1. Disclosure of HIV results among discordant couples in Rakai, Uganda: a facilitated couple counselling approach.
- Author
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Kairania, Robert, Gray, RonaldH., Kiwanuka, Noah, Makumbi, Fredrick, Sewankambo, NelsonK., Serwadda, David, Nalugoda, Fred, Kigozi, Godfrey, Semanda, John, and Wawer, MariaJ.
- Subjects
ANALYSIS of variance ,COUNSELING ,PUBLIC health surveillance ,STATISTICAL sampling ,COUPLES ,DISCLOSURE ,HIV seroconversion - Abstract
Disclosure of HIV sero-positive results among HIV-discordant couples in sub-Saharan Africa is generally low. We describe a facilitated couple counselling approach to enhance disclosure among HIV-discordant couples. Using unique identifiers, 293 HIV-discordant couples were identified through retrospective linkage of married or cohabiting consenting adults individually enrolled into a cohort study and into two randomised trials of male circumcision in Rakai, Uganda. HIV-discordant couples and a random sample of HIV-infected concordant and HIV-negative concordant couples (to mask HIV status) were invited to sensitisation meetings to discuss the benefits of disclosure and couple counselling. HIV-infected partners were subsequently contacted to encourage HIV disclosure to their HIV-uninfected partners. If the index positive partner agreed, the counsellor facilitated the disclosure of HIV results, and provided ongoing support. The proportion of disclosure was determined. Eighty-one per cent of HIV-positive partners in discordant relationships disclosed their status to their HIV-uninfected partners in the presence of the counsellor. The rates of disclosure were 81.3% in male HIV-positive and 80.2% in female HIV-positive discordant couples. Disclosure did not vary by age, education or occupation. In summary, disclosure of HIV-positive results in discordant couples using facilitated couple counselling approach is high, but requires a stepwise process of sensitisation and agreement by the infected partner. [ABSTRACT FROM AUTHOR]
- Published
- 2010
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