August 2001

HIV and Partner Violence: Implications for HIV Voluntary Counseling and Testing Programs

Program and Policy Recommendations

Encourage couple communication about HIV/AIDS and HIV testing when promoting VCT. This may make it easier for couples to get tested together and for individual women and men to share test results with sexual partners.

Train HIV counselors to ask questions about partner violence and to encourage disclosure when appropriate. At the time of this study counselors did not ask clients about experiences with partner violence. Counselors have an important role to play in helping clients develop safe disclosure plans, which include finding out about the role violence plays in their lives. Therefore counselors need to be trained in how to ask sensitive questions about violence and to use this information to foster but not force disclosure among clients. Counselors must also be made aware of existing services to help women living in violent relationships so that they can make appropriate referrals when necessary.

Ensure that clients are the ones to make decisions about partner notification of test results. Given the high prevalence of physical violence reported among these female VCT clients, involuntary disclosure of women’s test results through a provider-referral system of notification may have negative consequences for women. Women in violent relationships may face serious outcomes from involuntary disclosure of their serostatus to partners. A provider-referral system may also have a negative backlash on the number of clients who seek VCT services. A better alternative is to have counselors discuss disclosure plans with clients but to let the client decide whether to share results with a partner.

Institute community-based efforts to address sexuality and violence. Women are often at risk for both HIV infection and violence because of the behavior of their sexual partners. Developing an ethic of respect among men and women for the health and wellbeing of their intimate partners needs to be the foundation of both violence prevention and HIV prevention efforts. Implementing programs that focus on changing negative norms about male and female sexuality and on conflict resolution is crucial.

Conduct further research on HIV and violence. The findings from this study highlight the need to:

• Assess client-initiated approaches to facilitating serostatus disclosure, such as the use of a third party (e.g., a counselor, friend, religious person) chosen by the client to mediate disclosure to a partner.
   
• Identify the pathways through which partner violence increases women’s risk of HIV infection.
   
• Examine the relationship between VCT clients’ serostatus, their rate of serostatus disclosure to partners, and the incidence of negative outcomes of serostatus disclosure among women and men at other sites.
   
• Evaluate community-based HIV prevention interventions that address partner violence to change harmful attitudes and norms about sexuality and violence.

	Print this page
@	E-mail this page

This page updated
19 Oct 2007