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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Influence network effectiveness in promoting couples' HIV voluntary counseling and testing in Kigali, Rwanda
AIDS, Volume 26, No. 2, Year 2012
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Description
Objective: To identify predictors of promotion of couples' HIV voluntary counseling and testing (CVCT) in Kigali, Rwanda. Design: Analysis of CVCT promotional agent [influential network leaders (INLs), influential network agents (INAs)], and couple/invitation-level predictors of CVCT uptake. Methods: Number of invitations and couples tested were evaluated by INL, INA, and couple/contextual factors. Multivariable logistic regression accounting for two-level clustering analyzed factors predictive of couples' testing. Results: Twenty-six INLs recruited and mentored 118 INAs who delivered 24 991 invitations. 4513 couples sought CVCT services after invitation. INAs distributed an average of 212 invitations resulting in an average of 38 couples tested/agent. Characteristics predictive of CVCT in multivariate analyses included the invitee and INA being socially acquainted [adjusted odds ratio (aOR)=1.4; 95% confidence interval (CI) 1.2- 1.6]; invitations delivered after public endorsement (aOR=1.3; 95% CI 1.1-1.5); and presence of a mobile testing unit (aOR=1.4; 95% CI 1.0-2.0). In stratified analyses, predictors significant among cohabiting couples included invitation delivery to the couple (aOR=1.2; 95% CI 1.0-1.4) and in the home (aOR=1.3; 95% CI 1.1-1.4), whereas among noncohabiting couples, predictors included invitations given by unemployed INAs (aOR=1.7; 95%CI 1.1-2.7). Cohabiting couples with oldermenweremore likely to test, whereas younger age was associated with testing among men in noncohabiting unions. Conclusions: Invitations distributed by influential people were successful in prompting couples to seek joint HIV testing, particularly if the invitation was given in the home to someone known to the INA and accompanied by a public endorsement of CVCT. Mobile units also increased the number of couples tested. Country-specific strategies to promote CVCT programs are needed to reduce HIV transmission among those at highest risk for HIV in sub-Saharan Africa. © 2012 Lippincott Williams & Wilkins, Inc.
Authors & Co-Authors
Wall, Kristin Marie
United States, Atlanta
Rollins School of Public Health
Karita, Etienne
Rwanda, Kigali
Project San Francisco Psf
United States, Atlanta
Emory University
Nizam, Azhar
United States, Atlanta
Rollins School of Public Health
Bekan, Brigitte
Unknown Affiliation
Sardar, Gurkiran
Unknown Affiliation
Casanova, Deborah
Unknown Affiliation
Joseph-Davey, Dvora Leah
Unknown Affiliation
De Clercq, Freya
Unknown Affiliation
Kestelyn, Evelyne
Unknown Affiliation
Bayingana, Roger A.
Unknown Affiliation
Tichacek, Amanda C.
United States, Atlanta
Emory University
Allen, Susan A.
United States, Atlanta
Emory University
Statistics
Citations: 45
Authors: 12
Affiliations: 3
Identifiers
Doi:
10.1097/QAD.0b013e32834dc593
e-ISSN:
14735571
Research Areas
Infectious Diseases
Study Design
Case-Control Study
Study Locations
Rwanda
Participants Gender
Male