What Works for Women and Girls

Promising Strategies:6. Encouraging couple dialogue and counseling, including techniques to avert gender-basedviolence, may increase the number of couples who receive and disclose their test results.A study of 245 women who were enrolled after pre-test counseling and prior to thecollection of test results in Tanzania found that disclosure of HIV serostatus was significantlyhigher for couples who discussed HIV testing prior to coming to the healthcenter: 94.6% of women who told their partners they were going to be tested disclosedtheir HIV results to their partners within three months after testing, compared to only44% of women who did not tell their partners that they were going to be tested (Mamanet al., 2001a). (Gray IV) (HIV testing, counseling, couples, disclosure, Tanzania)A qualitative study of in-depth interviews with 15 women, 15 men and 15 couples inTanzania, including 10 seroconcordant HIV-negative couples, found that among seroconcordantHIV-negative couples VCT was an important strategy to encourage coupleswho may be at risk for HIV infection to initiate preventive health behaviors to maintaintheir HIV-negative status. “Couples described testing as a preventive health measurethey used prior to unprotected sexual intercourse, marriage or pregnancy” (Maman etal., 2001b: 597). (Gray IV) (counseling, HIV testing, couples, Tanzania)A study in Rwanda and Zambia that promoted couples’ voluntary counseling and testingresulted in 1,411 couples requesting couples counseling and testing. Cohabitatingcouples in Africa represent a large HIV risk group. (Allen et al., 2007b). (Gray V) (counseling,HIV testing, couples, Rwanda, Zambia)An intervention in one district in Uganda in which 35 VCT volunteer couples wereoriented on couple dialogue techniques to avert gender based violence and who subsequentlycounseled an additional 206 couples greatly increased the numbers of coupleswho were willing to know their HIV status. VCT volunteers from eight civil societyorganizations were trained in rights based community mobilization approaches topreventing violence and skills to integrate GBV interventions into VCT services. In2006 and 2007, out of 206 couples that were counseled in the GBV intervention area,all received their HIV test results. In comparison, 5% of 8,708 couples that receivedHIV counseling and testing service in the non-GBV intervention area received their testresults. Couples were ten times more likely to receive results in GBV intervention areasthan in non-GBV intervention areas (Wandera et al., 2008). (Abstract) (counseling, HIVtesting, violence, Uganda)7. Knowledge of treatment availability can increase uptake of HIV testing. [See also Chapter7A. Treatment: Provision and Access]A cross-sectional study during 2004 of 184 men and women (121 were women) attendinga hospital for any reason in South Africa found a significant association for womenbetween those who knew someone on antiretroviral therapy and having been testedWHAT WORKS FOR WOMEN AND GIRLS161