Background: Kenyan women have higher HIV prevalence than men (6.9% vs. 4.4%) with 4.8% of married/cohabitating couples serodiscordant. Partner''s HIV status is unknown to 42.2% of pregnant women. Antenatal care (ANC) attendance is nearly universal (95.4% attend first ANC). In 2012, 95% of Kenyan ANC clients were offered and accepted HIV testing. Despite a policy promoting male partner testing in ANC only 6% of male partners are tested. We evaluated the impact of using oral HIV self-testing on HIV testing among male partners of ANC clients in Kenya.
Methods: In a three-arm randomized controlled study in 14 ANC sites in Eastern and Central Kenya, consenting women at first ANC were randomized to either: Group 1 receiving standard-of-care; Group 2 receiving a card stating the importance of male HIV testing in prevention-of-mother-to-child-transmission; or Group 3 whose participants received the same card plus two OraQuick® HIV oral test kits with instructions for testing with the partner at home. Consenting women completed a baseline questionnaire and endline questionnaire after three months. Consenting male partners were surveyed three months after enrolling ANC clients. The primary outcome was male partner HIV testing, by any means, within three months after ANC client enrollment.
Results: 1410 women were randomized. At the time of analysis, 756 have been followed up and 669 men responded to the survey (623 couples). Baseline characteristics of the men in three study groups did not differ. (p>0.05). Of the 669 men surveyed, In Group 3, 83% of men reported having taken a HIV test, compared to 28% in Group 1 and 36% in Group 2 (p-value< .001) (overall 48%, n=326). Most men testing for HIV indicated testing together with their partner regardless of the study group. --information that was corroborated by the female partners. Of the men using HIV self-test kits, over 90% reported it was very easy to take a swab and read the test results.
Conclusions: Preliminary results indicate that the ANC platform offers a unique opportunity to increase HIV testing among men using oral self test kit. By increasing male partner testing, the potential exists to reduce mother-to-child-transmission and other new infections among adults.

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