HIV Prevention for Serodiscordant Couples
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HIV serodiscordant couples, in which one partner is HIV-positive and the other is HIV-negative, are a priority for HIV prevention interventions in developing countries. Although there is considerable variation across countries, recent studies in a few sub-Saharan countries with mature epidemics suggest that up to two-thirds of infected couples are discordant. Effective HIV prevention interventions targeting serodiscordant sex partners and cohabitating or married couples could potentially reduce new HIV infections to HIV-negative sex partner(s). Yet, program experience in this area is recent in developing countries.
A small number of interventions are aimed at preventing HIV transmission between partners in discordant couples. The three following types of interventions have emerged in the literature:
- Couple HIV Voluntary Counseling and Testing (CVCT)—both via community-based outreach and in antenatal clinics
- Group-based workshops with serodiscordant couples
- Integrated antiretroviral therapy (ART) and HIV prevention programs.
Couple HIV counseling and testing is the cornerstone of many discordant couple interventions -- it remains the only way to identify couples where one partner is HIV-positive and where one is HIV-negative. For effective prevention programming, couple testing programs will likely require integration with broader HIV programs, including linkages to care, treatment, and support services; MCTC programs; condom promotion; and other behavior change communication activities.
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