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The Impact of Couple HIV Testing and Counseling on Consistent Condom Use among Pregnant Women and their Male Partners: An Observational Study.

The Impact of Couple HIV Testing and Counseling on Consistent Condom Use among Pregnant Women and their Male Partners: An Observational Study.
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Rosenberg NE, Graybill LA, Wesevich A, McGrath N, Golin CE, Maman S, Bhushan N, Tsidya M, Chimndozi L, Hoffman IF, Hosseinipour MC, Miller WC,


Rosenberg NE, Graybill LA, Wesevich A, McGrath N, Golin CE, Maman S, Bhushan N, Tsidya M, Chimndozi L, Hoffman IF, Hosseinipour MC, Miller WC, (click to view)

Rosenberg NE, Graybill LA, Wesevich A, McGrath N, Golin CE, Maman S, Bhushan N, Tsidya M, Chimndozi L, Hoffman IF, Hosseinipour MC, Miller WC,

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Journal of acquired immune deficiency syndromes (1999) 2017 04 18() doi 10.1097/QAI.0000000000001398

Abstract
BACKGROUND
In sub-Saharan Africa couple HIV testing and counseling (CHTC) has been associated with substantial increases in safe sex, especially when at least one partner is HIV-infected. However, this relationship has not been characterized in an Option B+ context.

SETTING
The study was conducted at the antenatal clinic at Bwaila District Hospital in Lilongwe, Malawi in 2016 under an Option B+ program.

METHODS
Ninety heterosexual couples with an HIV-infected pregnant woman (female-positive couples) and 47 couples with an HIV-uninfected pregnant woman (female-negative couples) were enrolled in an observational study. Each couple member was assessed immediately before and one month after CHTC for safe sex (abstinence or consistent condom use in the last month). Generalized estimating equations were used to model change in safe sex before and after CHTC and to compare safe sex between female-positive and female-negative couples.

RESULTS
Mean age was 26 years among women and 32 years among men. Before CHTC, safe sex was comparable among female-positive couples (8%) and female-negative couples (2%) (RR: 3.7, 95% CI: 0.5, 29.8). One month after CHTC, safe sex was higher among female-positive couples (75%) than among female-negative couples (3%) (RR: 30.0, 95% CI: 4.3, 207.7). Safe sex increased substantially after CTHC for female-positive couples (RR 9.6, 95% CI: 4.6, 20.0), but not for female-negative couples (RR: 1.2, 95% CI: 0.1, 18.7).

CONCLUSION
Engaging pregnant couples in CHTC can have prevention benefits for couples with an HIV-infected pregnant woman, but additional prevention approaches may be needed for couples with an HIV-uninfected pregnant woman.

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