TB clinics boost HIV testing for couples

The Kenyan government is using national tuberculosis screening programmes to persuade married couples - at high risk of HIV, according to research - to get tested for the virus.



About half of all Kenyan TB patients are co-infected with HIV, so HIV testing has become routine in TB clinics, with 83 percent of TB patients also screened for HIV.



"We have encouraged health facilities to not only test TB patients for HIV but also to reach out to their partners to bring them along for counselling and testing for HIV together," Joseph Sitienei, the head of leprosy, TB and lung disease at the Ministry of Health, told IRIN/PlusNews. "The uptake of TB screening across the country has been impressive; it provides the best avenue to encourage partners to test together for HIV."



According to the latest Kenya AIDS Indicator Survey, 10 percent of married couples have at least one HIV-infected person, but just 22 percent of couples know the HIV status of their sexual partners. An estimated 44 percent of new HIV infections in Kenya occur among married or cohabiting couples; HIV discordance is also a problem, with 6 percent of couples - or 344,000 - having at least one HIV-positive partner.



In many African countries where multiple concurrent partnerships are blamed for high HIV incidence, couples counselling is now being recommended. Experts suggest reaching couples through partner testing in home- and facility-based treatment and care programmes, the integration of partner testing into provider-initiated testing and counselling and prevention of mother-to-child transmission programmes, as well as door-to-door testing and bio-medical interventions such as medical male circumcision.



"[Couples counselling and testing] does not only help them know their status but it provides an opportunity to identify discordant couples and then helping them to know better how to manage themselves," said Andrew Suleh, medical superintendent of Mbagathi District Hospital, one of the model sites for TB diagnosis/screening and couples counselling and testing in the capital, Nairobi. "Safe sex and reducing risky sexual behaviour is heavily emphasized... those who test positive are made to appreciate the need for positive living."

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Currently, there are 1,200 TB diagnostic sites in the country, 80 percent of which also offer counselling and testing for HIV; Kenya has an estimated 110,000 new TB infections every year.



"[Couples counselling and testing] also provides an opportunity to screen partners for TB together because TB is very infectious - it wouldn't be rare to find a situation where both partners are infected," Sitienei said.



He noted that couples testing was also helping to debunk myths about HIV and TB co-infection within the population, and to de-stigmatise the two conditions.



"Because of the correlation between TB and HIV infection, many people believe that a TB infection is a sure sign of HIV infection," he said. "Efforts are being put in place to debunk this kind of myth; one can have TB and not be infected with HIV just like one can be HIV infected and not be infected with TB."



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