Serosorting and the Evaluation of HIV Testing and Counseling for HIV Prevention in Generalized Epidemics
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UNAIDS and the WHO recognize the importance of HIV Testing and Counseling (HTC) as a gateway to both treatment and prevention [ 1]. Many studies aimed at identifying behavioral changes following HTC have, however, registered only modest reductions in risk behaviors: change—if any—is most commonly reported by women, HIV positives, and in serodiscordant couples. This is also the gist of the review of early studies from predominantly Europe and North America [ 2, 3, 4], and a review of seven studies set in developing countries [ 5]. More recent studies from sub-Saharan Africa, summarized in Table 1, largely corroborate these conclusions. The most ambitious HTC impact evaluation studies target reductions in HIV incidence, but none have been detected so far [ 6, 7, 8]. In serodiscordant couples, however, HTC is associated with a reduction in HIV transmission [ 9].
Description of selected HTC efficacy studies in sub-Saharan Africa and their main findings
KeywordsSexual Partnership Serodiscordant Couple Partner Characteristic Generalize Epidemic Seroadaptive Behavior
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
We thank Susan Watkins and the journal’s reviewers for their comments and suggestions.
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