Knowledge of HIV serodiscordance, transmission, and prevention among couples in Durban, South Africa

PLoS One. 2015 Apr 20;10(4):e0124548. doi: 10.1371/journal.pone.0124548. eCollection 2015.


Objective: Couples' voluntary HIV counseling and testing (CVCT) significantly decreases HIV transmission within couples, the largest risk group in sub-Saharan Africa, but it is not currently offered in most HIV testing facilities. To roll out such an intervention, understanding locale-specific knowledge barriers is critical. In this study, we measured knowledge of HIV serodiscordance, transmission, and prevention before and after receipt of CVCT services in Durban.

Design: Pre- and post-CVCT knowledge surveys were administered to a selection of individuals seeking CVCT services.

Methods: Changes in knowledge scores were assessed with McNemar Chi-square tests for balanced data and generalized estimating equation methods for unbalanced data.

Results: The survey included 317 heterosexual black couples (634 individuals) who were primarily Zulu (87%), unemployed (47%), and had at least a secondary level education (78%). 28% of couples proved to be discordant. Only 30% of individuals thought serodiscordance between couples was possible pre-CVCT compared to 95% post-CVCT. One-third thought there was at least one benefit of CVCT pre-CVCT, increasing to 96% post-CVCT. Overall, there were positive changes in knowledge about HIV transmission and prevention. However, many respondents thought all HIV positive mothers give birth to babies with AIDS (64% pre-CVCT, 59% post-CVCT) and that male circumcision does not protect negative men against HIV (70% pre-CVCT, 67% post-CVCT).

Conclusions: CVCT was well received and was followed by improvements in understanding of discordance, the benefits of joint testing, and HIV transmission. Country-level health messaging would benefit from targeting gaps in knowledge about serodiscordance, vertical transmission, and male circumcision.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS Serodiagnosis
  • Adult
  • Counseling
  • Family Characteristics*
  • Female
  • HIV Infections / diagnosis
  • HIV Infections / prevention & control*
  • HIV Infections / transmission*
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • South Africa
  • Surveys and Questionnaires

Associated data

  • figshare/10.6084/M9.FIGSHARE.13​52039