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Protocol: evaluation of an optimised couples-focused intervention to increase testing for HIV in rural KwaZulu-Natal, South Africa, the Igugu Lethu (‘Our treasure’) cohort study

Protocol: evaluation of an optimised couples-focused intervention to increase testing for HIV in rural KwaZulu-Natal, South Africa, the Igugu Lethu (‘Our treasure’) cohort study
Protocol: evaluation of an optimised couples-focused intervention to increase testing for HIV in rural KwaZulu-Natal, South Africa, the Igugu Lethu (‘Our treasure’) cohort study
Background: between 2012 and 2015, the Uthando Lwethu (UL) study demonstrated that a theory-based behavioural couples-focused intervention significantly increased participation in couples HIV testing and counselling (CHTC) among South African couples who had never previously tested for HIV together or mutually disclosed their HIV status, 42% compared to 12% of the control group at 9 months follow-up. Although effective, we were nonetheless concerned that in this high prevalence setting the majority (58%) of intervention couples chose not to test together. In response we optimised the UL intervention and in a new study, ‘Igugu Lethu’, we are evaluating the success of the optimised intervention in promoting CHTC.

Methods: one hundred eighty heterosexual couples, who have been in a relationship together for at least 6 months, are being recruited and offered the optimised couples-focused intervention. In the Igugu Lethu study, we have expanded the health screening visit offered to couples to include other health conditions in addition to CHTC. Enrolled couples who choose to schedule CHTC will also have the opportunity to undertake a random blood glucose test, blood pressure and BMI measurements, and self-sample for STI testing as part of their health screening. Individual surveys are administered at baseline, 4 weeks and 4 months follow-up. The proportion of couples who decide to test together for HIV will be compared to the results of the intervention arm in the UL study (historical controls). To facilitate this comparison, we will use the same recruitment and follow-up strategies in the same community as the previous UL study.

Discussion: by strengthening communication and functioning within the relationship, the Igugu Lethu study, like the previous UL study, aims to transform the motivation of individual partners from a focus on their own health to shared health as a couple. The Igugu Lethu study findings will answer whether the optimised couples-focused behavioural intervention and offering CHTC as part of a broader health screening for couples can increase uptake of CHTC by 40%, an outcome that would be highly desirable in populations with high HIV prevalence.

Trial registration: retrospectively registered. ISRCTN Registry ISRCTN 46162564 Registered on 26th May 2022.
Behavioural intervention, Couples health, Couples HIV testing and counselling, Couples-focused intervention, South Africa
1471-2458
Mcgrath, Nuala
b75c0232-24ec-443f-93a9-69e9e12dc961
Ngcobo, Nathi
84b344de-56de-4041-b71f-2a490e9ddd49
Feng, Zhixin
34b978b4-7e26-4118-ae94-3641b0b3ea1a
Joseph, Phillip
5bad9420-68b4-467a-bb77-816ed8f00a77
Dladla, Pumla
0981686c-4f12-48a9-86da-a313ef465d57
Ngubane, Thulani
27f50c05-bc6b-4a75-9ec0-44e432f49b87
Hosegood, Victoria
c59a89d5-5edc-42dd-b282-f44458fd2993
Morton, Kate
6fa41cd3-ba4d-476c-9020-b8ef93c7ade7
van Rooyen, Heidi
e101d89c-90a1-4fd9-a24d-fcb807ba547e
Van Heerden, Alastair
9a8f1413-27ef-4a2b-867b-63bbcdfd3379
Mcgrath, Nuala
b75c0232-24ec-443f-93a9-69e9e12dc961
Ngcobo, Nathi
84b344de-56de-4041-b71f-2a490e9ddd49
Feng, Zhixin
34b978b4-7e26-4118-ae94-3641b0b3ea1a
Joseph, Phillip
5bad9420-68b4-467a-bb77-816ed8f00a77
Dladla, Pumla
0981686c-4f12-48a9-86da-a313ef465d57
Ngubane, Thulani
27f50c05-bc6b-4a75-9ec0-44e432f49b87
Hosegood, Victoria
c59a89d5-5edc-42dd-b282-f44458fd2993
Morton, Kate
6fa41cd3-ba4d-476c-9020-b8ef93c7ade7
van Rooyen, Heidi
e101d89c-90a1-4fd9-a24d-fcb807ba547e
Van Heerden, Alastair
9a8f1413-27ef-4a2b-867b-63bbcdfd3379

Mcgrath, Nuala, Ngcobo, Nathi, Feng, Zhixin, Joseph, Phillip, Dladla, Pumla, Ngubane, Thulani, Hosegood, Victoria, Morton, Kate, van Rooyen, Heidi and Van Heerden, Alastair (2022) Protocol: evaluation of an optimised couples-focused intervention to increase testing for HIV in rural KwaZulu-Natal, South Africa, the Igugu Lethu (‘Our treasure’) cohort study. BMC Public Health, 22 (1), [1577]. (doi:10.1186/s12889-022-13894-3).

Record type: Article

Abstract

Background: between 2012 and 2015, the Uthando Lwethu (UL) study demonstrated that a theory-based behavioural couples-focused intervention significantly increased participation in couples HIV testing and counselling (CHTC) among South African couples who had never previously tested for HIV together or mutually disclosed their HIV status, 42% compared to 12% of the control group at 9 months follow-up. Although effective, we were nonetheless concerned that in this high prevalence setting the majority (58%) of intervention couples chose not to test together. In response we optimised the UL intervention and in a new study, ‘Igugu Lethu’, we are evaluating the success of the optimised intervention in promoting CHTC.

Methods: one hundred eighty heterosexual couples, who have been in a relationship together for at least 6 months, are being recruited and offered the optimised couples-focused intervention. In the Igugu Lethu study, we have expanded the health screening visit offered to couples to include other health conditions in addition to CHTC. Enrolled couples who choose to schedule CHTC will also have the opportunity to undertake a random blood glucose test, blood pressure and BMI measurements, and self-sample for STI testing as part of their health screening. Individual surveys are administered at baseline, 4 weeks and 4 months follow-up. The proportion of couples who decide to test together for HIV will be compared to the results of the intervention arm in the UL study (historical controls). To facilitate this comparison, we will use the same recruitment and follow-up strategies in the same community as the previous UL study.

Discussion: by strengthening communication and functioning within the relationship, the Igugu Lethu study, like the previous UL study, aims to transform the motivation of individual partners from a focus on their own health to shared health as a couple. The Igugu Lethu study findings will answer whether the optimised couples-focused behavioural intervention and offering CHTC as part of a broader health screening for couples can increase uptake of CHTC by 40%, an outcome that would be highly desirable in populations with high HIV prevalence.

Trial registration: retrospectively registered. ISRCTN Registry ISRCTN 46162564 Registered on 26th May 2022.

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Accepted/In Press date: 22 July 2022
e-pub ahead of print date: 19 August 2022
Additional Information: Funding Information: This report is independent research supported by the National Institute for Health Research using Official Development Assistance (ODA) funding (NIHR Global Health Research Professorship, Professor Nuala McGrath, RP-2017-08-ST2–008). NN, ZF, KM, and NMcG were supported by this funding. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health and Care Research or the Department of Health and Social Care. The sponsor is the University of Southampton, University Road, Southampton, Highfield, SO17 1BJ, UK. Both the funding body and the sponsor have not had any role in the design of the study and will not have any role in the collection, management, analysis, interpretation of the data, writing of the manuscript or decision to submit the report for publication. Publisher Copyright: © 2022, The Author(s).
Keywords: Behavioural intervention, Couples health, Couples HIV testing and counselling, Couples-focused intervention, South Africa

Identifiers

Local EPrints ID: 472049
URI: http://eprints.soton.ac.uk/id/eprint/472049
ISSN: 1471-2458
PURE UUID: f7f666cd-e809-483e-bb87-d3dbf8f4c1c2
ORCID for Nuala Mcgrath: ORCID iD orcid.org/0000-0002-1039-0159
ORCID for Victoria Hosegood: ORCID iD orcid.org/0000-0002-2244-2518
ORCID for Kate Morton: ORCID iD orcid.org/0000-0002-6674-0314

Catalogue record

Date deposited: 24 Nov 2022 17:47
Last modified: 07 Feb 2024 02:50

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Contributors

Author: Nuala Mcgrath ORCID iD
Author: Nathi Ngcobo
Author: Zhixin Feng
Author: Phillip Joseph
Author: Pumla Dladla
Author: Thulani Ngubane
Author: Kate Morton ORCID iD
Author: Heidi van Rooyen
Author: Alastair Van Heerden

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