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

Sex Transm Infect. 2016 Feb;92(1):5-11. doi: 10.1136/sextrans-2014-051882. Epub 2015 Jul 14.

Abstract

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: ClinicalTrials.gov registration NCT01121692.

Keywords: AFRICA; GENDER; HIV TESTING; PARTNER NOTIFICATION; SEXUAL BEHAVIOUR.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Awareness
  • Black People
  • Communication Barriers
  • Family Characteristics*
  • Female
  • HIV Infections / prevention & control
  • HIV Infections / psychology
  • HIV Infections / transmission*
  • Health Knowledge, Attitudes, Practice
  • Heterosexuality / psychology*
  • Humans
  • Male
  • Mass Screening / psychology
  • Mass Screening / statistics & numerical data*
  • Prevalence
  • Risk-Taking
  • South Africa / epidemiology
  • Substance-Related Disorders
  • Surveys and Questionnaires
  • Truth Disclosure*
  • Unsafe Sex / psychology*
  • Unsafe Sex / statistics & numerical data
  • Violence

Associated data

  • ClinicalTrials.gov/NCT01121692