Predictors of First Follow-up HIV Testing for Couples' Voluntary HIV Counseling and Testing in Ndola, Zambia
| Autor: | Randee Kastner, Susan Allen, Wan Hsuan Kuo, Nancy L. Czaicki, Julie Pulerwitz, Nurilign Ahmed, Jonathan Davitte, Kristin M. Wall, Kakungu Simpungwe, Bella Siangonya, Naw Htee Khu, Amanda Tichacek, Joseph F. Abdallah, Mubiana Inambao, Ibou Thior |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Counseling Male medicine.medical_specialty Multivariate analysis Adolescent Voluntary counseling and testing Zambia Developing country HIV Infections Hiv testing Article Young Adult medicine Humans Pharmacology (medical) Young adult Psychiatry Family Characteristics business.industry Odds ratio Middle Aged Patient Acceptance of Health Care Sexual Partners Infectious Diseases Turnover Female business Serostatus Demography |
| Zdroj: | JAIDS Journal of Acquired Immune Deficiency Syndromes. 66:e1-e7 |
| ISSN: | 1525-4135 |
| DOI: | 10.1097/qai.0000000000000076 |
| Popis: | Introduction We describe predictors of first follow-up testing for concordant negative and discordant couples seeking joint voluntary HIV counseling and testing in Ndola, Zambia, where cohabiting couples account for an estimated two-thirds of incident HIV infections. Methods Demographic and serostatus data were collected from couples' voluntary HIV testing and counseling and follow-up testing services implemented in government clinics. We calculated follow-up testing rates by serostatus and compared rates before and after the introduction of a Good Health Package (GHP). Results The follow-up testing rate from May 2011 to December 2012 was 12.2% for concordant negative (M-F-) couples and 24.5% for discordant (M+F- or M-F+) couples. Significant predictors of follow-up testing in multivariate analyses included increasing age of the man [adjusted odds ratio (aOR) = 1.02 per year] and the woman (aOR = 1.02 per year), and either partner being HIV+ (aOR = 2.57 for HIV+ man, aOR = 1.89 for HIV+ woman). The man (aOR = 1.29) and the couple (aOR = 1.22) having been previously tested for HIV were predictive of follow-up testing among concordant negative couples. Introduction of a GHP increased follow-up testing among discordant (aOR = 2.93) and concordant negative (aOR = 2.06) couples. Conclusions A low-cost GHP, including prevention, screening, and treatment for common causes of morbidity and mortality resulted in increased follow-up testing rates among HIV discordant and concordant negative couples. Overall follow-up testing rates remain low, and efforts to increase these rates are necessary to ensure linkage to combination prevention, reduce HIV transmission within couples, and identify seroconversions promptly. Further investigation of low-cost sustainable incentives and other factors influencing follow-up HIV testing for couples is needed. |
| Databáze: | OpenAIRE |
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