A group-based intervention to increase condom use among HIV serodiscordant couples in India, Thailand, and Uganda

Abstract

This study assessed the feasibility of a group-based couples intervention to increase condom use in HIV serodiscordant couples in three countries (India, Thailand and Uganda). The intervention focused on communication, problem solving, and negotiation skills. Forty-three couples enrolled in the intervention (15 in India, 14 in Thailand, and 14 in Uganda) and 40 couples completed all study activities. Participants were interviewed at baseline and at one and three months post- intervention. The intervention consisted of two same sex sessions and two couples sessions with 'homework' to practice skills between sessions. The same intervention modules were used at each site, tailored for local appropriateness. Participants at each site were enthusiastic about the intervention, citing information about HIV serodiscordancy and the opportunity to meet couples 'like us' as important features. Participants reported increased comfort discussing sex and condoms with their partner, although some participants remain concerned about situations when condoms might not be used (e.g. when drunk). At three-month follow up 90% of the participants reported having been able to use the skills from the intervention with their partner. Our results highlight the feasibility of this couples group-based intervention and the need for ongoing support for discordant couples.

Systematic Review of Couple-Based HIV Intervention and Prevention Studies: Advantages, Gaps, and Future Directions

“…A number of biobehavioral studies also focused on improving the intervention mediators and found greater intention to use condoms and increased HIV/AIDS knowledge [26, 38, 39]; positive attitudes towards condoms [26]; improved mental health outcomes [16]; improved comfort levels regarding discussions with their partners about sex and condoms and ability to use learned intervention skills with their partner [46]; and increased acceptability of barrier products [25]. …”

“…Among the biobehavioral skills-building studies, where noted, no adverse events occurred [8, 22, 42, 46]. Similarly, the adherence study paper reported no adverse events [31, 40].…”

“…All of the biobehavioral skills-building studies utilized appropriate data analytical approaches and ten provided good/clear information about their inclusion and exclusion criteria [8, 22–25, 28, 38, 39, 42, 46, 48, 49]. Similarly, the majority of the studies also had good/clear sampling procedures [8, 22–26, 28, 38, 39, 41, 42, 46, 49]; but, five studies had small sample sizes - under 50 couples [16, 38, 42, 46, 49].…”

“…Similarly, the majority of the studies also had good/clear sampling procedures [8, 22–26, 28, 38, 39, 41, 42, 46, 49]; but, five studies had small sample sizes - under 50 couples [16, 38, 42, 46, 49]. Where applicable, random assignment/randomization procedures were clear and the majority of studies provided some information about attrition and loss to follow-up.…”

Couple-centred testing and counselling for HIV serodiscordant heterosexual couples in sub-Saharan Africa

“…14,47,55 New counselling tools focused on couples could also contribute to increasing condom use. 56 Finally, research on HIV risk management and prevention within couple relationships should be strengthened. In sub-Saharan Africa, there is still inadequate socio-behavioural knowledge of HIV prevention within the dynamics of couple relationships.…”