in care via mixed-method phone interviews. Results: Most of the N=64 HIV-infected partners surveyed were men (89%), on antiretroviral treatment (ART) (92%), and many self-identified homosexual (62%). We observed high levels of willingness to participate in CHTC (64%) among HIV-infected partners. Reasons for not wanting to participate included perceived lack of need (26%), desire to self-disclose their status (26%), and fear of being asked sensitive questions with their partner present (17%). HIV-infected partners were interested in discussing ART (48%), other sexually transmitted infections (STIs) (44%), and relationship agreements like monogamy (31%) during CHTC sessions. All N=15 HIV-negative partners interviewed were men, most identified as homosexual (73%), and about half (54%) reported consistent condom use with HIV-infected partners. We observed high levels of willingness to participate in CHTC (87%) among HIV-negative partners, who were also interested in discussing ART (47%), other STIs (47%), mental health services (40%), and relationship agreements (33%). Most negative partners (93%) indicated that they believed their HIV-infected partner was virally suppressed, but in the event that they were not, many (73%) were willing to take pre-exposure prophylaxis (PrEP). Conclusion: These results indicate that CHTC for serodiscordant couples is acceptable and should emphasize aspects most pertinent to these couples, such as discussion of ART/PrEP, STIs, and relationship agreements.