Uthando Lwethu ('our Love'): a Protocol for a Couples-based Intervention to Increase Testing for HIV: a Randomized Controlled Trial in Rural KwaZulu-Natal, South Africa

Overview

Journal Trials

Publisher Biomed Central

Specialties General Medicine
Pharmacology

Date 2014 Feb 21

PMID 24552199

Citations 36

Authors

Lynae A Darbes

Heidi van Rooyen

Victoria Hosegood

Thulani Ngubane

Mallory O Johnson

Katherine Fritz

Nuala McGrath

Affiliations

Soon will be listed here.

Abstract

Background: Couples-based HIV counseling and testing (CHCT) is a proven strategy to reduce the risk of HIV transmission between partners, but uptake of CHCT is low. We describe the study design of a randomized controlled trial (RCT) aimed to increase participation in CHCT and reduce sexual risk behavior for HIV among heterosexual couples in rural KwaZulu-Natal, South Africa. We hypothesize that the rate of participation in CHCT will be higher and sexual risk behavior will be lower in the intervention group as compared to the control.

Methods/design: Heterosexual couples (N=350 couples, 700 individuals) are being recruited to participate in a randomized trial of a couples-based intervention comprising two group sessions (one mixed gender, one single gender) and four couples' counseling sessions. Couples must have been in a relationship together for at least 6 months. Quantitative assessments are conducted via mobile phones by gender-matched interviewers at baseline, 3, 6, and 9 months post-randomization. Intervention content is aimed to improve relationship dynamics, and includes communication skills and setting goals regarding CHCT.

Discussion: The Uthando Lwethu ('our love') intervention is the first couples-based intervention to have CHCT as its outcome. We are also targeting reductions in unprotected sex. CHCT necessitates the testing and mutual disclosure of both partners, conditions that are essential for improving subsequent outcomes such as disclosure of HIV status, sexual risk reduction, and improving treatment outcomes. Thus, improving rates of CHCT has the potential to improve health outcomes for heterosexual couples in a rural area of South Africa that is highly impacted by HIV. The results of our ongoing clinical trial will provide much needed information regarding whether a relationship-focused approach is effective in increasing rates of participation in CHCT. Our intervention represents an attempt to move away from individual-level conceptualizations, to a more integrated approach for HIV prevention.

Trial Registration: Study Name: Couples in Context: An RCT of a Couples-based HIV Prevention InterventionClinicalTrials.gov identifier: NCT01953133.South African clinical trial registration number: DOH-27-0212-3937.

Citing Articles

Economic and relationship-strengthening intervention to reduce alcohol use in couples living with HIV in Malawi: a study protocol for a randomised controlled trial of Mlambe.

Mkandawire J, Ssewamala F, Hahn J, Mulauzi N, Neilands T, Tebbetts S BMJ Open. 2025; 15(2):e097247.

PMID: 39929508 PMC: 11815408. DOI: 10.1136/bmjopen-2024-097247.

Two-way associations between relationship quality and uptake of couples health screening including HIV testing and counselling together: quantitative analysis of a couples cohort in rural South Africa.

Abdelkhalek F, Joseph P, DeRose L, Olamijuwon E, Dladla P, Ngubane T AIDS Care. 2024; 36(sup1):187-200.

PMID: 38381809 PMC: 11286206. DOI: 10.1080/09540121.2024.2308741.

Supportive couple relationships buffer against the harms of HIV stigma on HIV treatment adherence.

Gutin S, Ruark A, Darbes L, Neilands T, Mkandawire J, Conroy A BMC Public Health. 2023; 23(1):1878.

PMID: 37770885 PMC: 10540419. DOI: 10.1186/s12889-023-16762-w.

'If there is joy… I think it can work well': a qualitative study investigating relationship factors impacting HIV self-testing acceptability among pregnant women and male partners in Uganda.

Naughton B, Bulterys M, Mugisha J, Mujugira A, Boyer J, Celum C BMJ Open. 2023; 13(2):e067172.

PMID: 36806072 PMC: 9944652. DOI: 10.1136/bmjopen-2022-067172.

Development of an Economic and Relationship-Strengthening Intervention for Alcohol Drinkers Living with HIV in Malawi.

Conroy A, Tebbetts S, Darbes L, Hahn J, Neilands T, McKenna S AIDS Behav. 2022; 27(7):2255-2270.

PMID: 36520335 PMC: 9753077. DOI: 10.1007/s10461-022-03956-3.

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