Couples voluntary HIV counseling and testing (CVCT) has been used as an HIV prevention intervention in Africa for over 20 years, and is effective in reducing HIV transmission between sero-discordant couples, increasing contraceptive use, and encouraging future planning behaviors. However, the impact of CVCT has yet to be established outside of heterosexual couples in an African setting. The HIV epidemic among the MSM population has received considerable attention in developed country settings: however, research focusing on MSM in resource-poor settings is severely lacking. There is evidence to suggest that a substantial number of new HIV infections occur among MSM couples in South Africa, the country with the largest visible MSM population in the African continent. Thus, there exists the potential for CVCT services currently proven to be effective among heterosexual population to be adapted for MSM community in South Africa. In order to achieve this, three steps are needed. Firstly, MSM couples have to be willing to utilize a couples-based counseling and testing service. Secondly, measures of couple efficacy and other key theory-based constructs relating to the intervention in MSM are needed to be developed and tested. Finally, a small CVCT trial among MSM couples is needed to test the feasibility of CVCT. The current proposal seeks to achieve the first stage: to collect preliminary qualitative data that will investigate the acceptability of CVCT services among MSM in South Africa. Using a participatory approach, the current activities will examine the barriers and facilitators to CVCT perceived by MSM, the perceived behavioral changes associated with CVCT, and the changes necessary to adapt current CVCT for the MSM population. In addition to adding significantly to our understanding of HIV testing behavior among MSM in a resource-poor setting, the proposed activities will lay the foundation for the next two steps necessary to fully examine the potential for providing CVCT services to MSM. The expected outcome of the proposed activities is a body of qualitative data that will enable us to identify whether MSM in South Africa are open to CVCT services, and the steps necessary to surmount perceived barriers to MSM using CVCT services. The new information generated from the proposed activities will set the foundations for a larger proposal to examine the feasibility of CVCT for MSM couples in South Africa. If CVCT could be successfully adapted for MSM, and if the same magnitude of impact on HIV transmissions could be attained, then there is the potential for future activities to make a significant contribution to stemming the HIV epidemic among MSM and translating this work to other resource-poor settings.
Qualitative data will be collected from participatory research activities with self-identifying MSM in South Africa to examine the acceptability of CVCT services among MSM, and to explore barriers and facilitators to the adoption of couples-based HIV testing among MSM.
| Stephenson, Rob; Rentsch, Christopher; Sullivan, Patrick et al. (2013) Attitudes toward couples-based HIV counseling and testing among MSM in Cape Town, South Africa. AIDS Behav 17 Suppl 1:S43-50 |
| Stephenson, Rob; Rentsch, Christopher; Sullivan, Patrick (2012) High levels of acceptability of couples-based HIV testing among MSM in South Africa. AIDS Care 24:529-35 |
| Stephenson, Rob; de Voux, Alex; Sullivan, Patrick S (2011) Intimate Partner Violence and Sexual Risk-taking among Men Who Have Sex with Men in South Africa. West J Emerg Med 12:343-7 |
