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The goal of this study is to develop a preliminary understanding of the social and cultural context in which HIV serodiscordant couples in Kenya are making the decision to become pregnant. The specific aims of this study are:

• To explore the motivations for conception, understanding the risk of HIV transmission, and the decisionmaking process of serodiscordant couples desiring pregnancy.
• To assess the acceptability of:
• Limiting unprotected intercourse to the fertile window in a woman’s cycle to reduce the number of episodes of unprotected sex per month.
• Providing the HIV- partner with antiretroviral medication to take prior to unprotected intercourse to reduce the risk of HIV transmission.
• Starting antiretroviral medication in the HIV+ partner, regardless of immune status and clinical staging to reduce genital tract viral shedding and possibly HIV transmission.
• Sperm washing to isolate spermatozoa from semen of HIV+ men, followed by intrauterine insemination using the prepared sperm in order to achieve pregnancy while preventing HIV transmission.

The study tool will consist of a structured questionnaire, followed by an in-depth interview. Fifteen discordant couples of reproductive age who express a general desire to have children in the future will be recruited from an existing AIDS care program in Kisumu, Kenya. Findings from this study will be used to design an investigation to determine the uptake and acceptability of these potential HIV prevention strategies.

This project conducted in-depth qualitative interviews with couples (n=20) key informants (n=12), and focus groups (n=4) regarding the feasibility and acceptability of a comprehensive couples-based intervention. Key issues were explored to determine potential interest for intervention content. The research is based at the Chris Hani Baragwanath Hospital and the Perinatal HIV Research Unit at the University of the Witwatersrand in Johannesburg, South Africa. The primary aims of the project were to:

• Determine the ideal components of an integrated package delivering comprehensive HIV and reproductive health services to heterosexual couples in Soweto, South Africa.
• Explore the feasibility and acceptability of such a program via in-depth interviews with potential target audience members and key informants.

This project has two primary aims: 1. Identify barriers and facilitators for heterosexual couples pertaining to utilizing couples-based voluntary counseling and testing (CBVCT) in Soweto, South Africa 2. Identify relationship-based predictors of HIV risk behavior in couples (e.g., communication, intimacy, commitment, etc.). The study is comprised of two phases. The first phase was qualitative in nature, and focused on obtaining information from men and women regarding their relationships and their perceptions and attitudes about couples-based testing for HIV. Both individual interviews and focus groups were conducted (N=48, 16 couples in individual interviews and eight couples in focus groups). Data collection was completed for this phase in February of 2006. The second phase was a cross-sectional quantitative study of predictors of HIV risk behavior and of utilizing couples-based testing among a sample of 220 couples. The survey included questions about relationship dynamics, such as trust and communication, as well as social norms regarding HIV testing. This project finished data collection in December of 2008. The research is based at the Chris Hani Baragwanath Hospital and the Perinatal HIV Research Unit at the University of the Witwatersrand in Johannesburg, South Africa.

This project has two primary aims:

1. Identify barriers and facilitators for heterosexual couples pertaining to utilizing couples-based voluntary counseling and testing (CBVCT) in Soweto, South Africa
2. Identify relationship-based predictors of HIV risk behavior in couples (e.g., communication, intimacy, commitment, etc.).

The study is comprised of two phases. The first phase was qualitative in nature, and focused on obtaining information from men and women regarding their relationships and their perceptions and attitudes about couples-based testing for HIV. Both individual interviews and focus groups were conducted (N=48, 16 couples in individual interviews and eight couples in focus groups). Data collection was completed for this phase in February of 2006. The second phase was a cross-sectional quantitative study of predictors of HIV risk behavior and of utilizing couples-based testing among a sample of 220 couples. The survey included questions about relationship dynamics, such as trust and communication, as well as social norms regarding HIV testing. This project finished data collection in December of 2008. The research is based at the Chris Hani Baragwanath Hospital and the Perinatal HIV Research Unit at the University of the Witwatersrand in Johannesburg, South Africa.

This study tests the efficacy of an intervention utilizing HIV rapid testing and integration of HIV Voluntary Counseling and Testing (VCT) into Tuberculosis (TB) evaluation and home-based VCT for family members, to overcome identified logistical and psychological barriers to HIV VCT among new TB patients and their family members. The specific aims of the study are:

1. To determine the uptake of and barriers to HIV VCT among a cross-sectional sample of 2,000 TB evaluation patients offered same-day results HIV counseling and testing at the Uganda National TB and Leprosy Programme outpatient TB clinic at Old Mulago Hospital in Kampala, Uganda
2. To conduct a randomized trial of HIV VCT among 600 households comparing VCT uptake between home-based VCT and TB clinic-based VCT for family and household members of TB evaluation patients
3. To investigate the effectiveness of home-based and TB clinic-based VCT in linking HIV+ persons to HIV medical care and social support

Through this study’s dissemination plan and the proposed policy and community forums, information on a successful model could be made rapidly available to key stakeholders responsible for setting national policy and local HIV/AIDS control programs.