Factors influencing the uptake of couple's HIV counselling and testing among men in Livingstone District, Zambia
Background: HIV counselling and testing is important as a gateway to accessing prevention, treatment, care and support services. Studies have shown that couples who are married or are in a stable heterosexual relationship are at risk of transmitting HIV infection to each other if one partner is infected. The uptake of couples counselling and testing (CHCT) by males in Livingstone is very low despite the fact that they are the decision makers in most homes. Aim: The aim of the study was to assess the factors determining the uptake of CHCT amongst males in a long term heterosexual relationship who came to a health facility for HIV counselling and testing in Livingstone, Zambia and their perceived benefits of CHCT. Methodology: A case control study was conducted with cases being men age 21 years and above, who were married/cohabiting or were in a steady heterosexual relationship for six months and more and had jointly tested for HIV as a couple, and controls were men age 21 years and above, who were married/cohabiting or were in a steady relationship for six months and more and came to be tested for HIV alone without a partner. The structured questionnaires were administered to a total of 294 participants (147 controls, 147 cases) who were recruited from three public health facilities and one private facility in Livingstone between August and September 2013.Results: The only 2 factors independently associated with testing for HIV via CHCT was, talking about HIV as a couple‟ which positively affected CHCT and „had a previous HIV test as a couple‟ which negatively affected CHCT. Findings indicate that „talk about HIV as a couple‟ was a strong independent predictor of CHCT in the multivariate analysis; however it was uncertain whether it was a predictor of CHCT or a consequence of CHCT. It is probable that having already „had a previous HIV test as a couple‟ the participants would not see the need for testing via CHCT again. Other factors that were significantly associated with uptake of CHCT on bivariate analysis but were not significant on multivariate logistic regression analysis included those that are associated with a greater likelihood of CHCT: think CHCT is beneficial /useful, know partners HIV status, know positive things about CHCT and talk about sexual issues as a couple. Other factors negatively associated with uptake of CHCT were: ever tested for HIV before, informed partner about HIV status, think partner is at risk of contracting HIV, think self is at risk of contracting HIV, low self-risk-rating of HIV infection and marital status. Conclusion: The decision for a couple to go for CHCT is probably relatively complex, because most of the factors measured were linked to each other and it was difficult to separate them to identify if a factor on its own was able to influence the uptake of CHCT. However a couple that communicates with each other about HIV issues is likely to be motivated to go for CHCT.