XVIII International AIDS Conference


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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. Dabis3

1Université 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.

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