WITHDRAWN: Factors Associated with Greater Interest in Using Couples HIV Testing and Counseling (CHTC): Findings from a Nation-Wide, Online Study

Background: Couples HIV testing and counseling (CHTC) provides couples the opportunity to test, learn about their serostatus, and receive counseling together. CHTC has been available to heterosexual couples in sub-Sahara Africa, and more recently with gay male couples in the U.S. Few studies have investigated willingness to use CHTC among partnered heterosexual adults in the U.S. To expand this area of research, the present study investigated which factors were associated with greater interest in using CHTC among heterosexual-, bisexual-, and questioning-identified, partnered adults in the U.S.

Methods: Targeted Facebook ads were used to recruit 536 eligible and consented adults who completed a one-time, anonymous online survey. Eligibility included: ≥18 years of age; self identify as heterosexual, bisexual, or questioning; in a sexual relationship. Bivariate ordinal logistic regression models followed by an adjusted final multivariate model were conducted to identify factors significantly (p<.05) associated with greater interest in using CHTC.

Results: Participants’ mean age was 21.4 years (range: 18-61). Many self-identified as: female (n=497, 92%); Non-Hispanic (n=495, 92%); White (n=491, 92%); heterosexual (n=468, 87%); HIV-negative (n=397, 74%); dating exclusively (n=531, 99%); a current student (n=410, 77%). 26% of participants were unsure of their serostatus. Almost two-thirds of participants had been in their current relationship for > 1 year (n=346, 65%) and/or had a sexual agreement with their partner (n=331, 62%). Many participants had had oral (n=492, 92%) and/or vaginal sex (n=504, 94%) with their partner; few had had anal sex (n=100, 19%). Consistent condom use for vaginal and/or anal sex was uncommon, and less than half the sample had gotten tested for HIV/STIs while in their current relationship (n=240, 45%). Discussion of birth control was common (n=505, 95%) yet two-thirds actually used some form of it in their current relationship (n=351, 66%). After controlling for relationship length and ever tested for HIV/STI while in current relationship, greater interest in using CHTC was associated with identifying as bisexual or questioning (aOR=2.53, 95% CI 1.03 – 6.25, p<0.05), having a sexual agreement (aOR=6.82, 95% CI 2.47 – 17.72, p<0.001), and using condoms >50% of the time during anal sex (aOR=2.98, 95% CI 1.10 – 8.06, p<0.05).

Conclusion: Findings of the present study provide insights into characteristics of partnered adults who had greater interest in using CHTC, as well as who could benefit from using CHTC. Future efforts should consider these characteristics to increase interest and potential uptake of CHTC among different groups of couples in the U.S.