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Attitudes Towards Couples-Based HIV Testing Among MSM in Three US Cities

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Abstract

Couples-based voluntary HIV counseling and testing (CVCT)—in which couples receive counseling and their HIV test results together—has been shown to be an effective strategy among heterosexual sero-discordant couples in Africa for reducing HIV transmission by initiating behavioral change. This study examined attitudes towards CVCT among men who have sex with men (MSM) in three US cities. Four focus group discussions (FGD) were held with MSM in Atlanta, Chicago, and Seattle. Although initially hesitant, participants reported an overwhelming acceptance of CVCT. CVCT was seen as a sign of commitment within a relationship and was reported to be more appropriate for men in longer-term relationships. CVCT was also seen as providing a forum for the discussion of risk-taking within the relationship. Our results suggest that there may be a demand for CVCT among MSM in the United States, but some modifications to the existing African CVCT protocol may be needed.

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References

  1. Hall HI, Song R, Rhodes P, Prejean J, An Q, Lee LM, et al. Estimation of HIV incidence in the United States. J Am Med Assoc. 2008;300(5):520–9.

    Article  CAS  Google Scholar 

  2. Sullivan PS, Salazar LF, Buchbinder S, Sanchez TH. Estimating the proportion of HIV transmissions from main sex partners among venue-attending men who have sex with men in the 5 US cities. AIDS. 2009;23(9):1153–62.

    Article  PubMed  Google Scholar 

  3. Gates GJ. Same-sex couples and the gay, lesbian, bisexual population: new estimates from the American Community Survey [online report]. 2006. Available at: http://www.law.ucla.edu/Williamsinstitute/publications/SameSexCouplesandGLBpopACS.pdf. Accessed May 2010.

  4. Centers for Disease Control and Prevention. HIV Testing Survey, 2002. Atlanta: US. Department of Health and Human Services, Centers for Disease Control and Prevention; 2004. p. 1–28. HIV/AIDS Special Surveillance Report 5. 2004. Available at http://www.cdc.gov/hiv/stats/hasrsupp.htm.

  5. Centers for Disease Control and Prevention. HIV prevalence, unrecognized infection, and HIV testing among men who have sex with men—five US cities, June 2004–April 2005. MMWR. 2005;52(24):597–601.

    Google Scholar 

  6. Koblin BA, Chesney MA, Husnik MJ, Bozeman S, Celum CL, Buchbinder S, et al. High-risk behaviors among men who have sex with men in 6 US cities: baseline data from the EXPLORE study. Am J Public Health. 2003;93(6):926–32.

    Article  PubMed  Google Scholar 

  7. Stall RD, Hays RB, Waldo CR, Ekstrand M, Mc-Farland W. The gay ‘90s: a review of research in the 1990s on sexual behavior and HIV risk among men who have sex with men. AIDS. 2000;14(suppl 3):S101–14.

    PubMed  Google Scholar 

  8. Imrie J, Stephenson JM, Cowan FM, et al. A cognitive behavioural intervention to reduce sexually transmitted infections among gay men: randomised trial. BMJ. 2001;322:1451–6.

    Article  PubMed  CAS  Google Scholar 

  9. Elford J, Hart G. If HIV prevention works, why are rates of high-risk sexual behavior increasing among MSM? AIDS Educ Prev. 2003;15(4):294–308.

    Article  PubMed  Google Scholar 

  10. Weinhardt LS, Carey MP, Johnson BT, Bickham NL. Effects of HIV counseling and testing on sexual risk behavior: a meta-analytic review of published research, 1985–1997. Am J Public Health. 1999;89(9):1397–405.

    Article  PubMed  CAS  Google Scholar 

  11. Kalichman Sc, Jeffrey A, Rompa D. Continued high-risk sex among HIV seropositive gay and bisexual men seeking HIV prevention services. Health Psychol. 1997;16(4):369–73.

    Article  PubMed  CAS  Google Scholar 

  12. Allen S, Serufilira A, Bogaerts J, Van de Perre P, Nsengumuremyi F, Lindan C, et al. Confidential HIV testing and condom promotion in Africa. Impact on HIV and gonorrhea rates. JAMA. 1992;268(23):3338–43.

    Article  PubMed  CAS  Google Scholar 

  13. Chomba C, Allen S, Kaweka W, Tichacek A, Cox G, Shutes E, et al. Evolution of couples’ voluntary counseling and testing for HIV in Lusaka, Zambia. J AIDS. 2008;47(1):108–15.

    Google Scholar 

  14. Farquhar C, Kiarie JN, Richardson BA, Kabura M, Francis J, Nduati R, et al. Antenatal couple counseling increases uptake of interventions to prevent HIV-1 transmission. Epidemiol Soc Sci. 2004;37(5):1620–6.

    Google Scholar 

  15. Guthrie BL, de Bruyn G, Farquhar C. HIV 1 discordant couples in sub-Saharan Africa: explanations and implications for high rates of discordancy. Curr HIV Res. 2007;5(4):416–29.

    Article  PubMed  CAS  Google Scholar 

  16. Painter TM. Voluntary counseling and testing for couples: a high-leverage intervention for HIV/AIDS prevention in sub-Saharan Africa. Soc Sci Med. 2001;53(11):1397–411.

    Article  PubMed  CAS  Google Scholar 

  17. Dunkle K, Stephenson R, Karita E, Chomba E, Kayitenkore K, Vwalika C, et al. Estimating the proportion of new heterosexually transmitted HIV infections that occur within married/cohabiting couples in urban Zambia and Rwanda. Lancet. 2008;371:2183–91.

    Article  PubMed  Google Scholar 

  18. Hageman KH, Tichacek A, Allen S. Couples voluntary counseling and testing. In: Mayer KH, Pizer HF, editors. HIV prevention: a comprehensive approach. London: Academic Press; 2009.

    Google Scholar 

  19. Morgan DL. Focus groups. Annu Rev Soc. 1996;22:129–52.

    Article  Google Scholar 

  20. NUD*IST. QSR International: http://www.qsrinternational.com/. Accessed May 2010.

  21. Peterman TA, Todd KA, Mupanduki I. Opportunities for targeting publicly funded human immunodeficiency virus counseling and testing. J Acquir Immune Defic Syndr Hum Retrovirol. 1996;12:69–74.

    PubMed  CAS  Google Scholar 

  22. Spielberg F, Kurth A, Gorbach PM, Goldbaum G. Moving from apprehension to action: HIV counseling and testing preferences in three at-risk populations. AIDS Educ Prev. 2001;13(6):524–40.

    Article  PubMed  CAS  Google Scholar 

  23. Allen S, Tice J, Van de Pere P, Serufilira A, Hudes E, Nsengumuremyi F, Bohaerts J, et al. Effect of serotesting with counseling on condom use and seroconversion among HIV discordant couples in Africa. BMJ. 2001;304:1605–9.

    Article  Google Scholar 

  24. Roth DL, Stewart KE, Clay OJ, van der Straten A, Karita E, Allen S. Sexual practices of HIV discordant and concordant couples in Rwanda: effects of a testing and counseling programme for men. Int J STD AIDS. 2003;12:181–8.

    Article  Google Scholar 

  25. Allen A, Meinzen-Derr J, Kautzman M, Zulu I, Trask S, Fideli U, et al. Sexual behavior of HIV discordant couples after HIV counseling and testing. AIDS. 2003;17:733–40.

    Article  PubMed  Google Scholar 

  26. Gorbach PM, Holmes KK. Transmission of STIs/HIV at the partnership level: Beyond individual-level analyses. J Urban Health Bull NY Acad Med. 2003;80(3):iii15–25.

    Google Scholar 

  27. Theodore PS, Duran REF, Antoni M, Fernandez MI. Intimacy and sexual behavior among HIV-positive men who have sex with men in primary relationships. AIDS Behav. 2004;8(3):321–31.

    Article  PubMed  Google Scholar 

  28. Marks G, Crepaz N, Senterfitt JW, Janssen R. Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States Implications for HIV prevention programs. J AIDS. 2005;39(4):446–53.

    Google Scholar 

Download references

Acknowledgments

This research was supported by the Emory Center for AIDS Research (P30 AI050409), National Institute for Mental Health (1R34MH086331), and NIMH RO1 667667, Fogarty AIDS International Training and Research Program FIC 2D43 TW001042.

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Authors and Affiliations

  1. Hubert Department of Global Health, Rollins School of Public Health, 1518 Clifton Road NE, #722, Emory, Atlanta, GA, 30322, USA

    Rob Stephenson

  2. Department of Epidemiology, Rollins School of Public Health, Emory, Atlanta, GA, USA

    Patrick S. Sullivan

  3. Department of Behavioral Science & Health Education, Rollins School of Public Health, Emory, Atlanta, GA, USA

    Laura F. Salazar

  4. Howard Brown Health Center and School of Public Health, University of Illinois at Chicago, Chicago, IL, USA

    Beau Gratzer

  5. Zambia-Emory HIV Research Group, Department of Pathology, School of Medicine, Emory University, Atlanta, GA, USA

    Susan Allen

  6. Lifelong AIDS Alliance, Seattle, WA, USA

    Erick Seelbach

Authors
  1. Rob Stephenson
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  2. Patrick S. Sullivan
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  3. Laura F. Salazar
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  4. Beau Gratzer
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  5. Susan Allen
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  6. Erick Seelbach
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Correspondence to Rob Stephenson.

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Stephenson, R., Sullivan, P.S., Salazar, L.F. et al. Attitudes Towards Couples-Based HIV Testing Among MSM in Three US Cities. AIDS Behav 15 (Suppl 1), 80–87 (2011). https://doi.org/10.1007/s10461-011-9893-2

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  • DOI: https://doi.org/10.1007/s10461-011-9893-2

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