"Confidential HIV Testing and Condom Promotion in Africa"

Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.

"Confidential HIV Testing and Condom Promotion in Africa"

Journal of the American Medical Association (12/16/92) Vol. 268, No. 23, P. 3338
Allen, Susan et al.

Abstract: Rates of condom use increased and rates of gonorrhea and HIV infection in urban Rwandan women decreased after a confidential HIV testing and counseling program was implemented, write Susan Allen et al. of the University of California--San Francisco. A study was conducted in 1988 among women attending an outpatient research clinic in Kigali, the capital of Rwanda. The study involved 1,458 childbearing women, 32 percent of whom were HIV-positive, who were followed at 3- to 6-month intervals for 2 years. The study found that only 7 percent of the women reported ever using condoms before the intervention, but 22 percent reported condom use with good compliance a year later. The study also revealed that women who were infected with HIV were more inclined to adopt condom use than HIV-negative women. Independent predictors of condom use, both in HIV-positive and in HIV-negative women, included HIV testing and counseling of the male partner, having a nonmonogamous relationship, and believing condoms were not dangerous. HIV rates were reduced significantly from 4.1 to 1.8 per 100 person-years in women whose partners were tested and counseled. Also, the rate of gonorrhea decreased significantly (13 to 6 percent) among HIV-positive women, with the greatest decrease among condom users (16 to 4 percent). A total of 35 percent of women who knew that their steady male partners were nonmonogamous had asked these partners to limit their outside contacts in order to avoid AIDS. Interventions that encourage HIV testing and counseling for both members of a couple should be considered in other high-prevalence areas, the researchers conclude.

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