Helping Young Couples in South Africa Who Drink Alcohol or Use Drugs Uptake PrEP/ART and Reduce Their Risk for HIV

Use of alcohol and drugs is an ongoing issue in South Africa and has intersectional ramifications especially when it comes to HIV treatment and prevention for young adults. Although new forms of biobehavioral HIV interventions have become available, structural barriers exist including stigma which can take on many forms, from systemic barriers to health care utilization, to poor treatment of a particular group or identity within communities, like people who drink alcohol or use substances.

This HIV prevention project will address uptake of HIV prevention and treatment, and behavioral skills between couples who use alcohol and substances with the aim of healthier outcomes. It will also address interpersonal and gender-based violence, alcohol and other drug use, and communication and negotiation skills in a format that engages both partners. We will also conduct educational sessions about pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART) and community stigma.

The goal of the Couples Health CoOp (CHC+) intervention is to increase PrEP/ART uptake, to reduce HIV-risk behaviors among young heterosexual couples, and reduce stigma in selected communities in Cape Town, South Africa.

We are building upon a successful behavioral Couples Health CoOp (CHC) HIV prevention study that was previously conducted in Cape Town (2008-2014); however, at that time, the study did not include ART or PrEP or address stigma.  The CHC+ HIV prevention project incorporates community stigma reduction training and education on community members’ attitudes and behavior toward young couples who use alcohol and drugs who seek health services such as testing/ART/PrEP and other sexual and reproductive health services in their local clinics.

By addressing stigma at the community level, this couples HIV intervention project hopes to reduce an additional barrier to seeking alcohol and drug treatment, HIV services including prevention of HIV, initiation and continuation of HIV treatment among young couples in South Africa. With working with couples, we hope to prevent and treat HIV thus inching towards the end of HIV epidemic. We also propose the CHC+ project will help to reduce gender-based violence among young adults, particularly during the COVID-19 pandemic, which is of the utmost importance.

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• RTI International press release here.
• The Couples Health CoOp intervention addresses risk for HIV, gender-based violence, & drug use in South African couples (Original)