A number of American men who have sex with men are supportive of couples-based voluntary HIV counseling and testing (CVCT), in which couples receive counseling and their HIV test results together, according to a new study by Dr. Rob Stephenson from Rollins School of Public Health in Atlanta, USA, and his colleagues. The authors argue that there may be a demand among gay men for this effective strategy, used in Africa amongst heterosexual couples, albeit with some adaptations to the protocol to make it relevant in the US. The work is published online in Springer's journal, AIDS and Behavior.
Despite increases in options for HIV testing, including the development of oral and rapid HIV testing technologies, and expanded disease management options, the number of people undergoing HIV testing in the US has remained relatively stable. As a result, significant numbers of men who have sex with men are not currently accessing HIV testing services. HIV counseling and testing procedures in the US remain largely individually focused.
The authors examined whether couples voluntary counseling and testing could be a viable and feasible approach for gay men in the US. They carried out four focus group discussions with men in this target group in three cities - Atlanta, Chicago and Seattle - to explore their attitudes towards the possibility of a same-sex version of CVCT.
The focus groups demonstrate clear support for the concept of couples-based HIV counseling and testing among men who have sex with men. CVCT provides an opportunity for gay men to talk about sex, and make plans for safer sexual behavior as a couple, in the presence of a counselor. The discussions suggest that the provision of CVCT might help overcome several known barriers to HIV testing among this group. CVCT is seen as a sign of commitment within a relationship and is thought to be more appropriate for men in longer-term relationships. It is also seen as providing a forum for the discussion of risk-taking within the relationship. Men report they can draw emotional support from their partner when their sero-status is revealed.
The authors conclude: "CVCT is an acceptable format for HIV counseling and testing among men who have sex with men in this study, and if adapted and promoted well, could fill a significant gap in couples-based services for US men. By providing a forum in which couples can learn and share their sero-status, CVCT may help couples to be counseled on developing plans for behavioral change, and provide an opportunity to increase condom use and decrease risk-taking behaviors."
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Stephenson R et al (2011). Attitudes towards couples-based HIV testing among MSM in three US cities. AIDS and Behavior. DOI 10.1007/s10461-011-9893-2