Predictors of couple HIV counseling and testing among adult residents of Bukomero sub-county, Kiboga district, rural Uganda

Abstract

BackgroundStudies have shown that couple HIV counseling and testing (CHCT) increased rates of sero-status disclosure and adoption of safer sexual behaviors with better linkage to treatment and care. However, current evidence suggests that new HIV infections are occurring among heterosexual couples in stable relationships where the majority of the individuals are not aware of their partner’s serostatus. This study examined the predictors of CHCT uptake among married or cohabiting couples of Bukomero sub-county Kiboga district in Uganda.MethodsThis cross-sectional correlational study was conducted among 323 individuals who were either married or cohabiting, aged 18–49 years. Participants were enrolled from randomly selected households in Bukomero sub-county. Data were collected using an interviewer-administered questionnaire on socio-demographics, self-rating on awareness of CHCT benefits, couple discussion about HIV testing and CHCT practices. Couples were compared between those who had reported to have tested as a couple and those who had not. Binary logistic regression was performed to determine the adjusted odds ratio [aOR] and 95 % confidence intervals [CI] for CHCT uptake and the other independent variables.ResultsOf the participants 288 (89.2 %) reported to have ever taken an HIV test only 99 (34.4 %) did so as a couple. The predictors of testing for HIV as a couple were discussing CHCT with the partner (adjusted odds ratio 4.95[aOR], 95 % confidence interval [CI]:1.99–12.98; p < 0.001), awareness of CHCT benefits (aOR 3.23; 95 % CI 1.78–5.87; p < 0.001) and having time to test as a couple (aOR 2.61; 95 % CI 1.22–5.61; p <0.05).ConclusionUptake of HIV counseling and testing among couples was low. Discussing CHCT with partner, awareness of CHCT benefits, and availability of time to test as a couple were predictive of CHCT uptake. Thus CHCT campaigns should emphasize communication and discussion of HIV counseling and testing among partners.

Motivators of couple HIV counseling and testing (CHCT) uptake in a rural setting in Uganda

“…The uptake of CHCT among attendees of health facilities in rural Uganda is up to 34% [16, 17]. A figure that has remained low but what motivates these few couples to test?…”

How Do We Get Partners to Test for HIV?: Predictors of Uptake of Partner HIV Testing Following Individual Outpatient Provider Initiated HIV Testing in Rural Uganda

“…HCT is commonly segregated by gender for clinical reasons, and because women nearly universally receive testing in ANC, the burden often falls on women to engage their partners to test (32, 53). Couples-based testing and programs that engage men are especially important in settings where men have more decision-making power in a couple’s prevention behaviors (5, 68), but more research is needed on effective ways to increase male partner testing.…”

“…Across the region as a whole, it is estimated that only 45% of PLWH are aware of their status (2). In Uganda, where HIV prevalence in the adult population remains high at 7.3% (4), an estimated 45% of men and 64% of women reported ever testing for HIV in 2011, compared to 21% of men and 25% of women in 2004–2005 (5). The use of a variety of testing approaches has increased access to HIV testing services in Uganda, including: facility-based Voluntary HIV Counselling and Testing (VCT) (or an opt-in approach), facility-based provider initiated HIV testing and counseling (PITC) (or an opt-out approach, in which testing is made a routine part of services), mobile community-based HIV testing, and home-based HIV testing (6).…”

“…Awareness of partner’s status can reduce risk of HIV transmission (5, 9–11) and risky sexual behavior such as inconsistent or no condom use, as well as increase the use of PrEP and preventative male circumcision (12–15). Increasing knowledge of partner’s HIV status is especially important in reaching the 90-90-90 goals, and for HIV prevention in Uganda and sub-Saharan Africa, as the primary mode of transmission is through heterosexual sex and partner serodiscordance is high (16).…”

“…However, uptake remains low in Uganda (5, 18–20); a cohort study assessing uptake of PITC among 21,798 married individuals between 2003–2009 reported that uptake of couples-based testing remained consistently below 30% across the time period (18). Another common strategy to increase partner testing is to encourage individuals undergoing HCT to subsequently bring their partner to test for HIV.…”