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Open Access Research article

Couple-oriented prenatal HIV counseling for HIV primary prevention: an acceptability study

Joanna Orne-Gliemann12*, Patrice T Tchendjou3, Marija Miric4, Mukta Gadgil5, Maia Butsashvili6, Fred Eboko7, Eddy Perez-Then4, Shrinivas Darak5, Sanjeevani Kulkarni5, George Kamkamidze6, Eric Balestre12, Annabel Desgrées du Loû8 and Francois Dabis12

Author Affiliations

1 Institut de Santé Publique Épidémiologie Développement (ISPED), Université Victor Segalen Bordeaux 2, Bordeaux, France

2 Centre de recherche INSERM U897, Bordeaux, France

3 Laboratoire d'Epidémiologie et de Santé Publique, Centre Pasteur du Cameroun, Yaoundé, Cameroun

4 Centro Nacional de Investigaciones en Salud Materno Infantil, Santo Domingo, Dominican Republic

5 Prayas Health Group, Pune, India

6 Maternal and Child Care Union, Neoclinic, Tbilisi, Georgia

7 Institut de Recherche pour le Développement, UMR 912 IRD-INSERM-U2 Marseille, France

8 Institut de Recherche pour le Développement, UMR 196 CEPED, Paris, France

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BMC Public Health 2010, 10:197  doi:10.1186/1471-2458-10-197

Published: 19 April 2010

Abstract

Background

A large proportion of the 2.5 million new adult HIV infections that occurred worldwide in 2007 were in stable couples. Feasible and acceptable strategies to improve HIV prevention in a conjugal context are scarce. In the preparatory phase of the ANRS 12127 Prenahtest multi-site HIV prevention trial, we assessed the acceptability of couple-oriented post-test HIV counseling (COC) and men's involvement within prenatal care services, among pregnant women, male partners and health care workers in Cameroon, Dominican Republic, Georgia and India.

Methods

Quantitative and qualitative research methods were used: direct observations of health services; in-depth interviews with women, men and health care workers; monitoring of the COC intervention and exit interviews with COC participants.

Results

In-depth interviews conducted with 92 key informants across the four sites indicated that men rarely participated in antenatal care (ANC) services, mainly because these are traditionally and programmatically a woman's domain. However men's involvement was reported to be acceptable and needed in order to improve ANC and HIV prevention services. COC was considered by the respondents to be a feasible and acceptable strategy to actively encourage men to participate in prenatal HIV counseling and testing and overall in reproductive health services.

Conclusions

One of the keys to men's involvement within prenatal HIV counseling and testing is the better understanding of couple relationships, attitudes and communication patterns between men and women, in terms of HIV and sexual and reproductive health; this conjugal context should be taken into account in the provision of quality prenatal HIV counseling, which aims at integrated PMTCT and primary prevention of HIV.