Wall Kristin M, Canary Lauren, Workowski Kimberly, Lockard Annie, Jones Jeb, Sullivan Patrick, Hills Katherine, Fofana Kadija, Stephenson Rob, Allen Susan
Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Laney Graduate School, Emory University, Atlanta, Georgia, USA; Department of Epidemiology, Rollins School of Public Health, Laney Graduate School, Emory University, Atlanta, Georgia, USA.
Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Laney Graduate School, Emory University, Atlanta, Georgia, USA.
Open AIDS J. 2016 Feb 26;10:1-13. doi: 10.2174/1874613601610010001. eCollection 2016.
Couples' voluntary HIV counseling and testing (CHTC) is an HIV risk reduction strategy not widely available in the US.
We assessed willingness to participate in CHTC among US HIV-infected clinic patients via tablet-based survey and among HIV-negative persons with HIV-infected partners in care via mixed-method phone interviews.
Most of the N=64 HIV-infected partners surveyed were men (89%), on antiretroviral treatment (ART) (92%), and many self-identified homosexual (62%). We observed high levels of willingness to participate in CHTC (64%) among HIV-infected partners. Reasons for not wanting to participate included perceived lack of need (26%), desire to self-disclose their status (26%), and fear of being asked sensitive questions with their partner present (17%). HIV-infected partners were interested in discussing ART (48%), other sexually transmitted infections (STIs) (44%), and relationship agreements like monogamy (31%) during CHTC sessions. All N=15 HIV-negative partners interviewed were men, most identified as homosexual (73%), and about half (54%) reported consistent condom use with HIV-infected partners. We observed high levels of willingness to participate in CHTC (87%) among HIV-negative partners, who were also interested in discussing ART (47%), other STIs (47%), mental health services (40%), and relationship agreements (33%). Most negative partners (93%) indicated that they believed their HIV-infected partner was virally suppressed, but in the event that they were not, many (73%) were willing to take pre-exposure prophylaxis (PrEP).
These results indicate that CHTC for serodiscordant couples is acceptable and should emphasize aspects most pertinent to these couples, such as discussion of ART/PrEP, STIs, and relationship agreements.
夫妻自愿进行HIV咨询与检测(CHTC)是一种在美国尚未广泛应用的降低HIV风险策略。
我们通过基于平板电脑的调查评估了美国HIV感染门诊患者参与CHTC的意愿,并通过混合方法电话访谈评估了有HIV感染伴侣接受治疗的HIV阴性者参与CHTC的意愿。
在接受调查的N = 64名HIV感染伴侣中,大多数为男性(89%),正在接受抗逆转录病毒治疗(ART)(92%),且许多人自我认定为同性恋(62%)。我们观察到HIV感染伴侣中参与CHTC的意愿较高(64%)。不想参与的原因包括认为没有必要(26%)、希望自行透露自己的感染状况(26%)以及担心在伴侣在场时被问及敏感问题(17%)。HIV感染伴侣有兴趣在CHTC环节讨论ART(48%)、其他性传播感染(STIs)(44%)以及诸如一夫一妻制等关系协议(31%)。接受访谈的所有N = 15名HIV阴性伴侣均为男性,大多数自我认定为同性恋(73%),约一半(54%)报告与HIV感染伴侣始终坚持使用避孕套。我们观察到HIV阴性伴侣中参与CHTC的意愿较高(87%),他们也有兴趣讨论ART(47%)、其他STIs(47%)、心理健康服务(40%)以及关系协议(33%)。大多数阴性伴侣(93%)表示他们认为其HIV感染伴侣的病毒载量得到了抑制,但如果未得到抑制,许多人(73%)愿意接受暴露前预防(PrEP)。
这些结果表明,针对血清学不一致夫妻的CHTC是可以接受的,并且应强调与这些夫妻最相关的方面,如讨论ART/PrEP、STIs和关系协议。