Social influence and uptake of couples HIV testing and counselling in KwaZulu‑natal, South Africa

Johnson, Matthew, James, Darbes, Lynae, Hosegood, Victoria, Johnson, Mallory, Fritz, Katherine, Ngubane, Thulani, van Rooyen, Heidi and Mcgrath, Nuala (2021) Social influence and uptake of couples HIV testing and counselling in KwaZulu‑natal, South Africa. AIDS and Behavior. (doi:10.1007/s10461-021-03435-1).

Abstract

Social influences may create a barrier to couples HIV testing and counselling (CHTC) uptake in sub-Saharan Africa. This secondary analysis of data collected in the ‘Uthando Lwethu’ randomised controlled trial used discrete-time survival models to evaluate the association between within-couple average ‘peer support’ score and uptake of CHTC by the end of nine months’ follow-up. Peer support was conceptualised by self-rated strength of agreement with two statements describing friendships outside of the primary partnership. Eighty-eight couples (26.9%) took up CHTC. Results tended towards a dichotomous trend in models adjusted only for trial arm, with uptake significantly less likely amongst couples in the higher of four peer support score categories (OR 0.34, 95% CI 0.18, 0.68 [7–10 points]; OR 0.53, 95% CI 0.28, 0.99 [≥ 11 points]). A similar trend remained in the final multivariable model, but was no longer significant (AOR 0.59, 95% CI 0.25, 1.42 [7–10 points]; AOR 0.88, 95% CI 0.36, 2.10 [≥ 11 points]). Accounting for social influences in the design of couples-focused interventions may increase their success.

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Contributors

Author: Victoria Hosegood

Author: Nuala Mcgrath

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