Acceptability of Couples’ Voluntary HIV Testing Among HIV-infected Patients in Care and Their HIV-negative Partners in the United States



Kristin M. Wall1, 2, *, Lauren Canary1, Kimberly Workowski3, Annie Lockard4, Jeb Jones2, Patrick Sullivan2, Katherine Hills4, 5, Kadija Fofana6, Rob Stephenson7, Susan Allen1
1 Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Laney Graduate School, Emory University, Atlanta, Georgia, USA
2 Department of Epidemiology, Rollins School of Public Health, Laney Graduate School, Emory University, Atlanta, Georgia, USA
3 Department of Medicine, Emory University, Atlanta, Georgia, USA
4 Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Laney Graduate School, Emory University, Lusaka, Zambia
5 Centers for Disease Control and Prevention, Office of Public Health Preparedness and Response, Division of Emergency Operations, Atlanta, Georgia, USA
6 School of Public Health, Georgia State University, Atlanta, Georgia, USA
7 Department of Health Behavior and Biological Sciences, School of Nursing, and the Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, Michigan, USA


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© Wall et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/legalcode), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Epidemiology School of Public Health, Emory University 1518 Clifton Road NE, 4011, Atlanta, GA 30322, Georgia, USA; Tel: +001 404 727 9088; E-mail: kmwall@emory.edu


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.

Keywords: Acceptability, combination prevention, couples’ voluntary HIV counseling and testing, discordant couples, HIV prevention, United States.