Uptake and factors associated with couple HIV Counselling and testing among married/consensually related partners in fishing communities of Lake Victoria, Uganda.

Abstract

Introduction: Residents in the fishing communities in Uganda are at higher risk of HIV infection and in urgent need of prevention interventions. Couples HIV counselling and testing (CHCT) is one of such interventions. We determined the uptake of and factors associated with couples’ HCT among residents in two fishing communities of Lake Victoria in Uganda. Methods: This was a cross-sectional, mixed-methods study that included secondary analysis of quantitative data and primary qualitative data collection among consenting married and /or cohabiting individuals aged 18-49 years. Socio-demographic and behavioural data were extracted from a larger study that assessed the uptake of integrated couples’ HCT, modern contraceptives and willingness to use HIV self-testing among fishing communities of Lake Victoria, Uganda. Multivariate logistic regression was used to estimate factors associated with couples’ HCT uptake using STATA® 14 software. Qualitative data were collected from 8 in-depth interviews that were audio recorded with permission from the participants. Data were analysed manually following a thematic framework approach. Results: Uptake of Couples’ HIV Counselling and testing was 39% (321/822). Persons in polygamous relationships (aOR=1.77, 95% CI: 1.05-2.10) were significantly more likely to test as a couple /with all partners. Individuals who were not aware of the HIV status of their sexual partners were significantly less likely to test for HIV together with their sexual partners (aOR=0.06, 95% CI: 0.35-0.10). Potential benefits identified included; support for HIV care, preparation for marriage and limit of mistrust and perceived barrier to couples testing together were fear of disclosure that could lead to violence, fishing schedules, stigma, and worries about HIV positive results. Conclusion: Nearly one-third of married individuals in the two fishing communities had ever tested for HIV as a couple. Being in a polygamous relationship was significantly associated with couples’ HCT uptake while not being aware of partner’s HIV status reduced the likelihood of testing together as a couple. Continuous education of couples about the benefits of CHCT and integrated community health care outreach to promote couples’ HCT in these fishing communities should be encouraged among Fishing Communities. There is need to design intervention basing on barriers mentions in this study for instance encouraging moonlight interventions.