Is two better than one? HIV screening for gay couples

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Perhaps it’s the needle, or the white coat, or the fact that you suddenly have little choice but to grapple with your sex life, but getting screened for HIV can be terrifying – even when you think you’ve been playing it safe.

Amidst the dread it is all too easily overlooked that ultimately, regardless of how intimidating finding out your status may be, taking the appropriate steps to ensure responsible sex is above all a gesture of the deepest respect, support and love for your partner.

Recognising this important “romantic” dimension to HIV screening, a new initiative in Cape Town is introducing Couples Voluntary HIV Counselling & Testing(CVCT) for gay and bisexual men.

“For too long HIV services in South Africa have failed to recognize that gay men form significant long-term relationships and that these relationships are a vital part of their lives,” says study leader Dr. Rob Stephenson from Emory University in Atlanta, USA.

The CVCT programme’s emphasis on healthy relationships has already garnered positive responses elsewhere in Africa where it was targeted at straight couples. Twenty years of research vouch for the model’s positive impact on communication between partners and increased safer-sex behaviours, including more consistent condom usage.

Now for the first time, this “straight” CVCT model is being explored as an option for same-sex couples in Southern Africa.

“CVCT provides an opportunity for you and your partner to find out your HIV status together, in a safe, neutral environment with a counsellor present who can talk through your results, your feelings, and help you make plans for the future,” says Dr. Stephenson. 

Making the screening an experience that ultimately reflects positively on the relationship is essential to the process. “It is important that people understand that CVCT is focused on the future: A couple will not be asked about past behaviours. The model clearly helps both partners to focus on working together as a couple to keep each other safe. It also accommodates the possibility of either one or both partners screening HIV positive,” Dr. Stephenson adds. 

Here’s how it works: Once a couple have decided to go to a clinic offering CVCT, they enter a pre-counselling session together, during which they are asked about their relationship and how they deal with HIV-related issues.

They then get screened for HIV together. While they wait for the results, the couple work with a trained counsellor, exploring the possible outcomes. Regardless of the outcomes, they also discuss how they could encourage safer-sex behaviours within their relationship.

Finally, they are given their results together and revisit what they agreed on earlier in. The focus throughout the process remains on maintaining the integrity and functionality of the relationship.

It sounds simple enough, but will this work in Cape Town?

To find out, the researchers have teamed up with Health4Men, an initiative of the Anova Health Institute which caters to the sexual health needs of men who have sex with men. For the past year, the researchers have been inviting local gay men to participate in interviews and focus groups that explored how CVCT might work in their city. Footage from these sessions is being edited into videos which will be used to get more feedback.

“Making this model applicable to gay couples in a South African context is an exciting development as it offers these couples a tailor-made option to undergo an HIV screening together,” says Glenn de Swardt, Director of Health4Men in Cape Town.

“Just being able to acknowledge their relationship in this manner is functional for many gay couples. Importantly, CVCT caters for both open and closed relationships,” says de Swardt.

Certainly timing for this initiative couldn’t be better, as men who have sex with men are chronically under-researched in South Africa, despite their heightened risk for contracting HIV.

To find out more about the research or CVCT please contact Glenn de Swart at Health4Men in Cape Town, at glenn@health4men.co.za