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During pregnancy, offering HIV testing at home doubles the proportion of male partners who test
Roger Pebody, 2016-02-24 10:40:00

A programme of home visits, partner education and HIV testing for couples in Kenya was able to double the proportion of men who tested during their partner’s pregnancy, Carey Farquhar of the University of Washington told the Conference on Retroviruses and Opportunistic Infections (CROI 2016) in Boston yesterday. Partners became aware of each other’s HIV status without this being linked to an increase in intimate partner violence.

Whereas HIV testing is widely offered to women attending antenatal clinics, there are fewer opportunities for men to test. In African countries, no more than a third of men take an HIV test during their female partner’s pregnancy, but there are particular advantages to engaging with men at this time.

The male partner may strongly influence decisions affecting women’s reproductive health. Pregnant women who are diagnosed with HIV during individual HIV counselling and testing, without the support of their partner, may be afraid of disclosing their HIV status to him. Moreover they are less likely to adhere to HIV treatment during pregnancy and other interventions to prevent mother-to-child transmission.

In the case of a couple where the man has HIV and the woman does not, lack of male partner HIV testing may result in the woman seroconverting to HIV during pregnancy or breastfeeding (a period of elevated transmission risk). A woman who has herself just become HIV positive would have a very high viral load, putting her at exceptionally high risk of passing the infection on to her child.

Several interventions have been shown to modestly improve HIV testing rates in male partners, but have not had the large effect seen in the study presented yesterday. These interventions have included letters to invite male partners to attend HIV testing at antenatal clinics, making antenatal clinics more ‘male friendly’ and adapting post-test counselling for women so that it develops their communication skills and self-efficacy.