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PLWHIV are placing themselves at the centre to End the Epidemic by 2030

This segment of serodiscordant couples (SDC) is aware of their discordance (that one of them has HIV and the other does not) and have had their relationship disrupted by it in some way. They may be experiencing blame over who brought HIV into the relationship, disconnection around sex, and/or discouragement around conceiving. The discordance has been so disruptive for some that they now face the “discordance dilemma.” They see the avoidance of HIV transmission at odds with preserving their relationship. Other couples endure the discordance out of love and commitment, but the risk of HIV transmission is still disruptive, complicating the things they want and value in their relationship—intimacy and children. For Serodiscordant partners enrolling in PrEP is often perceived as more burdensome than helpful. Bringing up PrEP may resurface undesirable, negative feelings associated with the discordance, such as blame, guilt, and even violence. In visiting an HIV clinic, SDC risk disclosing their discordance to others, and partners without HIV risk being mislabelled as HIV positive. And taking PrEP may bring on undesirable stigma from others. Thus, when SDC compare PrEP to other HIV-prevention tools like condoms, many struggles to be convinced of its relative effectiveness and appeal.

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Elimination of Stigma=Elimination of HIV transmission

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Benefits of Assisted Partner Notification or HIV Status disclosure

The sexual partners and drug injecting partners of people diagnosed with HIV infection have an increased probability of also being HIV-positive . However, partner testing services, including partner notification, for people diagnosed with HIV have not been routinely offered or implemented, therefore, uptake and coverage remains low. The benefits of partner and couples HTS have been well documented, including mutual support to access prevention, treatment and care services, as well as improved adherence and retention in treatment and prevention of mother-to-child transmission programmes . Partner testing also allows those in serodiscordant partnerships to prioritize effective HIV prevention, such as the use of condoms, immediate antiretroviral therapy (ART), medication adherence by HIV-positive partners, and pre-exposure prophylaxis (PrEP) for HIV-negative partners

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Advantages of HIV couple counselling and testing

Provides a venue for mutual disclosure of HIV status in an environment where support can be provided by a counsellor or health worker. Risk-reduction messages can be tailored depending on the outcome of the test results of both partners. Decisions about prevention, accessing treatment, care and support, and family planning options can be made together. Moreover, through couples testing, the counsellor can help create a safe environment in which the couple can discuss potentially difficult issues, such as sexual agreements. Sexual agreements are mutually agreed upon conditions or limitations about sexual behaviours within and outside of the relationship. Couples HIV testing and counselling provides a forum for open discussion about sexual agreements, with the help of a counsellor. This helps both partners fully understand the agreement which may better protect them from HIV

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