Impact of a couple-oriented prenatal HIV counseling session on condom use and communication among stable couples in the Dominican Republic: preliminary results from Prenahtest ANRS 12127 randomized trial
M. Miric1,2, E. Pérez-Then1,2, L. Núñez1, J. Orne-Gliemann3, P. Tchendjou4, A. Desgrées du Loû5, F. Dabis3, G. Shor-Posner2, Prenahtest ANRS 12127 Study Group
1Centro Nacional de Investigaciones en Salud Materno Infantil, Santo Domingo, Dominican Republic, 2University of Miami, Fogarty International Research and Training Program, Miami, United States, 3Université Victor Segalen Bordeaux 2, Institut de Santé Publique Epidémiologie Développement, Bordeaux, France, 4Centre Pasteur du Cameroun, Yaounde, Cameroon, 5Institut de Recherche pour le Développement, UMR 196 CEPED, Paris, France
Background: An international randomized trial (Prenahtest ANRS 12127) is assessing the impact of a couple-oriented prenatal HIV counseling session (COC) on couples' HIV prevention attitudes and behaviors within different socio-cultural settings. The COC intervention was designed to enhance standard individual post-test HIV counseling by building women's skills to discuss sexual and reproductive health topics with their stable partners, including, among other issues, proposing and negotiating condom use.
Methods: In the Dominican Republic (DR) site, 484 pregnant women with stable partners were recruited after group pre-test HIV counseling on their first antenatal care visit (April-August 2009), and randomized to receive either standard individual (SC) or COC same-day post-test HIV counseling. Baseline data (T0) were collected before the intervention. 403 participants (83.3%) completed the first follow-up (T1) questionnaire (mean=6.3+3.4 weeks between measurements). Pearson's Chi-square test was used to compare couple communication regarding condoms and the incidence of condom use with current partner reported at T1 in SC and COC groups, with p< .05 considered significant.
Results: More women in the COC group discussed condom use with their partners (72.4% vs. 56.5%, x2=11.04, p=.001) and suggested them to use condoms together (66.9% vs. 50.8%, x2=6.83, p=.006) following the post-test session. They also reported more frequently the occurrence of condom use with their stable partners (13.2% vs. 5.1%, x2=5.42, p=.016) since baseline.
Conclusions: The preliminary results suggest a positive impact of the COC session on motivation and empowerment of pregnant women to discuss, propose and achieve condom use with their stable partners. COC might be an effective intervention not only to prevent Parent-to-Child Transmission (PPTCT) but also to reduce sexual transmission of HIV and other sexually transmitted infections within stable couples in DR, where reported condom use rates are consistently very low. Supported by: ANRS, EGPAF, Miami NIH Fogarty International Training Program (D43TW00017).
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