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Uthando Lwethu (‘our love’): a protocol for a couples-based intervention to increase testing for HIV: a randomized controlled trial in rural KwaZulu-Natal, South Africa

Uthando Lwethu (‘our love’): a protocol for a couples-based intervention to increase testing for HIV: a randomized controlled trial in rural KwaZulu-Natal, South Africa
Uthando Lwethu (‘our love’): a protocol for a couples-based intervention to increase testing for HIV: a randomized controlled trial in rural KwaZulu-Natal, South Africa
Background

Couples-based HIV counseling and testing (CHCT) is a proven strategy to reduce the risk of HIV transmission between partners, but uptake of CHCT is low. We describe the study design of a randomized controlled trial (RCT) aimed to increase participation in CHCT and reduce sexual risk behavior for HIV among heterosexual couples in rural KwaZulu-Natal, South Africa. We hypothesize that the rate of participation in CHCT will be higher and sexual risk behavior will be lower in the intervention group as compared to the control.

Methods/design

Heterosexual couples (N?=?350 couples, 700 individuals) are being recruited to participate in a randomized trial of a couples-based intervention comprising two group sessions (one mixed gender, one single gender) and four couples’ counseling sessions. Couples must have been in a relationship together for at least 6 months. Quantitative assessments are conducted via mobile phones by gender-matched interviewers at baseline, 3, 6, and 9 months post-randomization. Intervention content is aimed to improve relationship dynamics, and includes communication skills and setting goals regarding CHCT.

Discussion

The Uthando Lwethu (‘our love’) intervention is the first couples-based intervention to have CHCT as its outcome. We are also targeting reductions in unprotected sex. CHCT necessitates the testing and mutual disclosure of both partners, conditions that are essential for improving subsequent outcomes such as disclosure of HIV status, sexual risk reduction, and improving treatment outcomes. Thus, improving rates of CHCT has the potential to improve health outcomes for heterosexual couples in a rural area of South Africa that is highly impacted by HIV. The results of our ongoing clinical trial will provide much needed information regarding whether a relationship-focused approach is effective in increasing rates of participation in CHCT. Our intervention represents an attempt to move away from individual-level conceptualizations, to a more integrated approach for HIV prevention.
couples-based HIV testing, CHCT, couples-based intervention, HIV prevention, south africa
1745-6215
64
Darbes, L.A.
725109fb-1826-4af9-bef0-546ac43f6311
Van Rooyen, H.
199b19fa-11f5-4dc3-b079-2613f93ec5cc
Hosegood, V.
c59a89d5-5edc-42dd-b282-f44458fd2993
Ngubane, T.
417b344d-a2dd-440b-87a0-3cfd87ed5394
Johnson, M.O.
98f240bf-6b08-46de-ac42-7d8a01aad423
Fritz, K.
125fe928-2ae8-4e70-84cf-9c2d047b93bc
McGrath, N.
b75c0232-24ec-443f-93a9-69e9e12dc961
Darbes, L.A.
725109fb-1826-4af9-bef0-546ac43f6311
Van Rooyen, H.
199b19fa-11f5-4dc3-b079-2613f93ec5cc
Hosegood, V.
c59a89d5-5edc-42dd-b282-f44458fd2993
Ngubane, T.
417b344d-a2dd-440b-87a0-3cfd87ed5394
Johnson, M.O.
98f240bf-6b08-46de-ac42-7d8a01aad423
Fritz, K.
125fe928-2ae8-4e70-84cf-9c2d047b93bc
McGrath, N.
b75c0232-24ec-443f-93a9-69e9e12dc961

Darbes, L.A., Van Rooyen, H., Hosegood, V., Ngubane, T., Johnson, M.O., Fritz, K. and McGrath, N. (2014) Uthando Lwethu (‘our love’): a protocol for a couples-based intervention to increase testing for HIV: a randomized controlled trial in rural KwaZulu-Natal, South Africa. Trials, 15 (1), 64. (doi:10.1186/1745-6215-15-64). (PMID:24552199)

Record type: Article

Abstract

Background

Couples-based HIV counseling and testing (CHCT) is a proven strategy to reduce the risk of HIV transmission between partners, but uptake of CHCT is low. We describe the study design of a randomized controlled trial (RCT) aimed to increase participation in CHCT and reduce sexual risk behavior for HIV among heterosexual couples in rural KwaZulu-Natal, South Africa. We hypothesize that the rate of participation in CHCT will be higher and sexual risk behavior will be lower in the intervention group as compared to the control.

Methods/design

Heterosexual couples (N?=?350 couples, 700 individuals) are being recruited to participate in a randomized trial of a couples-based intervention comprising two group sessions (one mixed gender, one single gender) and four couples’ counseling sessions. Couples must have been in a relationship together for at least 6 months. Quantitative assessments are conducted via mobile phones by gender-matched interviewers at baseline, 3, 6, and 9 months post-randomization. Intervention content is aimed to improve relationship dynamics, and includes communication skills and setting goals regarding CHCT.

Discussion

The Uthando Lwethu (‘our love’) intervention is the first couples-based intervention to have CHCT as its outcome. We are also targeting reductions in unprotected sex. CHCT necessitates the testing and mutual disclosure of both partners, conditions that are essential for improving subsequent outcomes such as disclosure of HIV status, sexual risk reduction, and improving treatment outcomes. Thus, improving rates of CHCT has the potential to improve health outcomes for heterosexual couples in a rural area of South Africa that is highly impacted by HIV. The results of our ongoing clinical trial will provide much needed information regarding whether a relationship-focused approach is effective in increasing rates of participation in CHCT. Our intervention represents an attempt to move away from individual-level conceptualizations, to a more integrated approach for HIV prevention.

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More information

e-pub ahead of print date: 20 February 2014
Published date: 20 February 2014
Keywords: couples-based HIV testing, CHCT, couples-based intervention, HIV prevention, south africa
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 362909
URI: https://eprints.soton.ac.uk/id/eprint/362909
ISSN: 1745-6215
PURE UUID: 7367d299-563c-49b4-a121-3338c02b1c53
ORCID for V. Hosegood: ORCID iD orcid.org/0000-0002-2244-2518
ORCID for N. McGrath: ORCID iD orcid.org/0000-0002-1039-0159

Catalogue record

Date deposited: 10 Mar 2014 15:26
Last modified: 20 Jul 2019 00:45

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