The Magnetic Couples Study: protocol for a mixed methods prospective cohort study of HIV-serodifferent heterosexual couples’ perspectives and use of pre-exposure prophylaxis (PrEP)

Abstract

IntroductionHIV transmission within serodifferent heterosexual couples plays a key role in sustaining the global HIV pandemic. In the USA, transmission within established mixed-status couples accounts for up to half of all new HIV infections among heterosexuals. Oral HIV pre-exposure prophylaxis (PrEP) is a highly effective prevention method, although underutilised among serodifferent couples. Moreover, there is a dearth of research on US HIV-serodifferent couples’ perspectives and use of PrEP, alone or in combination with other prevention methods. In this paper, we describe the study protocol for the Magnetic Couples Study, designed to fill critical knowledge gaps regarding HIV-serodifferent heterosexual couples’ perspectives, experiences and utilisation of PrEP.Methods and analysisThe Magnetic Couples Study is a mixed methods prospective cohort study designed to describe temporal patterns and identify determinants at multiple levels (individual, couple, HCF) of PrEP outcomes along the care continuum (PrEP awareness, linkage, uptake, retention and medication adherence) among HIV-serodifferent heterosexual couples residing in New York City. The study will also examine clinical management of PrEP, side effects and changes in sexual-related and substance use–related behaviour. A prospective cohort of 230 mixed-status couples already on oral PrEP was recruited, with quarterly assessments over 18 months; in addition, a cross-sectional sample of 150 mixed-status couples not currently on PrEP was recruited. In-depth semistructured qualitative interviews were conducted with a subsample of 25 couples. Actor-partner interdependence modelling using multilevel analysis will be employed for the analysis of longitudinal dyadic data. Framework analysis will be used to analyse qualitative data. A parallel convergent design will be used for mixed methods integration.Ethics and disseminationThe study was approved by the University of Rochester Institutional Review Board (RSRB00052766). Study findings will be disseminated to community members and providers and to researchers and policy makers.

Procurement of patient medical records from multiple health care facilities for public health research: feasibility, challenges, and lessons learned

“…The medical record procurement approach described here was employed in a 5-year prospective cohort study, entitled the Magnetic Couples Study, designed to examine patterns and multi-level determinants of HIV oral PrEP utilization and clinical management among HIV-serodifferent heterosexual couples (couples in which one member is HIV-negative and the other is living with HIV). The Magnetic Couples Study protocol has been described in detail elsewhere 9 and was approved by the University of Rochester Institutional Review Board (STUDY00000568). Briefly, the study cohort consisted of 230 HIV-serodifferent couples (460 individuals) recruited through dissemination of study materials (eg, pamphlets and posters), passive referral from HCFs, social media (eg, Facebook and Twitter), advertisements (newspapers, magazines, subway signs, and radio), and peer-referral.…”