Project San Francisco, Rwanda Zambia HIV Research Group, Kigali, Rwanda.
PLoS One. 2011 May 9;6(5):e19573. doi: 10.1371/journal.pone.0019573.
Most incident HIV infections in sub-Saharan Africa occur between cohabiting, discordant, heterosexual couples. Though couples' voluntary HIV counseling and testing (CVCT) is an effective, well-studied intervention in Africa, <1% of couples have been jointly tested.
We conducted cross-sectional household surveys in Kigali, Rwanda (n = 600) and Lusaka, Zambia (n = 603) to ascertain knowledge, perceptions, and barriers to use of CVCT.
Compared to Lusaka, Kigali respondents were significantly more aware of HIV testing sites (79% vs. 56%); had greater knowledge of HIV serodiscordance between couples (83% vs. 43%); believed CVCT is good (96% vs. 72%); and were willing to test jointly (91% vs. 47%). Stigma, fear of partner reaction, and distance/cost/logistics were CVCT barriers.
Though most respondents had positive attitudes toward CVCT, the majority were unaware that serodiscordance between cohabiting couples is possible. Future messages should target gaps in knowledge about serodiscordance, provide logistical information about CVCT services, and aim to reduce stigma and fear.
撒哈拉以南非洲地区大多数偶发 HIV 感染发生在同居、关系不和谐的异性伴侣之间。尽管伴侣自愿艾滋病毒咨询和检测（CVCT）是非洲一种经过充分研究的有效干预措施，但只有 <1%的伴侣接受了联合检测。
我们在卢旺达基加利（n = 600）和赞比亚卢萨卡（n = 603）进行了横断面家庭调查，以确定对 CVCT 的知识、看法和使用障碍。
与卢萨卡相比，基加利的受访者对 HIV 检测地点的知晓率显著更高（79% vs. 56%）；对伴侣间 HIV 血清不一致的了解更多（83% vs. 43%）；认为 CVCT 是好的（96% vs. 72%）；并且愿意共同检测（91% vs. 47%）。污名化、对伴侣反应的恐惧以及距离/成本/后勤是 CVCT 的障碍。
尽管大多数受访者对 CVCT 持积极态度，但大多数人并不知道同居伴侣之间存在血清不一致的情况。未来的信息应针对关于血清不一致的知识差距，提供关于 CVCT 服务的后勤信息，并旨在减少污名化和恐惧。
