Antenatal Counseling May Reduce HIV Transmission

A Kenyan antenatal couple counseling program is helpful in reaching men and in reducing the risk of HIV transmission, according to researchers.

Women attending a Nairobi antenatal clinic were encouraged to bring their partners, Dr. Carey Farquar of the University of Washington, Seattle and colleagues note. The aim was to provide HIV counseling and testing. In addition, nevirapine was provided to HIV-positive women and condoms were distributed.

Of 2104 women tested for HIV infection, 308 (15%) had their partners participate and 116 (38%) went on to couple counseling, the researchers report in the December 15th issue of the Journal of the Acquired Immunodeficiency Syndromes.

In all, 32 of 314 HIV-positive women attended with their partners for testing and counseling. These women were three times more likely to return for nevirapine and to report using it at delivery (p = 0.009).

Nevirapine use was reported by 88% of women who took part in couple counseling. The corresponding proportion was 67% in women whose partners attended but were individually counseled and 45% in those whose partners did not attend.

HIV-positive women who received couple counseling were five times more likely to avoid breast feeding than were those who were counseled individually.

In addition, the 138 (64%) HIV-positive women who reported informing their partners were four times more likely to use condoms.

Should such programs be widely adopted Dr. Farquar said, "the end result would be more effective prevention programs and fewer HIV-1 infected infants. In addition, if both partners know their HIV-1 status this could help reduce heterosexual HIV-1 transmission among young couples -- a high risk group in sub Saharan Africa."

"Our findings may encourage programs to try harder to involve male partners in mother-to-child HIV-1 transmission prevention efforts," Dr. Farquar added. "This could help overcome a major barrier to uptake of antiretroviral prophylaxis and formula feeding by HIV-1 infected women in developing countries."

01/19/05

J Acquir Immune Defic Syndr 2004;37:1620-1626.