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Home-Based HIV Testing Among Pregnant Couples Increases Partner Testing and Identification of Serodiscordant Partnerships

INTRODUCTION: Male partner HIV testing has been recognized as an important component of prevention of mother-to-child HIV transmission. Scheduled home-based couple HIV testing may be an effective strategy to reach men. METHODS: Women attending their first antenatal visit at Kisumu County Hospital in...

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Autores principales: Krakowiak, Daisy, Kinuthia, John, Osoti, Alfred O., Asila, Victor, Gone, Molly A., Mark, Jennifer, Betz, Bourke, Parikh, Saloni, Sharma, Monisha, Barnabas, Ruanne, Farquhar, Carey
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JAIDS Journal of Acquired Immune Deficiency Syndromes 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5113239/
https://www.ncbi.nlm.nih.gov/pubmed/27355505
http://dx.doi.org/10.1097/QAI.0000000000001053
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author Krakowiak, Daisy
Kinuthia, John
Osoti, Alfred O.
Asila, Victor
Gone, Molly A.
Mark, Jennifer
Betz, Bourke
Parikh, Saloni
Sharma, Monisha
Barnabas, Ruanne
Farquhar, Carey
author_facet Krakowiak, Daisy
Kinuthia, John
Osoti, Alfred O.
Asila, Victor
Gone, Molly A.
Mark, Jennifer
Betz, Bourke
Parikh, Saloni
Sharma, Monisha
Barnabas, Ruanne
Farquhar, Carey
author_sort Krakowiak, Daisy
collection PubMed
description INTRODUCTION: Male partner HIV testing has been recognized as an important component of prevention of mother-to-child HIV transmission. Scheduled home-based couple HIV testing may be an effective strategy to reach men. METHODS: Women attending their first antenatal visit at Kisumu County Hospital in Kenya were randomized to home-based education and HIV testing within 2 weeks of enrollment (HOPE) or to written invitations for male partners to attend clinic (INVITE). Male partner HIV testing and maternal child health outcomes were compared at 6 months postpartum. RESULTS: Of 1101 women screened, 620 were eligible and 601 were randomized to HOPE (n = 306) or INVITE (n = 295). At 6 months postpartum, male partners were more than twice as likely [relative risk (RR) = 2.10; 95% CI (CI): 1.81 to 2.42] to have been HIV tested in the HOPE arm [233 (87%)] compared with the INVITE arm [108 (39%)]. Couples in the HOPE arm [192 (77%)] were 3 times as likely (RR = 3.17; 95% CI: 2.53 to 3.98) to have been tested as a couple as the INVITE arm [62 (24%)] and women in the HOPE arm [217 (88%)] were also twice as likely (RR = 2.27; 95% CI: 1.93 to 2.67) to know their partner's HIV status as the INVITE arm [98 (39%)]. More serodiscordant couples were identified in the HOPE arm [33 (13%)] than in the INVITE arm [10 (4%)] (RR = 3.38; 95% CI: 1.70 to 6.71). Maternal child health outcomes of facility delivery, postpartum family planning, and exclusive breastfeeding did not vary by arm. CONCLUSIONS: Home-based HIV testing for pregnant couples resulted in higher uptake of male partner and couple testing, as well as higher rates of HIV status disclosure and identification of serodiscordant couples. However, the intervention did not result in higher uptake of maternal child health outcomes, because facility delivery and postpartum family planning were high in both arms, whereas exclusive breastfeeding was low. The HOPE intervention was successful at its primary aim to increase HIV testing and disclosure among pregnant couples and was able to find more serodiscordant couples compared with the invitation-only strategy. TRIAL REGISTRATION: Clinicaltrials.gov registry: NCT01784783.
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spelling pubmed-51132392016-11-23 Home-Based HIV Testing Among Pregnant Couples Increases Partner Testing and Identification of Serodiscordant Partnerships Krakowiak, Daisy Kinuthia, John Osoti, Alfred O. Asila, Victor Gone, Molly A. Mark, Jennifer Betz, Bourke Parikh, Saloni Sharma, Monisha Barnabas, Ruanne Farquhar, Carey J Acquir Immune Defic Syndr Supplement Article INTRODUCTION: Male partner HIV testing has been recognized as an important component of prevention of mother-to-child HIV transmission. Scheduled home-based couple HIV testing may be an effective strategy to reach men. METHODS: Women attending their first antenatal visit at Kisumu County Hospital in Kenya were randomized to home-based education and HIV testing within 2 weeks of enrollment (HOPE) or to written invitations for male partners to attend clinic (INVITE). Male partner HIV testing and maternal child health outcomes were compared at 6 months postpartum. RESULTS: Of 1101 women screened, 620 were eligible and 601 were randomized to HOPE (n = 306) or INVITE (n = 295). At 6 months postpartum, male partners were more than twice as likely [relative risk (RR) = 2.10; 95% CI (CI): 1.81 to 2.42] to have been HIV tested in the HOPE arm [233 (87%)] compared with the INVITE arm [108 (39%)]. Couples in the HOPE arm [192 (77%)] were 3 times as likely (RR = 3.17; 95% CI: 2.53 to 3.98) to have been tested as a couple as the INVITE arm [62 (24%)] and women in the HOPE arm [217 (88%)] were also twice as likely (RR = 2.27; 95% CI: 1.93 to 2.67) to know their partner's HIV status as the INVITE arm [98 (39%)]. More serodiscordant couples were identified in the HOPE arm [33 (13%)] than in the INVITE arm [10 (4%)] (RR = 3.38; 95% CI: 1.70 to 6.71). Maternal child health outcomes of facility delivery, postpartum family planning, and exclusive breastfeeding did not vary by arm. CONCLUSIONS: Home-based HIV testing for pregnant couples resulted in higher uptake of male partner and couple testing, as well as higher rates of HIV status disclosure and identification of serodiscordant couples. However, the intervention did not result in higher uptake of maternal child health outcomes, because facility delivery and postpartum family planning were high in both arms, whereas exclusive breastfeeding was low. The HOPE intervention was successful at its primary aim to increase HIV testing and disclosure among pregnant couples and was able to find more serodiscordant couples compared with the invitation-only strategy. TRIAL REGISTRATION: Clinicaltrials.gov registry: NCT01784783. JAIDS Journal of Acquired Immune Deficiency Syndromes 2016-08-01 2016-06-28 /pmc/articles/PMC5113239/ /pubmed/27355505 http://dx.doi.org/10.1097/QAI.0000000000001053 Text en Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially.
spellingShingle Supplement Article
Krakowiak, Daisy
Kinuthia, John
Osoti, Alfred O.
Asila, Victor
Gone, Molly A.
Mark, Jennifer
Betz, Bourke
Parikh, Saloni
Sharma, Monisha
Barnabas, Ruanne
Farquhar, Carey
Home-Based HIV Testing Among Pregnant Couples Increases Partner Testing and Identification of Serodiscordant Partnerships
title Home-Based HIV Testing Among Pregnant Couples Increases Partner Testing and Identification of Serodiscordant Partnerships
title_full Home-Based HIV Testing Among Pregnant Couples Increases Partner Testing and Identification of Serodiscordant Partnerships
title_fullStr Home-Based HIV Testing Among Pregnant Couples Increases Partner Testing and Identification of Serodiscordant Partnerships
title_full_unstemmed Home-Based HIV Testing Among Pregnant Couples Increases Partner Testing and Identification of Serodiscordant Partnerships
title_short Home-Based HIV Testing Among Pregnant Couples Increases Partner Testing and Identification of Serodiscordant Partnerships
title_sort home-based hiv testing among pregnant couples increases partner testing and identification of serodiscordant partnerships
topic Supplement Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5113239/
https://www.ncbi.nlm.nih.gov/pubmed/27355505
http://dx.doi.org/10.1097/QAI.0000000000001053
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