Evidence of marked sexual behavior change associated with low HIV-1 seroconversion in 149 married couples with discordant HIV-1 serostatus: experience at an HIV counselling center in Zaire.

To determine the effect of an HIV-1 counselling program on 149 married Zairian couples with discordant HIV-1 serology the rates of HIV-1 seroconversion and reported condom utilization have been observed during 382.4 person-years of followup (minimum followup time/couple of 6 months). Before determination of HIV-1 serostatus and counselling less than 5% of these couples had ever used a condom. 1 month following notification of HIV-1 serostatus and counselling 70.7% of couples reported using condoms during all episodes of sexual intercourse. At 18 months followup 77.4% of the 140 couples still being followed reported continued use of condoms during all episodes of sexual intercourse. At the time of notification of HIV-1 serostatus 18 couples experienced acute psychological distress. Home-based counselling by trained nurses resolved these difficulties in all but 3 couples who subsequently divorced. Intensive counselling following notification of HIV-1 serostatus led to low rates of HIV-1 seroconversion (3.1%/100 person- years of observation) in Zairian married couples with discordant HIV-1 serostatus who voluntarily attended an HIV counselling center. (authors)