Promotion of couples’ voluntary HIV counseling and testing: a comparison of influence networks in Rwanda and Zambia
Abstract Background Many African adults do not know that partners in steady or cohabiting relationships can have different HIV test results. Despite WHO recommendations for couples’ voluntary counseling and testing (CVCT), fewer than 10 % of couples have been jointly tested and counseled. We examine...
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| Format: | Article |
| Language: | English |
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BMC
2016-08-01
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| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12889-016-3424-z |
| _version_ | 1818037495632232448 |
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| author | April L. Kelley Ashley K. Hagaman Kristin M. Wall Etienne Karita William Kilembe Roger Bayingana Amanda Tichacek Michele Kautzman Susan A. Allen |
| author_facet | April L. Kelley Ashley K. Hagaman Kristin M. Wall Etienne Karita William Kilembe Roger Bayingana Amanda Tichacek Michele Kautzman Susan A. Allen |
| author_sort | April L. Kelley |
| collection | DOAJ |
| description | Abstract Background Many African adults do not know that partners in steady or cohabiting relationships can have different HIV test results. Despite WHO recommendations for couples’ voluntary counseling and testing (CVCT), fewer than 10 % of couples have been jointly tested and counseled. We examine the roles and interactions of influential network leaders (INLs) and influential network agents (INAs) in promoting CVCT in Kigali, Rwanda and Lusaka, Zambia. Methods INLs were identified in the faith-based, non-governmental, private, and health sectors. Each INL recruited and mentored several INAs who promoted CVCT. INLs and INAs were interviewed about demographic characteristics, promotional efforts, and working relationships. We also surveyed CVCT clients about sources of CVCT information. Results In Zambia, 53 INAs and 31 INLs were surveyed. In Rwanda, 33 INAs and 27 INLs were surveyed. Most (75 %–90 %) INAs believed that INL support was necessary for their promotional work. Zambian INLs reported being more engaged with their INAs than Rwandan INLs, with 58 % of Zambian INLs reporting that they gave a lot of support to their INAs versus 39 % in Rwanda. INAs in both Rwanda and Zambia reported promoting CVCT via group forums (77 %–97 %) and speaking to a community leader about CVCT (79 %–88 %) in the past month. More Rwandan INAs and INLs reported previous joint or individual HIV testing compared with their Zambian counterparts, of which more than half had not been tested. In Zambia and Rwanda, 1271 and 3895 CVCT clients were surveyed, respectively. Hearing about CVCT from INAs during one-on-one promotions was the most frequent source of information reported by clients in Zambia (71 %). In contrast, Rwandan couples who tested were more likely to have heard about CVCT from a previously tested couple (59 %). Conclusions CVCT has long been endorsed for HIV prevention but few couples have been reached. Influential social networks can successfully promote evidence-based HIV prevention in Africa. Support from more senior INLs and group presentations leveraged INAs’ one-on-one promotions. The INL/INA model was effective in promoting couples to seek joint HIV testing and counseling and may have broader application to other sub-Saharan African countries to sustainably increase CVCT uptake. |
| first_indexed | 2024-12-10T07:27:45Z |
| format | Article |
| id | doaj.art-d608e8bc0038484fa0638a8ab4c08627 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-10T07:27:45Z |
| publishDate | 2016-08-01 |
| publisher | BMC |
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| series | BMC Public Health |
| spelling | doaj.art-d608e8bc0038484fa0638a8ab4c086272022-12-22T01:57:40ZengBMCBMC Public Health1471-24582016-08-011611810.1186/s12889-016-3424-zPromotion of couples’ voluntary HIV counseling and testing: a comparison of influence networks in Rwanda and ZambiaApril L. Kelley0Ashley K. Hagaman1Kristin M. Wall2Etienne Karita3William Kilembe4Roger Bayingana5Amanda Tichacek6Michele Kautzman7Susan A. Allen8Zambia Emory HIV Research Project (ZEHRP)Rwanda Zambia HIV Research Group (RZHRG), Department of Pathology & Laboratory Medicine, School of Medicine, Emory UniversityRwanda Zambia HIV Research Group (RZHRG), Department of Pathology & Laboratory Medicine, School of Medicine, Emory UniversityProject San Francisco (PSF)Zambia Emory HIV Research Project (ZEHRP)Project San Francisco (PSF)Rwanda Zambia HIV Research Group (RZHRG), Department of Pathology & Laboratory Medicine, School of Medicine, Emory UniversityProject San Francisco (PSF)Rwanda Zambia HIV Research Group (RZHRG), Department of Pathology & Laboratory Medicine, School of Medicine, Emory UniversityAbstract Background Many African adults do not know that partners in steady or cohabiting relationships can have different HIV test results. Despite WHO recommendations for couples’ voluntary counseling and testing (CVCT), fewer than 10 % of couples have been jointly tested and counseled. We examine the roles and interactions of influential network leaders (INLs) and influential network agents (INAs) in promoting CVCT in Kigali, Rwanda and Lusaka, Zambia. Methods INLs were identified in the faith-based, non-governmental, private, and health sectors. Each INL recruited and mentored several INAs who promoted CVCT. INLs and INAs were interviewed about demographic characteristics, promotional efforts, and working relationships. We also surveyed CVCT clients about sources of CVCT information. Results In Zambia, 53 INAs and 31 INLs were surveyed. In Rwanda, 33 INAs and 27 INLs were surveyed. Most (75 %–90 %) INAs believed that INL support was necessary for their promotional work. Zambian INLs reported being more engaged with their INAs than Rwandan INLs, with 58 % of Zambian INLs reporting that they gave a lot of support to their INAs versus 39 % in Rwanda. INAs in both Rwanda and Zambia reported promoting CVCT via group forums (77 %–97 %) and speaking to a community leader about CVCT (79 %–88 %) in the past month. More Rwandan INAs and INLs reported previous joint or individual HIV testing compared with their Zambian counterparts, of which more than half had not been tested. In Zambia and Rwanda, 1271 and 3895 CVCT clients were surveyed, respectively. Hearing about CVCT from INAs during one-on-one promotions was the most frequent source of information reported by clients in Zambia (71 %). In contrast, Rwandan couples who tested were more likely to have heard about CVCT from a previously tested couple (59 %). Conclusions CVCT has long been endorsed for HIV prevention but few couples have been reached. Influential social networks can successfully promote evidence-based HIV prevention in Africa. Support from more senior INLs and group presentations leveraged INAs’ one-on-one promotions. The INL/INA model was effective in promoting couples to seek joint HIV testing and counseling and may have broader application to other sub-Saharan African countries to sustainably increase CVCT uptake.http://link.springer.com/article/10.1186/s12889-016-3424-zHIV/AIDSCouples’ voluntary HIV counseling and testingHIV educationHealth service promotionInfluential networks |
| spellingShingle | April L. Kelley Ashley K. Hagaman Kristin M. Wall Etienne Karita William Kilembe Roger Bayingana Amanda Tichacek Michele Kautzman Susan A. Allen Promotion of couples’ voluntary HIV counseling and testing: a comparison of influence networks in Rwanda and Zambia BMC Public Health HIV/AIDS Couples’ voluntary HIV counseling and testing HIV education Health service promotion Influential networks |
| title | Promotion of couples’ voluntary HIV counseling and testing: a comparison of influence networks in Rwanda and Zambia |
| title_full | Promotion of couples’ voluntary HIV counseling and testing: a comparison of influence networks in Rwanda and Zambia |
| title_fullStr | Promotion of couples’ voluntary HIV counseling and testing: a comparison of influence networks in Rwanda and Zambia |
| title_full_unstemmed | Promotion of couples’ voluntary HIV counseling and testing: a comparison of influence networks in Rwanda and Zambia |
| title_short | Promotion of couples’ voluntary HIV counseling and testing: a comparison of influence networks in Rwanda and Zambia |
| title_sort | promotion of couples voluntary hiv counseling and testing a comparison of influence networks in rwanda and zambia |
| topic | HIV/AIDS Couples’ voluntary HIV counseling and testing HIV education Health service promotion Influential networks |
| url | http://link.springer.com/article/10.1186/s12889-016-3424-z |
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