Implementation of couples’ voluntary HIV counseling and testing services in Durban, South AfricaReport as inadecuate

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BMC Public Health

, 15:601

First Online: 02 July 2015Received: 06 January 2015Accepted: 22 June 2015DOI: 10.1186-s12889-015-1959-z

Cite this article as: Kilembe, W., Wall, K.M., Mokgoro, M. et al. BMC Public Health 2015 15: 601. doi:10.1186-s12889-015-1959-z


BackgroundCouples’ voluntary HIV counseling and testing CVCT is an evidence-based intervention that significantly reduces HIV incidence in couples. Despite the high prevalence of HIV and HIV couple serodiscordance in South Africa, there are few CVCT services.

MethodsFrom February-June 2013, The Rwanda Zambia HIV Research Group provided support, training, and technical assistance for local counselors and promoters to pilot CVCT services in five hospital-based clinics in Durban, South Africa. Client-level data age, gender, years cohabiting, pregnancy status, previous testing, antiretroviral treatment ART status, neighborhood, and test site collected as a component of routine CVCT service operation is presented stratified by couple serostatus.

ResultsTwenty counselors and 28 promoters completed training. Of 907 couples 1,814 individuals that underwent CVCT, prevalence of HIV was 41.8 % and prevalence of HIV serodiscordance was 29.5 % 19.3 % M-F+, 10.3 % M + F-. Most participants were 25–34 years of age, and this group had the highest prevalence. Previous individual HIV testing was low 50 % for men, 63 % for women. Only 4 % of couples reported previous CVCT. Most 75 % HIV+ partners were not on ART, and HIV+ individuals in discordant couples were more likely to be on ART than those in concordant positive couples. Pregnancy among HIV+ women was not associated with previous HIV testing or ART use.

ConclusionsImplementation of standard CVCT services was found to be feasible in Durban. The burden of HIV and couple serodiscordance in Durban was extremely high. CVCT would greatly benefit couples in Durban as an HIV prevention strategy.

KeywordsHeterosexual couples Couples’ HIV voluntary counseling and testing South Africa HIV prevention Implementation science AbbreviationsCVCTCouples’ voluntary HIV counseling and testing

ARTAntiretroviral treatment

STISexually transmitted infection

MTCTMother-to-child transmission

RZHRGThe Rwanda Zambia HIV Research Group

HPPIV Pathogenesis Programme

DDMRIDoris Duke Medical Research Institute

SDStandard deviation

IPVIntimate partner violence

PMTCTPrevention of mother-to-child transmission

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Author: William Kilembe - Kristin M. Wall - Mammekwa Mokgoro - Annie Mwaanga - Elisabeth Dissen - Miriam Kamusoko - Hilda Phiri -


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