Contact Us

Instructions

Frequently Asked Questions

ETD Help

Policies and Procedures

Copyright and Patents

Access Restrictions

Search ETDs:
Advanced Search
Browse by:
Browse ProQuest
Search ProQuest

Laney Graduate School

Rollins School of Public Health

Candler School of Theology

Emory College

Emory Libraries

New ETD website is now LIVE and located here: etd.library.emory.edu

COUPLES-BASED VOLUNTARY HIV COUNSELING AND TESTING FOR MSM IN SOUTH AFRICA

Rentsch, Christopher (2011)
Master's Thesis (114 pages)
Committee Chair / Thesis Advisers: Stephenson, Robert; Sullivan, Patrick S
Committee Members:
Research Fields: Health Sciences, Public Health; Health Sciences, Epidemiology; Health Sciences, General
Partnering Agencies: International Non-governmental organization (e.g., CARE, Inc.)
Keywords: CVCT; MSM; HIV testing; Couples
Program: Rollins School of Public Health, Epidemiology (Global Epidemiology)
Permanent url: http://pid.emory.edu/ark:/25593/92hch

Abstract

Couples-based voluntary HIV counseling and testing (CVCT) allows couples to receive their HIV test results together and has been demonstrated to be effective in reducing HIV transmission, increasing and sustaining condom use, and reducing sexual risk-taking among at-risk heterosexual couples. However, the acceptability of CVCT among MSM has yet to be evaluated in an African setting. This thesis utilizes a mixed-methods approach to determine if CVCT would be a viable option for an HIV testing service among MSM in South Africa, and how the service would need to be structured in order to attract the most MSM in this setting. Using online advertisements, quantitative data were collected from 486 MSM, who were 18 years of age or older with a current residence in South Africa and had at least one male sex partner in the previous 12 months. The analysis examined associations between individual characteristics and willingness to utilize CVCT services. Concurrently, seven focus group discussions and twenty-nine in-depth interviews were used to investigate the attitudes toward CVCT among MSM in Cape Town, South Africa. The willingness to utilize CVCT services was compellingly high (89%). The results from the focus groups and interviews further exhibit nearly universal acceptance of CVCT. Participants were particularly attracted to the counseling components of the service, stating that these would allow for the couple to increase their commitment and to explore methods of how to effectively reduce their risk of acquiring or transmitting HIV in the presence of a trained counselor. Several studies show the discontent MSM currently have with public and government clinics offering HIV testing services, which may be a large factor of the low awareness of sero-status among MSM in South Africa. Having the knowledge of a partner's sero-status is possibly one of the most effective strategies to reduce the risk of HIV infection due to the elimination of risk that comes from assuming or guessing a partner's sero-status. These results suggest CVCT would be highly welcomed and could work to fill the significant lack of services acceptable by and accessible to MSM in South Africa.

Table of Contents

TABLE OF CONTENTS -- PREAMBLE 1 -- CHAPTER 1: INTRODUCTION 3 -- PROJECT BACKGROUND 4 -- AIMS AND OBJECTIVES 6 -- COUNTRY CONTEXT: SOUTH AFRICA 6 -- RESEARCH SETTING 12 -- SUMMARY 13 -- CHAPTER 2: REVIEW OF THE LITERATURE 15 -- EPIDEMIOLOGY OF HIV AMONG MSM 16 -- HIGH-RISK SEXUAL BEHAVIORS AND HIV STATUS AMONG MSM 21 -- AWARENESS OF HIV STATUS 25 -- POTENTIAL FOR CVCT 29 -- CHAPTER 3: QUANTITATIVE MANUSCRIPT 33 -- ABSTRACT 35 -- INTRODUCTION 36 -- METHODS 38 -- RESULTS 40 -- DISCUSSION 41 -- CONCLUSIONS 42 -- CHAPTER 4: QUALITATIVE MANUSCRIPT 46 -- ABSTRACT 48 -- INTRODUCTION 49 -- METHODS 52 -- RESULTS 54 -- DISCUSSION 68 -- CONCLUSIONS 73 -- CHAPTER 5: IMPLICATIONS AND FUTURE DIRECTIONS 77 -- APPENDICES 85 -- APPENDIX 1: EMORY UNIVERSITY IRB DOCUMENTATION 86 -- APPENDIX 2: WITS UNIVERSITY ETHICS COMMITTEE CLEARANCE 88 -- APPENDIX 3: FOCUS GROUP AND INTERVIEW GUIDE 89 -- REFERENCES 91

Files

application/pdf Dissertation/Thesis 114 pages (2.1 MB) [Access copy of Dissertation/Thesis]
Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.