Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America.
Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America; Department of Epidemiology, Rollins School of Public Health, Laney Graduate School, Emory University, Atlanta, Georgia, United States of America.
PLoS One. 2015 Apr 20;10(4):e0124548. doi: 10.1371/journal.pone.0124548. eCollection 2015.
Couples' voluntary HIV counseling and testing (CVCT) significantly decreases HIV transmission within couples, the largest risk group in sub-Saharan Africa, but it is not currently offered in most HIV testing facilities. To roll out such an intervention, understanding locale-specific knowledge barriers is critical. In this study, we measured knowledge of HIV serodiscordance, transmission, and prevention before and after receipt of CVCT services in Durban.
Pre- and post-CVCT knowledge surveys were administered to a selection of individuals seeking CVCT services.
Changes in knowledge scores were assessed with McNemar Chi-square tests for balanced data and generalized estimating equation methods for unbalanced data.
The survey included 317 heterosexual black couples (634 individuals) who were primarily Zulu (87%), unemployed (47%), and had at least a secondary level education (78%). 28% of couples proved to be discordant. Only 30% of individuals thought serodiscordance between couples was possible pre-CVCT compared to 95% post-CVCT. One-third thought there was at least one benefit of CVCT pre-CVCT, increasing to 96% post-CVCT. Overall, there were positive changes in knowledge about HIV transmission and prevention. However, many respondents thought all HIV positive mothers give birth to babies with AIDS (64% pre-CVCT, 59% post-CVCT) and that male circumcision does not protect negative men against HIV (70% pre-CVCT, 67% post-CVCT).
CVCT was well received and was followed by improvements in understanding of discordance, the benefits of joint testing, and HIV transmission. Country-level health messaging would benefit from targeting gaps in knowledge about serodiscordance, vertical transmission, and male circumcision.
夫妻间自愿进行艾滋病病毒咨询和检测（CVCT）可显著降低撒哈拉以南非洲这一最大艾滋病病毒感染风险群体内部的艾滋病病毒传播，但目前大多数艾滋病病毒检测点并未提供这一服务。要推广这一干预措施，了解特定地区的知识障碍至关重要。在这项研究中，我们在德班对接受 CVCT 服务前后的个体进行了有关艾滋病病毒血清不一致、传播和预防的知识调查。
对寻求 CVCT 服务的个体进行了 CVCT 前后的知识调查。
采用平衡数据的 McNemar Chi-square 检验和非平衡数据的广义估计方程方法评估知识评分的变化。
该调查包括 317 对异性恋黑人夫妇（634 人），他们主要是祖鲁人（87%）、失业（47%），且至少受过中等教育（78%）。28%的夫妇被证明是不一致的。只有 30%的人在接受 CVCT 前认为夫妻间血清不一致是可能的，而 95%的人在接受 CVCT 后这样认为。三分之一的人认为在接受 CVCT 前至少有一个 CVCT 的好处，而在接受 CVCT 后这一比例上升到 96%。总的来说，人们对艾滋病病毒传播和预防的知识有了积极的变化。然而，许多受访者认为所有 HIV 阳性母亲所生的婴儿都患有艾滋病（64%的人在接受 CVCT 前这样认为，59%的人在接受 CVCT 后这样认为），而且男性割礼并不能保护阴性男性免受 HIV 感染（70%的人在接受 CVCT 前这样认为，67%的人在接受 CVCT 后这样认为）。
CVCT 受到了欢迎，并在理解不一致、联合检测的好处以及艾滋病病毒传播方面有了提高。国家一级的健康宣传可以针对血清不一致、垂直传播和男性割礼方面的知识差距进行宣传。
