Allen Susan, Karita Etienne, Chomba Elwyn, Roth David L, Telfair Joseph, Zulu Isaac, Clark Leslie, Kancheya Nzali, Conkling Martha, Stephenson Rob, Bekan Brigitte, Kimbrell Katherine, Dunham Steven, Henderson Faith, Sinkala Moses, Carael Michel, Haworth Alan
The Rwanda-Zambia HIV Research Group, 1520 Clifton Road, Emory University, Atlanta, GA 30322, USA.
BMC Public Health. 2007 Dec 11;7:349. doi: 10.1186/1471-2458-7-349.
Most new HIV infections in Africa are acquired from cohabiting heterosexual partners. Couples' Voluntary Counselling and Testing (CVCT) is an effective prevention strategy for this group. We present our experience with a community-based program for the promotion of CVCT in Kigali, Rwanda and Lusaka, Zambia.
Influence Network Agents (INAs) from the health, religious, non-governmental, and private sectors were trained to invite couples for CVCT. Predictors of successful promotion were identified using a multi-level hierarchical analysis.
In 4 months, 9,900 invitations were distributed by 61 INAs, with 1,411 (14.3%) couples requesting CVCT. INAs in Rwanda distributed fewer invitations (2,680 vs. 7,220) and had higher response rates (26.9% vs. 9.6%), than INAs in Zambia. Context of the invitation event, including a discreet location such as the INA's home (OR 3.3-3.4), delivery of the invitation to both partners in the couple (OR 1.6-1.7) or to someone known to the INA (OR 1.7-1.8), and use of public endorsement (OR 1.7-1.8) were stronger predictors of success than INA or couple-level characteristics.
Predictors of successful CVCT promotion included strategies that can be easily implemented in Africa. As new resources become available for Africans with HIV, CVCT should be broadly implemented as a point of entry for prevention, care and support.
非洲大多数新的艾滋病毒感染是通过与异性同居伴侣接触而获得的。夫妻自愿咨询检测（CVCT）是针对这一群体的有效预防策略。我们介绍了在卢旺达基加利和赞比亚卢萨卡开展的一项以社区为基础的促进夫妻自愿咨询检测项目的经验。
对来自卫生、宗教、非政府和私营部门的影响网络代理人（INA）进行培训，以便邀请夫妻进行CVCT。使用多层次分层分析确定成功推广的预测因素。
在4个月内，61名影响网络代理人发放了9900份邀请，其中1411对（14.3%）夫妻要求进行CVCT。卢旺达的影响网络代理人发放的邀请较少（2680份对7220份），但回应率较高（26.9%对9.6%），高于赞比亚的影响网络代理人。邀请活动的背景，包括在诸如影响网络代理人的家中等隐秘地点（比值比3.3 - 3.4）、向夫妻双方发放邀请（比值比1.6 - 1.7）或向影响网络代理人认识的人发放邀请（比值比1.7 - 1.8）以及使用公开认可（比值比1.7 - 1.8），比影响网络代理人或夫妻层面的特征更能预测成功。
成功推广夫妻自愿咨询检测的预测因素包括可在非洲轻松实施的策略。随着新资源流向感染艾滋病毒的非洲人，夫妻自愿咨询检测应作为预防、护理和支持的切入点广泛实施。
