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Perceived acceptability of home-based couples voluntary HIV counseling and testing in Northern Tanzania.

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Date
2012
Authors
Njau, B
Watt, MH
Ostermann, J
Manongi, R
Sikkema, KJ
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Abstract
It is estimated that 5.6% of the Tanzanian population ages 15-49 are infected with HIV, but only 30% of adults have ever had an HIV test. Couples' testing has proven to increase testing coverage and introduce HIV prevention, but barriers include access to testing services and unequal gender dynamics in relationships. Innovative approaches are needed to address barriers to couple's testing and increase uptake of HIV testing. Using qualitative data collection methods, a formative study was conducted to assess the acceptability of a home-based couples counseling and testing (HBCCT) approach. Eligible study participants included married men and women, HIV-infected individuals, health care and home-based care providers, voluntary counseling and testing counselors, and community leaders. A total of 91 individuals participated in focus group discussions (FGDs) and in-depth interviews conducted between September 2009 and January 2010 in rural settings in Northern Tanzania. An HBCCT intervention appears to be broadly acceptable among participants. Benefits of HBCCT were identified in terms of access, confidentiality, and strengthening the relationship. Fears of negative consequences from knowing one's HIV status, including stigma, blame, physical abuse, or divorce, remain a concern and a potential barrier to the successful provision of the intervention. Lessons for implementation highlighted the importance of appointments for home visits, building relationships of confidence and trust between counselors and clients, and assessing and responding to a couple's readiness to undergo HIV testing. HBCCT should addresses HIV stigma, emphasize confidentiality, and improve communication skills for disclosure and decision-making among couples.
Type
Journal article
Subject
Adult
Counseling
Emotional Intelligence
Female
Focus Groups
HIV Infections
HIV Seropositivity
Health Services Needs and Demand
Home Care Services
Humans
Interpersonal Relations
Male
Mass Screening
Middle Aged
Patient Acceptance of Health Care
Rural Health
Social Perception
Social Stigma
Spouses
Tanzania
Permalink
https://hdl.handle.net/10161/6063
Published Version (Please cite this version)
10.1080/09540121.2011.608796
Publication Info
Njau, B; Watt, MH; Ostermann, J; Manongi, R; & Sikkema, KJ (2012). Perceived acceptability of home-based couples voluntary HIV counseling and testing in Northern Tanzania. AIDS Care, 24(4). pp. 413-419. 10.1080/09540121.2011.608796. Retrieved from https://hdl.handle.net/10161/6063.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
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Scholars@Duke

Jan Ostermann

Adjunct Associate Professor of Global Health
Sikkema

Kathleen J. Sikkema

Research Professor in the Department of Psychology and Neuroscience
Kathleen J. Sikkema, Ph.D., Gosnell Family Professor of Global Health, Psychology and Neuroscience, and Psychiatry and Behavioral Sciences at Duke University, is a clinical psychologist with emphases in health and community psychology. She is the Director of Doctoral Studies at the Duke Global Health Institute (DGHI), Director of the Social and Behavioral Science Core in Duke's Center for AIDS Research (CFAR), an
Watt

Melissa Watt

Adjunct Associate Professor of Global Health
Dr. Watt's research focuses on understanding and addressing gender-specific health issues in sub-Saharan Africa, with specific attention to HIV, substance use and mental health. In Tanzania, she currently leads an implementation science study aimed at improving access to long-term antiretroviral therapy for pregnant women with HIV. In South Africa, she is collaborating with Dr. Kathleen Sikkema on a study to support H
Alphabetical list of authors with Scholars@Duke profiles.
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