The Lancet HIV in conversation with
Aug 26, 2026 · 23 min · 8 segments
HIV remains underdiagnosed among men in many settings, contributing to ongoing transmission. When women seek care during pregnancy, there is an opportunity to reach out to their partners. Home-based…
Janet TuranGuest
Zachary KwenaGuest
Peter HaywardHost
Moving on, some of the additional impacts that HIV disclosure within relationships can carry risks.
And I'm just wondering what steps you took in the trial to protect participants and then how people trying to implement or scale up couples testing and counselling can set about using these approaches responsibly and safely.
One thing that we are very clear from the very beginning is that this sort of intervention will not be appropriate for couples that were already experiencing intimate partner violence.
And as such, when we are recruiting, we excluded the couples that reported intimate partner violence, but supported women from such a relationship during the intervention.
We also ensure that as part of the home visit intervention, there was a lot of content around intimate partner violence and how to prevent intimate partner violence before it occurs.
and based on that we think that pre-empting such before it occurs could help prevent it of overall and just to emphasize that when we scale this up or if it gets scaled up this will need to build in a lot of information about intimate partner violence negotiations to avoid such violence within within couples so that the the intervention is is overly Save
I'll just say that I was I was actually really proud of our team and the way that we very carefully monitored and responded to any Reports that we got of any level of intimate partner violence throughout the study either from the questionnaires or from couples or women reporting to us individually and so they were followed up and monitored and supported.
I think a positive thing that I've seen in healthcare facilities in this part of Kenya over time is that awareness and services for IPV have increased a lot.
Most facilities have hotlines and a special desk or somewhere, you know, procedures for for screening and helping women with IPV.
So I think when scaling this up, it's going to be really important to link with those services.
And I mean, in general, we don't feel like this type of intervention necessarily increases violence.
I don't I think there's evidence to the contrary, but In any situation, it's important to have those supports and referrals and follow-up in
These sorts of contacts are potentially a way of signposting people to support and interventions to address these sorts of issues.
I mean, when we talked to couples after the home-based visit intervention, after we first developed and piloted it, the thing they remembered almost the most from the sessions was the content on IPV.
They didn't, you know, even realize maybe what it was and how dangerous it was and how it can harm the family.
Moving on, some of the additional impacts that HIV disclosure within relationships can carry risks.
And I'm just wondering what steps you took in the trial to protect participants and then how people trying to implement or scale up couples testing and counselling can set about using these approaches responsibly and safely.
One thing that we are very clear from the very beginning is that this sort of intervention will not be appropriate for couples that were already experiencing intimate partner violence.
And as such, when we are recruiting, we excluded the couples that reported intimate partner violence, but supported women from such a relationship during the intervention.
We also ensure that as part of the home visit intervention, there was a lot of content around intimate partner violence and how to prevent intimate partner violence before it occurs.
and based on that we think that pre-empting such before it occurs could help prevent it of overall and just to emphasize that when we scale this up or if it gets scaled up this will need to build in a lot of information about intimate partner violence negotiations to avoid such violence within within couples so that the the intervention is is overly Save
I'll just say that I was I was actually really proud of our team and the way that we very carefully monitored and responded to any Reports that we got of any level of intimate partner violence throughout the study either from the questionnaires or from couples or women reporting to us individually and so they were followed up and monitored and supported.
I think a positive thing that I've seen in healthcare facilities in this part of Kenya over time is that awareness and services for IPV have increased a lot.
Most facilities have hotlines and a special desk or somewhere, you know, procedures for for screening and helping women with IPV.
So I think when scaling this up, it's going to be really important to link with those services.
And I mean, in general, we don't feel like this type of intervention necessarily increases violence.
I don't I think there's evidence to the contrary, but In any situation, it's important to have those supports and referrals and follow-up in
These sorts of contacts are potentially a way of signposting people to support and interventions to address these sorts of issues.
I mean, when we talked to couples after the home-based visit intervention, after we first developed and piloted it, the thing they remembered almost the most from the sessions was the content on IPV.
They didn't, you know, even realize maybe what it was and how dangerous it was and how it can harm the family.
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