HIV prevention in Africa and couple sero-discordancy : is couple-centred HIV counselling and testing a relevant approach ?

Annabel Desgrees-du-Lou, Institut de Recherche pour le Développement (IRD)
Joanna Orne-Gliemann, Université Victor Segalen Bordeaux 2

In Africa, a large proportion of HIV infections occur within stable relationships, either because of prior infection of one of the partners or because of infidelity. Hence, there is an urgent need to define strategies to improve HIV prevention in a conjugal context. This communication will first describe the stakes of HIV prevention within serodiscordant heterosexual couples in sub-Saharan Africa, and will then discuss the possible tracks to stimulate and strengthen HIV prevention efforts within the couple. In particular, we will review all couple-centred initiatives for HIV counselling and testing that have been evaluated in the scientific literature since the early nineties. We will show that despite positive results, such couple-oriented programs have not been implemented at a large scale. We will compare the outputs of couple voluntary counselling and testing (VCT) to individual VCT and will discuss strengths and weaknesses of such couple-centred counselling and testing approaches.