Pilot Study of Home-Based Delivery of HIV Testing and Counseling and Contraceptive Services to Couples in Malawi

February 2015 - Combination Prevention

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Becker, S., Taulo, F. O., Hindin, M. J., et al. BMC Public Health (December 2014), E-publication ahead of print.

This pilot study examined the uptake of couple HIV counseling and testing (CHCT) and couple family planning (CFP) services during a single home visit. The authors enrolled 180 couples from the three villages in Mpemba, a peri-urban area of Blantyre, Malawi. A pair of counselors (male and female) visited each couple and conducted a baseline interview assessing reproductive and health risks within the partnership, along with attitudinal questions about the partners' emotional closeness and likeliness to discuss pregnancy. The counselors then privately asked the female partner about her consent to CHCT + CFP, CHCT only, or CFP only. The man was offered whichever service(s) the woman had accepted. The authors reported that 89 percent of the couples accepted at least one of the services offered. Among untested participants, 78 percent of women and 91 percent of men accepted HIV testing. Additionally, reported condom use increased from 6 percent to 25 percent. Moreover, each couple’s acceptance of services was positively and significantly associated with several factors specific to the female partner: the woman’s number of live births, reported emotional closeness to her partner, and prior HIV testing. The authors concluded that home-based CHCT and CFP can increase access to HIV testing and contraceptive services to couples and prevent unplanned pregnancies and sexually transmitted infections.

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