The Awareness Framework: A Novel Approach for Understanding HIV Testing and Disclosure in HIV-discordant Dyads

Consistent with the Couples HIV Testing and Counseling Guidelines recently released by the World Health Organization, we assert that the prevention impact of HTC will hinge on whether both members of HIV-discordant dyads receive HTC and whether they share their HIV status with each other. However, a better understanding of the prevention impact of other awareness possibilities is needed. We introduce a novel framework for considering a person’s awareness of his/her own HIV status (through HTC) and his/her partner’s HIV status (through HIV disclosure) within HIV-discordant dyads. This framework is useful for understanding HTC trends, examining behavioral and biomedical risk in partnerships, and ultimately optimizing the impact of HIV prevention.