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Corresponding author Email: Susan Allen - sallen5@sph.emory.edu

SA is the Principal Investigator for the Rwanda Zambia HIV Research Group; EK is the Senior Co-Investigator of Projet San Francisco and EC is the Senior Co-Investigator of the Zambia Emory HIV Research Project.

Each participated in all aspects of the study, from study design to creation of instruments and data analysis and reviewed the manuscript.

DLR contributed to the design of the study and performed statistical data analysis.

JT is an expert in community based research and LC is a behavioral scientist; both contributed to the design of the study, development of the data collection instruments and standard operating procedures, data analysis, and manuscript preparation.

IZ and NK oversaw all recruitment efforts in the field and were an active part of the paper revision process while completing their Master's in Public Health degrees in the United States.

BB is a physician and public health practitioner who contributed to development of the study design and analysis of the INA level data.

KK, medical student, SD, and FH supervised selection and training of INAs, data collection and ongoing monitoring and evaluation analyses during the study.

MS, District Director of Health for Lusaka led the dialogues with city leaders in the politico-administrative realm, as well as contacts with community leaders in preparation for the study along with EK.

They were responsible for on-site supervision of all activities during the study, and for revision of the manuscript.

MCarael is a Sociologist with more than 30 years of experience with the design and implementation of HIV prevention programs in Africa.

He participated in development of the grant proposal and study design, and in drafting the manuscript.

AH, MConkling and RS assisted with manuscript preparation and revision.

The investigators would like to thank all of the participants in this study and all of the RZHRG staff members who made this study possible.

The authors declare that they have no competing interests.

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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.

Promotion of couples' voluntary counselling and testing for HIV through influential networks in two African capital cities

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Journal Title:

BMC Public Health

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Volume 7, Number 349

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Article | Final Publisher PDF

Abstract:

Background Most new HIV infections in Africa are acquired from cohabiting heterosexual partners. Couples' Voluntary Counselling and Testing (CVCT) is an effective prevention strategy for this group. We present our experience with a community-based program for the promotion of CVCT in Kigali, Rwanda and Lusaka, Zambia. Methods Influence Network Agents (INAs) from the health, religious, non-governmental, and private sectors were trained to invite couples for CVCT. Predictors of successful promotion were identified using a multi-level hierarchical analysis. Results In 4 months, 9,900 invitations were distributed by 61 INAs, with 1,411 (14.3%) couples requesting CVCT. INAs in Rwanda distributed fewer invitations (2,680 vs. 7,220) and had higher response rates (26.9% vs. 9.6%), than INAs in Zambia. Context of the invitation event, including a discreet location such as the INA's home (OR 3.3–3.4), delivery of the invitation to both partners in the couple (OR 1.6–1.7) or to someone known to the INA (OR 1.7–1.8), and use of public endorsement (OR 1.7–1.8) were stronger predictors of success than INA or couple-level characteristics. Conclusion Predictors of successful CVCT promotion included strategies that can be easily implemented in Africa. As new resources become available for Africans with HIV, CVCT should be broadly implemented as a point of entry for prevention, care and support.

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© 2007 Allen et al; licensee BioMed Central Ltd.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 2.0 Generic License (http://creativecommons.org/licenses/by/2.0/).

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