Kampala — WHILE the majority of men prefer to attend HIV counselling and testing alone, the women prefer to be accompained by a friend or relative. Dr. Stephen Watiti, a senior medical officer at Mildmay HIV Centre in Lweza on Entebbe Road, says: "It's the women who normally come. We ask them to bring their partners and children too because HIV/AIDS is a family disease."

Adding: "When they come together, it is likely the man has already been tested."

He says the majority of couples test together when they intend to get married.

Robert Kanwagi, a counsellor from Reproductive Health Uganda, says some couples test together when the woman is pregnant.

"People are aware of Prevention of Mother-to-Child-Transmission programmes and want to save their unborn babies, so they conduct the test." He says people do not want to be labelled HIV-positive due to stigma. Many fear to reveal their status to their partners.

"It's easier to accept your results alone, especially if you test positive. Women fear to be blamed or abandoned while men fear being accountable and unable to provide for the family," he says.

According to the Uganda AIDS Control programme manager, Dr. Zainabu Akol, over 77% of HIV-positive people are married. This means 737,000 couples are living with the HIV/AIDS.

He attributes the high numbers to lack of spousal HIV status disclosure. "One partner will go for a test and begin on treatment, without informing the other sexual partner."

"Ignorance of one's HIV status and their partner's is a key deiver of the epidemic. It is important that people embrace couple-counselling. It breaks the barrier of disclosure and gives one psychological healing because you have someone to talk to and this encourages support," Akol says.

To reduce HIV transmission, couples need to know their joint HIV status and have access to information. This enables them to reduce the risk of infection both within and outside the union.

Dr. Kristin Dunkle of Emory University in Atlanta, US, and colleagues wrote in the journal, Lancet: "This is especially important for women who might not have the cultural freedom to negotiate condom use and sexual activity with their partners."

Increasing discordance and secrecy puts the negative partner at risk.