Project Stronger Together: Protocol to Test a Dyadic Intervention to Improve Engagement in HIV Care Among Sero-Discordant Male Couples in Three US Cities

Abstract

BackgroundAn estimated one- to-two-thirds of new human immunodeficiency virus (HIV) infections among US men who have sex with men (MSM) occur within the context of primary partnerships. Despite this fact, there remains a lack of prevention interventions that focus on male sero-discordant dyads. Interventions that provide male couples with skills to manage HIV risk, and to support each other towards active engagement in HIV prevention and care, are urgently needed.ObjectiveThe objective of this paper is to describe the protocol for an innovative dyadic intervention (Stronger Together) that combines couples’ HIV testing and dyadic adherence counseling to improve treatment adherence and engagement in care among HIV sero-discordant male couples in the United States.MethodsThe research activities involve a prospective randomized controlled trial (RCT) of approximately 165 venue- and clinic-recruited sero-discordant male couples (330 individuals: 165 HIV sero-negative and 165 HIV sero-positive). Couples randomized into the intervention arm receive couples’ HIV counseling and testing plus dyadic adherence counseling, while those randomized to the control arm receive individual HIV counseling and testing. The study takes place in three cities: Atlanta, GA (study site Emory University); Boston, MA (study site The Fenway Institute); and Chicago, IL (study site Ann & Robert H. Lurie Children’s Hospital of Chicago). Cohort recruitment began in 2015. Couples are followed prospectively for 24 months, with study assessments at baseline, 6, 12, 18, and 24 months.ResultsStronger Together was launched in August 2014. To date, 160 couples (97% of the target enrollment) have been enrolled and randomized. The average retention rate across the three sites is 95%. Relationship dissolution has been relatively low, with only 13 couples breaking up during the RCT. Of the 13 couples who have broken up, 10 of the 13 HIV-positive partners have been retained in the cohort; none of these HIV-positive partners have enrolled new partners into the RCT.ConclusionsThe intervention offers a unique opportunity for sero-discordant couples to support each other towards common HIV management goals by facilitating their development of tailored prevention plans via couples-based HIV testing and counseling, as well as problem-solving skills in Partner Strategies to Enhance Problem-solving Skills (STEPS).Trial RegistrationClinicalTrials.gov NCT01772992; https://clinicaltrials.gov/ct2/show/NCT01772992 (Archived by WebCite at http://www.webcitation.org/6szFBVk1R)

Dyadic Reporting of Intimate Partner Violence Among Male Couples in Three U.S. Cities

“…For example, partner A answered his experience of IPV and perpetration, and these answers were compared to partner B’s answers to the same questions. A description of the protocol for the full study can be found in Stephenson et al (2017) . Approval for this study was obtained from the (University) Institutional Review Boards.…”

Perceptions of HIV Self-Testing Among Men Who Have Sex With Men in the United States: A Qualitative Analysis

“…Users of HIVST have the autonomy to include other individuals in their testing experience such as their partners, friends, or family members. Given the growing evidence in support of couples HIV testing among MSM, the use of HIVST with main partners is being explored in multiple studies (Koblin et al, 2017;Neme, Goldenberg, Stekler, Sullivan, & Stephenson, 2015;Stephenson, Freeland, et al, 2017;Stephenson, Suarez, et al, 2017;Sullivan, Wall, et al, 2014;Wall et al, 2016). Partners can be a source of comfort and support during the HIV testing experience and can help mitigate the emotional distress that may occur after receiving a positive test result (Martinez et al, 2014).…”

The Development and Testing of a Relationship Skills Intervention to Improve HIV Prevention Uptake Among Young Gay, Bisexual, and Other Men Who Have Sex With Men and Their Primary Partners (We Prevent): Protocol for a Randomized Controlled Trial

“…For phases II and III, couples’ eligibility will be verified post hoc by assessing concordance in both partners’ responses to items in the eligibility screener. These post hoc verification procedures have been successfully used in other studies with male couples [45]. Study staff will follow up with a phone call to go over study logistics and will confirm the contact information for each participant.…”