Lifting The Lid On Hiv And Aids

Couples counselling—go together, know together

I love that line—Go together, know together. A Ugandan campaign to encourage couples to get tested together; my favourite campaign poster reads ‘HIV couple testing brought us closer together.’

Couples HIV counselling and testing (CHCT) aims to empower couples, both married and cohabiting, to know their status and adopt practices to improve their health. Counsellors can encourage couples to plan for their future and discuss options that reduce risks that they can implement together.

Any couple can seek CHCT: those dating, engaged, married, those not yet intimate (even better!), homosexual, cohabiting and those planning on having children. Couple testing is important as people in stable relationships may not know their partner’s status or one partner may be positive and not aware of their status.

Couples counselling and testing has many benefits; it can help support positive and negative partners in discordant relationships (where one partner is negative and the other positive).  Partners can support each other adhere to treatment and make plans about having children safely or having sexual relations which reduce transmission to their partner.

Research has shown that couples who learn their status together are more likely to adopt appropriate behaviours than people who do not know their status.

They are instances when individual testing, particularly for women who may experience violence, is preferred. People should be given a choice whether they would like to be tested individually or as a couple.

Earlier this year, the World Health Organisation released new guidelines on CHCT. One of the recommendations is that antiretroviral therapy be offered to HIV-positive individuals in discordant relationships even when they do not require it for their own health. This is aimed at preventing transmission to the negative partner.

The Centre for Disease Control, USA, has developed training manuals for CHCT. Some of the goals of the training is to equip counsellors with the skills to mitigate tension and diffuse blame, create a safe environment for disclosure, discuss options for disclosure to couple’s children and, if appropriate, next steps for testing children.

Couples testing provides the opportunity to reduce tension and blame. The counsellors help couples talk about their reactions, their feelings. Couples are given a chance to focus on the solutions and not the problem, to not dwell on the past but concentrate on the present and future.

‘Go together, know together.’

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