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Results of a couples-based randomized controlled trial aimed to increase testing for HIV

Results of a couples-based randomized controlled trial aimed to increase testing for HIV
Results of a couples-based randomized controlled trial aimed to increase testing for HIV

BACKGROUND: Although couples HIV testing and counseling (CHTC) is effective for facilitating mutual disclosure and linkage to HIV care, uptake remains low. Using a randomized controlled design, we tested the efficacy of a behavioral couples-based intervention aimed to increase CHTC.

SETTING: The Vulindlela district of KwaZulu-Natal, South Africa.

METHODS: Couples were recruited from the community (eg, markets and community events). Couples were excluded if mutual HIV serostatus disclosure had occurred. Both partners had to report being each other's primary partner and relationship length was at least 6 months. Assessments occurred at baseline, and 3, 6, and 9 months after intervention. Eligible couples attended a group session (3-4 hours) after which randomization occurred. Intervention couples additionally received: one couples-based group session followed by 4 couples' counseling sessions (1-2 hours). Intervention topics included communication skills, intimate partner violence, and HIV prevention. Our primary outcomes were CHTC and sexual risk behavior.

RESULTS: Overall, 334 couples were enrolled. Intervention couples were significantly more likely to have participated in CHTC [42% vs. 12% (P ≤ 0.001)]. In addition, their time to participate in CHTC was significantly shorter (logrank P ≤ 0.0001) (N = 332 couples). By group, 59% of those who tested HIV-positive in intervention and 40% of those who tested in control were new HIV diagnoses (P = 0.18). There were no group differences in unprotected sex.

CONCLUSIONS: Our intervention improved CHTC uptake-a vehicle for mutual serostatus disclosure and entrée into HIV treatment, both of which exert a significant public health impact on communities substantially burdened by HIV.

1525-4135
404-413
Darbes, Lynae A.
c3efdf20-68ff-44bf-bf90-acaf249b334e
Mcgrath, Nuala
b75c0232-24ec-443f-93a9-69e9e12dc961
Hosegood, Victoria
c59a89d5-5edc-42dd-b282-f44458fd2993
Johnson, Mallory O.
8228e7a9-d94e-4cfb-bb0a-c922d33f2206
Fritz, Katherine
04fb526b-2470-40f8-b626-047b9990611c
Ngubane, Thulani
d79a055c-ba37-419a-a4a6-c5f4c4531d4d
van Rooyen, Heidi
19159681-0f8c-42da-8c8b-3001d4ada200
Darbes, Lynae A.
c3efdf20-68ff-44bf-bf90-acaf249b334e
Mcgrath, Nuala
b75c0232-24ec-443f-93a9-69e9e12dc961
Hosegood, Victoria
c59a89d5-5edc-42dd-b282-f44458fd2993
Johnson, Mallory O.
8228e7a9-d94e-4cfb-bb0a-c922d33f2206
Fritz, Katherine
04fb526b-2470-40f8-b626-047b9990611c
Ngubane, Thulani
d79a055c-ba37-419a-a4a6-c5f4c4531d4d
van Rooyen, Heidi
19159681-0f8c-42da-8c8b-3001d4ada200

Darbes, Lynae A., Mcgrath, Nuala, Hosegood, Victoria, Johnson, Mallory O., Fritz, Katherine, Ngubane, Thulani and van Rooyen, Heidi (2019) Results of a couples-based randomized controlled trial aimed to increase testing for HIV. JAIDS Journal of Acquired Immune Deficiency Syndromes, 80 (4), 404-413. (doi:10.1097/QAI.0000000000001948).

Record type: Article

Abstract

BACKGROUND: Although couples HIV testing and counseling (CHTC) is effective for facilitating mutual disclosure and linkage to HIV care, uptake remains low. Using a randomized controlled design, we tested the efficacy of a behavioral couples-based intervention aimed to increase CHTC.

SETTING: The Vulindlela district of KwaZulu-Natal, South Africa.

METHODS: Couples were recruited from the community (eg, markets and community events). Couples were excluded if mutual HIV serostatus disclosure had occurred. Both partners had to report being each other's primary partner and relationship length was at least 6 months. Assessments occurred at baseline, and 3, 6, and 9 months after intervention. Eligible couples attended a group session (3-4 hours) after which randomization occurred. Intervention couples additionally received: one couples-based group session followed by 4 couples' counseling sessions (1-2 hours). Intervention topics included communication skills, intimate partner violence, and HIV prevention. Our primary outcomes were CHTC and sexual risk behavior.

RESULTS: Overall, 334 couples were enrolled. Intervention couples were significantly more likely to have participated in CHTC [42% vs. 12% (P ≤ 0.001)]. In addition, their time to participate in CHTC was significantly shorter (logrank P ≤ 0.0001) (N = 332 couples). By group, 59% of those who tested HIV-positive in intervention and 40% of those who tested in control were new HIV diagnoses (P = 0.18). There were no group differences in unprotected sex.

CONCLUSIONS: Our intervention improved CHTC uptake-a vehicle for mutual serostatus disclosure and entrée into HIV treatment, both of which exert a significant public health impact on communities substantially burdened by HIV.

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JAIDS Uthando Lwethu Revision final_December 2018 - Accepted Manuscript
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More information

Accepted/In Press date: 26 November 2018
e-pub ahead of print date: 1 April 2019
Published date: 1 April 2019

Identifiers

Local EPrints ID: 427057
URI: http://eprints.soton.ac.uk/id/eprint/427057
ISSN: 1525-4135
PURE UUID: ac82d2fa-c507-4a50-a1fc-7990f7fc7790
ORCID for Nuala Mcgrath: ORCID iD orcid.org/0000-0002-1039-0159
ORCID for Victoria Hosegood: ORCID iD orcid.org/0000-0002-2244-2518

Catalogue record

Date deposited: 21 Dec 2018 16:30
Last modified: 08 Jul 2020 04:01

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Contributors

Author: Lynae A. Darbes
Author: Nuala Mcgrath ORCID iD
Author: Mallory O. Johnson
Author: Katherine Fritz
Author: Thulani Ngubane
Author: Heidi van Rooyen

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