Intended for healthcare professionals

Research Article

Effect of serotesting with counselling on condom use and seroconversion among HIV discordant couples in Africa.

British Medical Journal 1992; 304 doi: (Published 20 June 1992) Cite this as: British Medical Journal 1992;304:1605
  1. S. Allen,
  2. J. Tice,
  3. P. Van de Perre,
  4. A. Serufilira,
  5. E. Hudes,
  6. F. Nsengumuremyi,
  7. J. Bogaerts,
  8. C. Lindan,
  9. S. Hulley
  1. Department of Pathology, University of California, San Francisco.


    OBJECTIVE--To determine whether HIV testing and counselling increased condom use and decreased heterosexual transmission of HIV in discordant couples. DESIGN--Prospective study. SETTING--Kigali, the capital of Rwanda. SUBJECTS--Cohabiting couples with discordant HIV serology results. MAIN OUTCOME MEASURES--Condom use in the couple and HIV seroconversion in the negative partners. RESULTS--60 HIV discordant couples were identified, of whom 53 were followed for an average of 2.2 years. The proportion of discordant couples using condoms increased from 4% to 57% after one year of follow up. During follow up two of the 23 HIV negative men and six of the 30 HIV negative women seroconverted (seroconversion rates of 4 and 9 per 100 person years). The rate among women was less than half that estimated for similar women in discordant couples whose partners had not been serotested. Condom use was less common among those who seroconverted (100% v 5%, p = 0.01 in men; 67% v 25%, p = 0.14 in women). CONCLUSIONS--Roughly one in seven cohabiting couples in Kigali have discordant HIV serological results. Confidential HIV serotesting with counselling caused a large increase in condom use and was associated with a lower rate of new HIV infections. HIV testing is a promising intervention for preventing the spread of HIV in African cities.