TY - JOUR
T1 - Disclosure of HIV results among discordant couples in Rakai, Uganda
T2 - A facilitated couple counselling approach
AU - Kairania, Robert M.
AU - Gray, Ronald H.
AU - Kiwanuka, Noah
AU - Makumbi, Fredrick
AU - Sewankambo, Nelson K.
AU - Serwadda, David
AU - Nalugoda, Fred
AU - Kigozi, Godfrey
AU - Semanda, John
AU - Wawer, Maria J.
N1 - Funding Information:
This study was funded by the National Institutes of Health (#U1AI51171), the Bill and Melinda Gates Foundation (#22006.02) and the Fogarty International Centre (#5D43TW001508 and #D43TW00015). This study was also supported by the Intramural Research Program of the National Institute of Allergy and Infectious Diseases, NIH. The authors would like to thank the study participants whose commitment and cooperation to disclosure made this study a success. We also thank the field counsellors for their continuous endurance and effort in locating, counselling and mobilising these couples without whom this study would have not proceeded. Finally, we thank Rakai Health Sciences Programme management for all the support in developing this paper.
PY - 2010/9
Y1 - 2010/9
N2 - Disclosure of HIV sero-positive results among HIV-discordant couples in sub-Saharan Africa is generally low. We describe a facilitated couple counselling approach to enhance disclosure among HIV-discordant couples. Using unique identifiers, 293 HIV-discordant couples were identified through retrospective linkage of married or cohabiting consenting adults individually enrolled into a cohort study and into two randomised trials of male circumcision in Rakai, Uganda. HIV-discordant couples and a random sample of HIV-infected concordant and HIV-negative concordant couples (to mask HIV status) were invited to sensitisation meetings to discuss the benefits of disclosure and couple counselling. HIV-infected partners were subsequently contacted to encourage HIV disclosure to their HIV-uninfected partners. If the index positive partner agreed, the counsellor facilitated the disclosure of HIV results, and provided ongoing support. The proportion of disclosure was determined. Eighty-one per cent of HIV-positive partners in discordant relationships disclosed their status to their HIV-uninfected partners in the presence of the counsellor. The rates of disclosure were 81.3% in male HIV-positive and 80.2% in female HIV-positive discordant couples. Disclosure did not vary by age, education or occupation. In summary, disclosure of HIV-positive results in discordant couples using facilitated couple counselling approach is high, but requires a stepwise process of sensitisation and agreement by the infected partner.
AB - Disclosure of HIV sero-positive results among HIV-discordant couples in sub-Saharan Africa is generally low. We describe a facilitated couple counselling approach to enhance disclosure among HIV-discordant couples. Using unique identifiers, 293 HIV-discordant couples were identified through retrospective linkage of married or cohabiting consenting adults individually enrolled into a cohort study and into two randomised trials of male circumcision in Rakai, Uganda. HIV-discordant couples and a random sample of HIV-infected concordant and HIV-negative concordant couples (to mask HIV status) were invited to sensitisation meetings to discuss the benefits of disclosure and couple counselling. HIV-infected partners were subsequently contacted to encourage HIV disclosure to their HIV-uninfected partners. If the index positive partner agreed, the counsellor facilitated the disclosure of HIV results, and provided ongoing support. The proportion of disclosure was determined. Eighty-one per cent of HIV-positive partners in discordant relationships disclosed their status to their HIV-uninfected partners in the presence of the counsellor. The rates of disclosure were 81.3% in male HIV-positive and 80.2% in female HIV-positive discordant couples. Disclosure did not vary by age, education or occupation. In summary, disclosure of HIV-positive results in discordant couples using facilitated couple counselling approach is high, but requires a stepwise process of sensitisation and agreement by the infected partner.
KW - HIV disclosure
KW - discordant couples
KW - facilitated couple counselling
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U2 - 10.1080/09540121003602226
DO - 10.1080/09540121003602226
M3 - Article
C2 - 20824557
AN - SCOPUS:77956463498
SN - 0954-0121
VL - 22
SP - 1041
EP - 1051
JO - AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
JF - AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
IS - 9
ER -