Counseling heterosexual couples about HIV in Zambia, Rwanda could prevent 60% of HIV cases

Jul 2 2008

Counseling heterosexual couples living in Zambia and Rwanda about HIV transmission could prevent up to 60% of new cases, according to a study published Saturday in the journal Lancet, Reuters reports (Fox, Reuters, 6/26).

Of the new HIV cases examined in the study, between 55.1% and 92.7% occurred among "serodiscordant" couples -- in which one partner is HIV-positive and the other is not -- AFP/Google.com reports.

Kristin Dunkle of Emory University's Rollins School of Public Health and colleagues conducted the study among 2,279 people in Zambia and 1,782 people in Rwanda who were living in towns (AFP/Google.com, 6/26). The researchers used a mathematical model based on existing data from voluntary HIV counseling and testing in urban areas of Zambia and Rwanda. The study found that 55% to 93% of new HIV cases among heterosexuals occur within couples who are married or living together. When the researchers factored in the higher rates of condom use among heterosexual partners not living together, the estimate of new HIV cases among married couples and those living together increased to 60% to 94%, Reuters reports. According to the researchers, a program in Zambia reduced HIV rates from 20% to 7% by providing HIV counseling to couples. They added that if such a program were applied more broadly, HIV transmission rates potentially would be reduced by 36% to 60%.

The researchers said that most HIV prevention efforts in Africa are focused on abstinence and sex outside marriage, but the findings indicate that investing in counseling for couples who are married or living together might have a significant impact. "To reduce HIV transmission, couples need to know their joint (HIV status) and have access to information which enables them to reduce the risk of infection both within and outside the union," Dunkle said. She added, "This is especially important for women, who might not have the cultural freedom to negotiate condom use and sexual activity within a union" (Reuters, 6/26).

The study is available online.