Couple Concordance in Home-Based Voluntary Counseling and Testing for HIV in Malawi

Marissa P. Yeakey, Population Reference Bureau (PRB)
Effie Chipeta, University of Malawi
Carie J. Muntifering, Johns Hopkins Bloomberg School of Public Health

Since HIV epidemic began, there has been considerable effort to expand the delivery of voluntary counseling and testing (VCT) services. To address barriers to testing, home-based VCT for couples may be a promising strategy in HIV prevention. Using Malawi 2004 DHS data on consent-to-test, we employ logistic and multinomial regression analysis methods to identify individual-level variables associated with sex-specific and couple-concordance consent-to-test. The independent variables that are significantly related tend to differ by sex. This suggests a couple-level dynamic influencing the outcome that cannot be assessed by focusing on only one partner. We found that while education is more pronounced on the male partner’s test acceptance, exposure to mass media appears more influential for the female; recent experience with STI symptoms is important for both. Since access to HIV testing in Malawi is likely to expand, increasing uptake of the service will benefit from addressing couple-level behaviors and individual determinants.