COUPLES-BASED VOLUNTARY HIV COUNSELING AND TESTING FOR MSM IN SOUTH AFRICA Público
Rentsch, Christopher (2011)
Published
Abstract
Couples-based voluntary HIV counseling and testing (CVCT)
allows
couples to receive their HIV test results together and has been
demonstrated to
be effective in reducing HIV transmission, increasing and
sustaining condom
use, and reducing sexual risk-taking among at-risk heterosexual
couples.
However, the acceptability of CVCT among MSM has yet to be
evaluated in an
African setting. This thesis utilizes a mixed-methods approach to
determine if
CVCT would be a viable option for an HIV testing service among MSM
in South
Africa, and how the service would need to be structured in order to
attract the
most MSM in this setting. Using online advertisements, quantitative
data were
collected from 486 MSM, who were 18 years of age or older with a
current
residence in South Africa and had at least one male sex partner in
the previous 12
months. The analysis examined associations between individual
characteristics
and willingness to utilize CVCT services. Concurrently, seven focus
group
discussions and twenty-nine in-depth interviews were used to
investigate the
attitudes toward CVCT among MSM in Cape Town, South Africa.
The
willingness to utilize CVCT services was compellingly high (89%).
The results
from the focus groups and interviews further exhibit nearly
universal acceptance
of CVCT. Participants were particularly attracted to the counseling
components
of the service, stating that these would allow for the couple to
increase their
commitment and to explore methods of how to effectively reduce
their risk of
acquiring or transmitting HIV in the presence of a trained
counselor. Several
studies show the discontent MSM currently have with public and
government
clinics offering HIV testing services, which may be a large factor
of the low
awareness of sero-status among MSM in South Africa. Having the
knowledge of
a partner's sero-status is possibly one of the most effective
strategies to reduce
the risk of HIV infection due to the elimination of risk that comes
from assuming
or guessing a partner's sero-status. These results suggest CVCT
would be highly
welcomed and could work to fill the significant lack of services
acceptable by
and accessible to MSM in South Africa.
Table of Contents
TABLE OF CONTENTS
PREAMBLE 1
CHAPTER 1: INTRODUCTION 3
PROJECT BACKGROUND 4
AIMS AND OBJECTIVES 6
COUNTRY CONTEXT: SOUTH AFRICA 6
RESEARCH SETTING 12
SUMMARY 13
CHAPTER 2: REVIEW OF THE LITERATURE 15
EPIDEMIOLOGY OF HIV AMONG MSM 16
HIGH-RISK SEXUAL BEHAVIORS AND HIV STATUS AMONG MSM 21
AWARENESS OF HIV STATUS 25
POTENTIAL FOR CVCT 29
CHAPTER 3: QUANTITATIVE MANUSCRIPT 33
ABSTRACT 35
INTRODUCTION 36
METHODS 38
RESULTS 40
DISCUSSION 41
CONCLUSIONS 42
CHAPTER 4: QUALITATIVE MANUSCRIPT 46
ABSTRACT 48
INTRODUCTION 49
METHODS 52
RESULTS 54
DISCUSSION 68
CONCLUSIONS 73
CHAPTER 5: IMPLICATIONS AND FUTURE DIRECTIONS
77
APPENDICES 85
APPENDIX 1: EMORY UNIVERSITY IRB DOCUMENTATION 86
APPENDIX 2: WITS UNIVERSITY ETHICS COMMITTEE CLEARANCE 88
APPENDIX 3: FOCUS GROUP AND INTERVIEW GUIDE 89
REFERENCES 91
About this Master's Thesis
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