Implementing Couple's Human Immunodeficiency Virus Testing and Counseling in the Antenatal Care Setting.


Journal

Obstetrics and gynecology
ISSN: 1873-233X
Titre abrégé: Obstet Gynecol
Pays: United States
ID NLM: 0401101

Informations de publication

Date de publication:
09 2020
Historique:
pubmed: 10 8 2020
medline: 26 11 2020
entrez: 10 8 2020
Statut: ppublish

Résumé

To describe a pilot implementation of couple's human immunodeficiency virus (HIV) testing and counseling in an antenatal care clinic in the United States. We used a cross-sectional study design. Couples were recruited from an antenatal care clinic of a large, urban, tertiary medical center, and were eligible if both partners agreed to receive HIV test results together and reported no coercion to participate in testing and counseling and no intimate partner violence. We assessed relationship characteristics, HIV risk-related behaviors and concordance of couples' sexual agreement (ie, mutual agreement about sexual risk behaviors that are permissible within or outside of their relationship). Acceptability of couple's HIV testing and counseling (ie, format, quality of the sessions, ability to meet their needs) was assessed after completing the session. Barriers and facilitators to couple's HIV testing and counseling were assessed at the individual-level among decliners and participants and at the clinic-level among members of the care team. Dyadic data were collected from 82 individuals (41 couples). Most partners (n=56, 68%) did not have a sexual agreement or had differing expectations about their sexual agreement. Partners with a concordant sexual agreement (n=26) felt more confident working with their partners on condom use when having sex outside of their relationship (P=.008) and were more likely to agree with their partner to get tested regularly for HIV or sexually transmitted infections (P=.015). Acceptability was high, with a rating of 93 or more (out of 100) among all items. Individual-level barriers to couple's HIV testing and counseling included difficulty bringing the male partner for counseling and a perception by either member of the couple that they were at low-risk for HIV. At the clinic level, need for training, staff turnover, and integration of couple's HIV testing and counseling in the clinic flow presented as barriers, whereas commitment by the clinic leadership facilitated the couple's HIV testing and counseling program. Despite barriers, couple's HIV testing and counseling can be implemented in antenatal clinics and is a highly acceptable method of HIV testing.

Identifiants

pubmed: 32769640
doi: 10.1097/AOG.0000000000003932
pii: 00006250-202009000-00019
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

582-590

Références

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Auteurs

Florence Momplaisir (F)

Division of Infectious Diseases, Department of Medicine, University of Pennsylvania Perelman School of Medicine, the Departments of Obstetrics & Gynecology and Psychiatry, Drexel University College of Medicine, the AIDS Activities Coordinating Office, Philadelphia Department of Public Health, the Undergraduate Program in Neurosciences, University of Pennsylvania, and the Department of Community and Prevention, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania; and Massachusetts General Hospital, School of Public Health, Boston, Massachusetts.

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