%0 Journal Article
%T Promotion of couples' voluntary counselling and testing for HIV through influential networks in two African capital cities
%A Susan Allen
%A Etienne Karita
%A Elwyn Chomba
%A David L Roth
%A Joseph Telfair
%A Isaac Zulu
%A Leslie Clark
%A Nzali Kancheya
%A Martha Conkling
%A Rob Stephenson
%A Brigitte Bekan
%A Katherine Kimbrell
%A Steven Dunham
%A Faith Henderson
%A Moses Sinkala
%A Michel Carael
%A Alan Haworth
%J BMC Public Health
%D 2007
%I BioMed Central
%R 10.1186/1471-2458-7-349
%X Influence Network Agents (INAs) from the health, religious, non-governmental, and private sectors were trained to invite couples for CVCT. Predictors of successful promotion were identified using a multi-level hierarchical analysis.In 4 months, 9,900 invitations were distributed by 61 INAs, with 1,411 (14.3%) couples requesting CVCT. INAs in Rwanda distributed fewer invitations (2,680 vs. 7,220) and had higher response rates (26.9% vs. 9.6%), than INAs in Zambia. Context of the invitation event, including a discreet location such as the INA's home (OR 3.3¨C3.4), delivery of the invitation to both partners in the couple (OR 1.6¨C1.7) or to someone known to the INA (OR 1.7¨C1.8), and use of public endorsement (OR 1.7¨C1.8) were stronger predictors of success than INA or couple-level characteristics.Predictors of successful CVCT promotion included strategies that can be easily implemented in Africa. As new resources become available for Africans with HIV, CVCT should be broadly implemented as a point of entry for prevention, care and support.In 2006 more than 65% of the 4.3 million new cases of HIV occurred in Sub-Saharan Africa [1]. In this region, most transmission is heterosexual, occurring predominately between cohabiting partners [2]. Among pregnant women tested with their partners in antenatal clinics in Lusaka, the capital of Zambia, 19% of couples had two HIV+ partners ("concordant +") and 17% had one HIV+ and one HIV- partner ("discordant"). In Kigali, the capital of Rwanda, 8% of couples were concordant + and 9% were discordant [3]. These results are similar to those reported in couples' voluntary HIV counselling and testing (CVCT) centres [4-7], cluster sampling surveys [8], and to those reported for couples in neighbouring Kenya and Tanzania [9].Cohabiting couples in Africa now represent the world's largest HIV risk group [10,11]. VCT is a cost-effective method of reducing HIV transmission [12-14] and traditional clinic-based services have recently expanded to
%U http://www.biomedcentral.com/1471-2458/7/349