Couples' counseling in Africa could cut HIV spread
CHICAGO (Reuters) - Counseling heterosexual couples in Zambia and Rwanda about HIV could avert up to 60 percent of infections, U.S. researchers said on Thursday.
Most transmission of the human immunodeficiency virus that causes AIDS in these countries is heterosexual, and the researchers said it is mainly among married couples or people who live together.
"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," Dr. Kristin Dunkle of Emory University in Atlanta and colleagues wrote in the journal Lancet.
"This is especially important for women, who might not have the cultural freedom to negotiate condom use and sexual activity within a union," they added.
Using a mathematical model based on existing data from voluntary HIV counseling and testing in urban Zambia and Rwanda, Dunkle and colleagues showed that 55 to 93 percent of new HIV infections among heterosexuals occur within couples who are married or living together.
When they figured in the higher rates of condom use among heterosexual partners not living together, the estimate of new infections among married couples and those living together rose to 60 to 94 percent.
Next, they figured out how this transmission rate might change if the couples got HIV counseling, using the results from a program in Zambia that reduced transmission among couples living together from 20 percent to 7 percent.
If applied more broadly, they believe a similar program could cut transmission rates by 36 to 60 percent.
The researchers said most HIV prevention efforts in Africa are focused on abstinence and nonmarital sex, but their findings suggest investing in programs that focus on couples who are married or living together might have a significant impact.
Sixty-eight percent of all people infected with HIV live in sub-Saharan Africa, where 76 percent of all AIDS-related deaths occurred in 2007. AIDS infects 33 million people globally and has killed 25 million since the epidemic began in the 1980s.
(Editing by Maggie Fox and Eric Walsh)
