Journal of Antivirals & Antiretrovirals
Open Access

Abstract

The Awareness Framework: A Novel Approach for Understanding HIV Testing and Disclosure in HIV-discordant Dyads

Nora E Rosenberg, Audrey E Pettifor and William C Miller

HIV testing and counseling (HTC) is rapidly being brought to scale in sub-Saharan Africa [1]. Scale-up has been driven primarily by the goal of linking HIV-infected persons to treatment. But what impact will HTC scale-up have on HIV prevention, especially as new biomedical HIV prevention interventions are introduced? Consistent with the Couples HIV Testing and Counseling Guidelines recently released by the World Health Organization, we assert that the prevention impact of HTC will hinge on whether both members of HIVdiscordant dyads receive HTC and whether they share their HIV status with each other. However, a better understanding of the prevention impact of other awareness possibilities is needed. We introduce a novel framework for considering a person’s awareness of his/her own HIV status (through HTC) and his/her partner’s HIV status (through HIV disclosure) within HIV-discordant dyads. This framework is useful for understanding HTC trends, examining behavioral and biomedical risk in partnerships, and ultimately optimizing the impact of HIV prevention.