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Uptake of Home-Based Syphilis and Human Immunodeficiency Virus Testing Among Male Partners of Pregnant Women in Western Kenya

Mark, Jennifer MPH*; Kinuthia, John MBChB, MMed, MPH†‡§; Roxby, Alison C. MD, MSc¶∥; Krakowiak, Daisy MPH, PhD*; Osoti, Alfred MBChB, MMed, MPH*‡§; Richardson, Barbra A. PhD**; Gone, Molly Ann BSc§; Asila, Victor BSc§; Parikh, Saloni BS††; Farquhar, Carey MD, MPH*¶∥

doi: 10.1097/OLQ.0000000000000649
Original Studies

Background: Few men are tested for syphilis or human immunodeficiency virus (HIV) during their partner’s pregnancy, a high-risk period for HIV and syphilis transmission. Offering home-based rapid testing of syphilis to couples during pregnancy can support prevention efforts to reduce transmission of sexually transmitted diseases and adverse pregnancy outcomes.

Methods: We assessed men’s uptake of paired (separate tests, single blood draw) point-of-care syphilis and HIV tests within a randomized controlled trial of pregnant women who received clinic or home partner HIV testing. We evaluated acceptance of paired HIV-syphilis testing during pregnancy or at 6 months postpartum, and evaluated whether addition of syphilis testing affected the uptake of HIV testing among men.

Results: Of 601 women, we were unable to meet 101 male partners, and 180 tested before syphilis tests were available. Paired syphilis and HIV testing was offered at home to 80 men during pregnancy and to 230 men postpartum. For syphilis, 93% of men agreed to test during pregnancy and 98% agreed postpartum. For paired syphilis and HIV testing, 91% of men tested for both during pregnancy and 96% tested postpartum. Before syphilis test introduction, 96% of men accepted HIV testing, compared with 95% of men who accepted HIV testing when paired testing was offered.

Conclusions: Uptake of syphilis and HIV testing was high among male partners offered couple testing at home. Introducing syphilis testing did not adversely affect HIV testing among men. Point-of-care diagnostics outside facilities can increase testing of male partners who rarely accompany women to antenatal clinics.

A study in Nyanza Province, Kenya, found that point-of-care syphilis testing is as acceptable to male partners of pregnant women as human immunodeficiency virus testing and does not adversely affect human immunodeficiency virus testing.

From the *Department of Epidemiology, University of Washington, Seattle, WA; †Departments of Research and Programs, ‡Department of Reproductive Health, Kenyatta National Hospital, Nairobi, Kenya; §Department of Obstetrics and Gynaecology, University of Nairobi; Nairobi, Kenya; ¶Departments of Medicine, ∥Global Health, **Biostatistics, and ††Computer Science and Engineering, University of Washington, Seattle, WA

Acknowledgements: The authors thank the participants and Kisumu County Hospital for their support; without it this research would not be possible. The authors also would like to thank their partners at the Kenya National AIDS and STI Control Program.

Presentations: Presented in part at the 8th International AIDS Society, 2015, Vancouver, Canada, Abstract TUPPD0105.

Conflicts of Interest: None declared.

Sources of grant funding: This study was funded by National Institutes of Health [R01 HD 075108], NIH Fogarty International Center Northern Pacific Global Health Fellows Program [research training grant R25-TW009345], Boren International Fellowships, and International and Foreign Language Education [P015B100200].

Correspondence: Jennifer Mark, MPH, Department of Epidemiology, 1959 NE Pacific Street, Seattle, WA 98195. E-mail: jmark55@uw.edu.

Received for publication February 20, 2017, and accepted April 17, 2017.

© Copyright 2017 American Sexually Transmitted Diseases Association