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Health practitioner counseling man

Gender-based Violence and HIV Testing and
Counseling in Kenya

Couples HIV testing and counseling (CHTC) is a core intervention for identifying sero-discordant couples for both treatment and prevention interventions and is correlated with positive outcomes for both partners. Currently, CHTC has been introduced in different modalities and settings and is being expanded in many sub-Saharan African countries. However, it also poses risks for specific populations with respect to possible unintended negative outcomes, including gender-based violence (GBV). Similarly, violence and fear of violence are often cited as barriers to HIV testing and disclosing a positive test result. While there are a number of tools and resources regarding integration of GBV in HIV interventions generally, there are few or none specifically designed for the HIV testing and counseling (HTC) context.

This study reviewed and modified available tools to develop an intervention that integrated GBV/intimate partner violence (IPV) issues in the HTC context and enabled providers to become more sensitive to GBV/IPV and raise, screen and discuss this issue with clients, and refer them appropriately. HIVCore piloted the intervention in the antenatal care setting to gather 1) primarily process data, specifically, on providers’ experience, and clients’ reports of the actual counseling experience; and 2) on an exploratory basis gather data on intermediate outcomes including, women’s knowledge about IPV, referral for IPV services for those screening positive for IPV, sense of agency related to decisions around uptake of services and perception that they have received meaningful support and counsel.

Key findings show:

  • The enhanced counseling significantly increased the proportion of women who were screened for IPV as well as the proportion of women who disclosed IPV to their HTC counselor.
  • The intervention increased women’s knowledge about IPV and IPV services, but not attitudes toward domestic violence.
  • The proportion of women who had experienced violence and reported beneficial behavior change or intent—better able to take care of their health/well-being, being supported by others to take care of their health/well-being, intending to regularly take PMTCT medications, and intending to ask their partner to use a condom—was higher in the intervention relative to the control group.

The study responds to discussions in the field regarding how best to address IPV in the HTC/CHTC context.

To learn more about this study, please contact us at info@hivcore.org.

 

Publications

Addressing intimate partner violence and power in relationships in HIV testing services: Results of an intervention piloted in Nairobi, Kenya (PDF)
Report

What's New

Join us for HIVCore's End-of-Project Meeting!
On 28 September, HIVCore will host its end-of-project meeting in Washington, DC at the 20 F St. NW Conference Center (two blocks from Union Station). The event will also be broadcasted via WebEx for those cannot join in person. Please click here, to learn more and/or RSVP (this will take you to the Population Council website).

HIVCore has published new reports!
Learn about the results of a pilot intervention that sought to provide all women, regardless of whether they screened positive for intimate partner violence (IPV), with basic information and resources about IPV and power inequalities in relationships during post-test HIV counseling in Nairobi, Kenya.

Read about findings from a successfully tested patient-centered proof of concept of HIV-TB service integration in South Africa.

As HIVCore is winding down, several reports are coming out. Go to our “Resources” page to learn more.

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