Sex Transm Infect 92:5-11 doi:10.1136/sextrans-2014-051882
  • Behaviour
  • Original article

Seek, Test and Disclose: knowledge of HIV testing and serostatus among high-risk couples in a South African township

  1. Wendee M Wechsberg1,6
  1. 1Substance Abuse Treatment Evaluation & Interventions, RTI International, Research Triangle Park, North Carolina, USA
  2. 2Alcohol, Tobacco & Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa
  3. 3Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
  4. 4Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
  5. 5Columbia University, School of Social Work, New York, New York, USA
  6. 6Department of Psychology in the Public Interest, North Carolina State University, Raleigh, North Carolina, USA
  1. Correspondence to Dr Irene A Doherty, RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, USA; idoherty{at}
  • Received 1 October 2014
  • Revised 16 June 2015
  • Accepted 20 June 2015
  • Published Online First 14 July 2015


Objectives HIV testing and disclosure of results to partners is an important strategy in HIV prevention but is under-researched within heterosexual partnerships. To address this gap, we describe patterns of HIV testing, discrepancies between beliefs and biologically confirmed HIV status of each partner, and characteristics of mutually correct knowledge of HIV status among heterosexual couples in a high-prevalence community.

Methods The study recruited 290 high-risk heterosexual couples in stable relationships from a township in Cape Town, South Africa. Male patrons of shebeens (drinking establishments) were approached to participate with their main partner in an intervention designed to reduce substance use, violence and unsafe sex. All participants were tested for HIV at baseline and asked about their partner's past HIV testing and current status. Using the couple as the unit of analysis, we conducted logistic regression to identify partnership and individual characteristics associated with having mutually correct knowledge of partner's HIV status.

Results Half (52%) of women and 41% of men correctly knew whether their partner had ever been tested for HIV. 38% of women, 28% of men and in 17% of couples, both members reported mutually correct knowledge of their partner's HIV status. Correlates of correct knowledge included married/cohabitating (aOR 2.69, 95% CI 1.35 to 5.40), both partners HIV-negative (aOR 3.32 (1.38 to 8.00)), women's acceptance of traditional gender roles (aOR 1.17 (1.01 to 1.40)) and men's relationship satisfaction (aOR 2.22 (1.01 to 4.44)).

Conclusions Findings highlight the need to improve HIV testing uptake among men and to improve HIV disclosure among women in heterosexual partnerships.

Trial registration number registration NCT01121692.