Recorded presentation

Dvora Joseph, MPH, Emory University Rollins School of Public Health, Projet San Francisco, BP 780, Kigali, Rwanda, 250-08595615, dvora@rwanda1.com and Susan Allen, MD, MPH, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322.

BACKGROUND: Heterosexual couples are the largest risk group for HIV in Africa; greater than 60% of new infections are acquired from a spouse. When husbands and wives receive couples’ VCT (CVCT) together, HIV incidence decreases >50%/year. However, <1% of African couples have received CVCT. Increases in CVCT demand and supply are critical.

METHODOLOGY: “Influence Network Agents” (INAs), recruited by community leaders, were trained to invite couples for CVCT in Lusaka, Zambia and Kigali, Rwanda. We improved upon this model by inviting couples to mobile HIV testing units (MU) in local churches, schools and administrative offices.

RESULTS: INAs dramatically increased demands for CVCT. Predictors of successful invitations (couple tested) included inviting couples together, inviting couples known to INAs, issuing invitations after public announcements. In Lusaka, INAs invited a higher number of couples than Kigali, but couples invited in Kigali were more likely to receive CVCT. INA work in the communities increased the numbers of couples tested in our facilities by 450% in Kigali and 187% in Lusaka from October-December 2003.

In addition to fixed testing sites, each city utilized 8 MUs. Lusaka MUs tested 43 couples while Kigali sites tested 95 couples; numbers of couples tested increased in each site. Success of MUs should be weighed against costs of such services.

CONCLUSIONS: INAs were effective in recruiting couples to receive CVCT, and increased the demand for CVCT in both capitals. MUs providing CVCT in accessible neighborhood locations increase testing rates. Cost-effectiveness analysis is needed to assess the best model of promoting CVCT.

Learning Objectives:

• Participants will learn about a successful program of promoting Couples Voluntary Counseling and Testing (CVCT) in two African capitals (Lusaka, Zambia and Kigali, Rwanda) that increased couples testing rates by 450% in Kigali and 190% in Lusaka. Participants will discover the importance of CVCT allowing them to implement similar community VCT promotion and Mobile HIV testing activities.

Keywords: International Public Health, Community-Based Health Promotion

Related Web page: www.soph.uab.edu/epicontent.asp?ID=656

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation