BMC Public Health 2007, 7:349 http://www.biomedcentral.com/1471-2458/7/349 Authors' contributions SA is the Principal Investigator for the Rwanda Zambia HIV Research Group; EK is the Senior Co-Investigator of Projet San Francisco and EC is the Senior Co-Investigator of the Zambia Emory HIV Research Project. Each partici- pated in all aspects of the study, from study design to cre- ation of instruments and data analysis and reviewed the manuscript. DLR contributed to the design of the study and performed statistical data analysis. JT is an expert in community based research and LC is a behavioral scien- tist; both contributed to the design of the study, develop- ment of the data collection instruments and standard operating procedures, data analysis, and manuscript prep- aration. IZ and NK oversaw all recruitment efforts in the field and were an active part of the paper revision process while completing their Master's in Public Health degrees in the United States. BB is a physician and public health practitioner who contributed to development of the study design and analysis of the INA level data. KK, medical stu- dent, SD, and FH supervised selection and training of INAs, data collection and ongoing monitoring and evalu- ation analyses during the study. MS, District Director of Health for Lusaka led the dialogues with city leaders in the politico-administrative realm, as well as contacts with community leaders in preparation for the study along with EK. They were responsible for on-site supervision of all activities during the study, and for revision of the man- uscript. MCarael is a Sociologist with more than 30 years of experience with the design and implementation of HIV prevention programs in Africa. He participated in devel- opment of the grant proposal and study design, and in drafting the manuscript. AH, MConkling and RS assisted with manuscript preparation and revision. Acknowledgements The investigators would like to thank all of the participants in this study and all of the RZHRG staff members who made this study possible. This work was supported by funding from the NIMH RO1 66767, with contribution from the AIDS International Training and Research Program (AITRP) FIC D43 TW001042, the Social & Behavioral Core of the Emory Center for AIDS Research P30 AI050409, R01 AI40951, R01 AI51231, NICHD R01 40125, and the International AIDS Vaccine Initiative. 4. 3. References 1. UNAIDS and WHO: AIDS Epidemic Update: 2006. In AIDS Epi- demic Updates Geneva: The Joint United Nations Programme on HIV/ AIDS and the World Health Organization; 2006. 2. Trask SA, Derdeyn CA, Fideli U, Chen Y, Meleth S, Kasolo F, Musonda R, Hunter E, Gao F, Allen S, Hahn BH: Molecular Epide- miology of Human Immunodeficiency Virus Type 1 Trans- mission in a Heterosexual Cohort of Discordant Couples in Zambia. J Virol 2002, 76:397-405. Iwanowski MR, Rwanda Zambia HIV Research Group: Couples' VCT in ANC clinics: prevention of perinatal and heterosex- ual HIV transmission in Africa. Antivir Ther 2003, 8(Suppl 1):S485. McKenna SL, Muyinda GK, Roth D, Mwali M, Ng'andu N, Myrick A, Luo C, Priddy FH, Hall VM, von Lieven AA, Sabatino JR, Mark K, Allen SA: Rapid HIV testing and counseling for voluntary testing centers in Africa. AIDS 1997, 11(Suppl 1):S103-110. 5. Chomba E, Allen S, Kanweka W, Tichacek A, Cox G, Shutes E, Zulu I, Kancheya N, Sinkala M, Stephenson R, Haworth A, the Rwanda Zambia HIV Research Group: Evolution of Couples' Voluntary Counseling and Testing for HIV in Lusaka, Zambia. J Acquir Immune Defic Syndr 2007 in press. [Epub ahead of print] 6. Roth DL, Stewart KE, Clay OJ, van Der Straten A, Karita E, Allen S: Sexual practices of HIV discordant and concordant couples in Rwanda: effects of a testing and counselling programme for men. Int J STD AIDS 2001, 12:181-188. 7. Allen S, Tice J, Van de Perre P, Serufilira A, Hudes E, Nsengumuremyi F, Bogaerts J, Lindan C, Hulley S: Effect of serotesting with coun- selling on condom use and seroconversion among HIV dis- cordant couples in Africa. BMJ 1992, 304:1605-1609. 8. Fylkesnes K, Ndhlovu Z, Kasumba K, Mubanga Musonda R, Sichone M: Studying dynamics of the HIV epidemic: population-based data compared with sentinel surveillance in Zambia. AIDS 1998, 12:1227-1234. 9. The Voluntary HIV-1 Counseling and Testing Efficacy Study Group: Efficacy of voluntary HIV-1 counselling and testing in individ- uals and couples in Kenya, Tanzania, and Trinidad: a ran- domised trial. Lancet 2000, 356:103-112. 10. Bagala A: Uganda: Married Couples Top HIV Infection Rates. In The Daily Monitor, Online edition Kampala, Uganda; 2006. 11. Painter TM: Voluntary counseling and testing for couples: a high-leverage intervention for HIV/AIDS prevention in sub- Saharan Africa. Soc Sci Med 2001, 53:1397-1411. 12. Sweat M, Gregorich S, Sangiwa G, Furlonge C, Balmer D, Kamenga C, Grinstead O, Coates T: Cost-effectiveness of voluntary HIV-1 counselling and testing in reducing sexual transmission of HIV-1 in Kenya and Tanzania. Lancet 2000, 356:113-121. 13. Colebunders R, Ndumbe P: Priorities for HIV testing in develop- ing countries? Lancet 1993, 342:601-602. 14. Grinstead OA, Gregorich SE, Choi KH, Coates TJ: Positive and negative life events after counselling and testing: the Volun- tary HIV-1 Counselling and Testing Efficacy Study. AIDS 2001, 15:1045-1052. 15. Angotti NBA, Gaydosh L, Kimchi E, Thornton R, Watkins S, Yeatman S: The Fear Factor in HIV Testing: Local Reactions to Door- to-Door Rapid Blood Testing for HIV in Rural Malawi. In American Sociological Association Annual Conference New York, NY; 2007. 16. Fylkesnes K, Siziya S: A randomized trial on acceptability of vol- untary HIV counselling and testing. Trop Med Int Health 2004, 9:566-572. 17. Corbett EL, Dauya E, Matambo R, Cheung YB, Makamure B, Bassett MT, Chandiwana S, Munyati S, Mason PR, Butterworth AE, et al.: Uptake of workplace HIV counselling and testing: a cluster- randomised trial in Zimbabwe. PLoS Med 2006, 3:e238. 18. Wolff B, Nyanzi B, Katongole G, Ssesanga D, Ruberantwari A, Whit- worth J: Evaluation of a home-based voluntary counselling and testing intervention in rural Uganda. Health Policy Plan 2005, 20:109-116. 19. Were WA, Mermin JH, Wamai N, Awor AC, Bechange S, Moss S, Sol- berg P, Downing RG, Coutinho A, Bunnell RE: Undiagnosed HIV infection and couple HIV discordance among household members of HIV-infected people receiving antiretroviral therapy in Uganda. J Acquir Immune Defic Syndr 2006, 43:91-95. 20. Nuwaha F, Kabatesi D, Muganwa M, Whalen CC: Factors influenc- ing acceptability of voluntary counselling and testing for HIV in Bushenyi district of Uganda. East Afr Med J 2002, 79:626-632. 21. Castle S: Doubting the existence of AIDS: a barrier to volun- tary HIV testing and counselling in urban Mali. Health Policy Plan 2003, 18:146-155. 22. Bakari JP, McKenna S, Myrick A, Mwinga K, Bhat GJ, Allen S: Rapid voluntary testing and counseling for HIV. Acceptability and feasibility in Zambian antenatal care clinics. Ann N Y Acad Sci 2000, 918:64-76. 23. Ginwalla SK GAD, Day JH, Dlova TW, Macintyre S, Baggaley R, Churchyard GJ: Use of UNAIDS tools to evaluate HIV volun- tary counselling and testing services for mineworkers in South Africa. AIDS Care 2002, 5:707-726. 24. Kamenga M, Ryder RW, Jingu M, Mbuyi N, Mbu L, Behets F, Brown C, Heyward WL: 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. AIDS 1991, 5:61-67. Page 9 of 10 (page number not for citation purposes)