One limitation of our findings is that the majority of couples were recruited from voluntary counseling and testing centers, demonstrating motivation and health-seeking behavior, thus potentially impacting the generalizability to settings with provider-initiated counseling and testing and other testing strategies [16, 17]. Furthermore, we assessed feasibility of using the HIV-1 risk score within the Partners Demonstration Project at research clinics. Thus, the use of this score within a public health setting has not been evaluated. However, the Partners Demonstration Project was designed to reflect operations of public health clinics in Kenya and Uganda as much as possible.