The Effect of HIV Counselling and Testing on HIV Acquisition in Sub-Saharan Africa: A Systematic Review

October 2016 - Combination Prevention

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Rosenberg, N.E., Hauser, B.M., Ryan, J., et al., Sexually Transmitted Infections (August 2016), 0:1–8, doi: 10.1136/sextrans-2016-052651.

This systematic review of eight articles examined the influence of HIV counseling and testing (HCT) on risk of acquiring HIV among HIV-negative individuals. The authors compared sites that provided complete HCT services versus those that did not; individuals who received HCT versus those who did not; and provision of individual versus couples HCT. The site comparisons, which compared full workplace HCT versus workplace HCT with provision of off-site results, did not show that the HCT site had an impact on HIV acquisition. Of the five studies that examined individual HCT HIV acquisition, four were conducted in households and one in the work setting. There was no statistically significant difference in HIV positivity between those who received individual HCT and those who did not. One study that adjusted for sexual behavior found that HCT was protective. Two studies examining individual versus couples testing showed that couples HCT tended to be more protective, though one study indicated that this effect was stronger for women. All results indicated that individual HCT does not change the risk of HIV positivity; and that couples HCT reduces the risk of HCT positivity by nearly half. These findings, the authors said, are consistent with other studies that show larger behavioral changes following couples HCT versus individual HCT.

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