Couples Voluntary Counseling and Testing Research -

Couples Voluntary Counseling and Testing

In sub-Saharan Africa, the majority of new HIV infections are acquired from a spouse or long-term partner. In urban Zambia, an estimated 70 percent of new HIV infections occur in couples who don’t realize that one partner is HIV+ and the other partner is HIV-. Couples Voluntary Counseling and Testing (CVCT), a prevention program pioneered by RZHRG, has been proven to decrease the transmission of HIV/AIDS among co-habiting and long-term partners couples by more than 50 percent.

Since the advent of the HIV/AIDS pandemic, testing has been a key component of prevention and treatment efforts. When people know their HIV status, they’re in a better position to make informed decisions about prevention, sexual behavior and family planning. But that’s only half the picture. It is critical that both partners in a relationship know each other’s HIV status. At RZHRG clinics in Rwanda and Zambia, couples are tested and results are shared with the partners together. Counselors then work with the couples to develop a plan to protect each other, depending on whether the couple is concordant (those who share the same results) or discordant (those having different test results). Counseling and testing together builds respect, confidence and commitment within relationships.

The research team at RZHRG has more than 25 years of experience conducting heterosexual HIV prevention research and prevention programs, and has provided CVCT to more than 100,000 Rwandan and Zambian couples. Since 1986, RZHRG has operated Projet San Francisco (PSF) in Kigali, Rwanda, and since 1994, the Zambia Emory HIV Research Project (ZEHRP), has led CVCT initiatives in Lusaka, Zambia. Early studies performed by RZHRG in Rwanda showed that CVCT results in a remarkable reduction of risk in married couples. Although this research has been published and confirmed for over a decade, existing Voluntary HIV Counseling and Testing (VCT) programs typically place a stronger focus on testing individuals. By failing to test couples together, traditional testing sites miss a critical opportunity for HIV prevention in Africa’s largest risk group – long-term, cohabiting couples.


• After participating in the project’s CVCT intervention, the transmission rate of HIV within couples is reduced to 7%-8% per year, compared with 20%-25% per year in discordant couples who have not been counseled.

• RZHRG maintains one of the largest cohorts of discordant heterosexual couples in the world.

• The prevalence of HIV + adults in east-central Africa exceeds 30 percent, and the epidemic has spread to include groups traditionally considered "low risk."

VIDEO: Couples Voluntary Testing and Counseling

Couples Voluntary Testing and Counseling - Get Tested Together

USAID Information on Couples Counseling