Abstract

Prenatal couple-oriented HIV counselling to increase HIV testing uptake among men - the prenahtest ANRS 12127 randomised trial

J. Orne-Gliemann¹, P. Tchendjou², K. Malateste³, M. Miric⁴, S. Darak⁵, M. Butsashvili⁶, M. Gadgil⁵, M. Kajaia⁶, E. Balestre³, E. Perez-Then⁴, F. Eboko⁷, A. Desgrées du Loû⁸, F. Dabis<sup>3

1</sup>Université Victor Segalen Bordeaux 2, Institut de Santé Publique Epidémiologie Développement, Bordeaux, France, ²Centre Pasteur du Cameroun, Laboratoire d'Epidémiologie et de Santé Publique, Yaounde, Cameroon, ³Université Victor Segalen Bordeaux 2, Institut de Santé Publique Épidémiologie Développement, Bordeaux, France, ⁴Centro Nacional de Investigaciones en Salud Materno Infantil, Santo Domingo, Dominican Republic, ⁵Prayas Health Group, Pune, India, ⁶Maternal and Child Care Union, Neoclinic, Tbilisi, Georgia, ⁷Institut de Recherche pour le Développement, UMR 912 IRD-INSERM-U2, Marseille, France, ⁸Institut de Recherche pour le Développement, UMR 196 CEPED, Paris, France

Background: Men's involvement in prevention of mother-to-child transmission of HIV programmes is limited though essential. The Prenahtest ANRS 12127 Study is evaluating, within different socio-cultural contexts, a counselling intervention which aims at supporting women in involving their partner within prenatal HIV counselling and testing.
Methods: A multi-site HIV intervention trial is conducted in Cameroon, Dominican Republic (DR), Georgia and India to evaluate the impact of prenatal couple-oriented post-test HIV counselling (COC), on partner HIV testing, couple HIV counselling and reproductive and sexual health behaviours. Pregnant women, individually randomised to receive standard post-test HIV counselling (SC) or COC, were interviewed before post-test HIV counselling (T0) and 2-8 weeks after (T1). We analysed the impact of COC on partner HIV testing rates reported by women at T1, using logistic regression.
Results: 1943 pregnant women were enrolled in the four sites. Median age was 24 years, 86.3% were living with their partner. At T1, respectively 21.7% and 10.8% of women from COC and SC groups reported partner HIV testing since T0 (p< 0.01). Having received COC was associated with partner HIV testing at T1 in Georgia (22.9% vs 1.3% in the COC and SC groups respectively, Odds Ratio (OR)=22.3 [95% IC 6.9-72.6]) and India (30.0% vs 12.4%, OR=3.0 [1.8-5.0]), but not in Cameroun (OR=1.2 [0.7-2.1]) and DR (OR=0.8 [0.5-1.5]). Verbal or physical conjugal violence reported between T0 and T1 was similar in both groups (7.7 for COC and 10.1% for SC, p=0.07). Analysis of individual and couple characteristics and couple communication as predictors of partner HIV testing is ongoing.
Conclusions: COC may contribute to improve male partner HIV testing and HIV prevention in a conjugal context. Longer-term follow-up will document the impact of COC on couple communication about sexual risks and related practices in these four different contexts.