The male factor: Outcomes from a cluster randomized field experiment with a couples-based HIV prevention intervention in a South African township

Wendee M. Wechsberg; William A. Zule; Scott P. Novak; Alexandra Marena Minnis; Irene Ann Doherty; Wendee M. Wechsberg; William A. Zule; N El-Bassel; Irene Ann Doherty; Alexandra Marena Minnis; Scott P. Novak; B Myers; T Carney

The male factor

Outcomes from a cluster randomized field experiment with a couples-based HIV prevention intervention in a South African township

Wechsberg, W., Zule, W., El-Bassel, N., Doherty, I., Minnis, A., Novak, S., Myers, B., & Carney, T. (2016). The male factor: Outcomes from a cluster randomized field experiment with a couples-based HIV prevention intervention in a South African township. Drug and Alcohol Dependence, 161, 307-315. https://doi.org/10.1016/j.drugalcdep.2016.02.017

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Abstract

Background This study examined the effects of the Couples Health CoOp intervention on heavy drinking, condom use, and HIV incidence. Methods Thirty neighborhoods from one South African township were cluster randomized into three intervention arms: Couples Health CoOp (CHC), Women’s Health CoOp/Men’s Health CoOp (WHC/MHC), or a comparison arm. We recruited 290 men from informal drinking establishments who reported drinking alcohol regularly. We also recruited their main heterosexual sex partners. Results At 6-month follow-up, men in the CHC arm were less likely to report heavy drinking (OR 0.47, 95% CI: 0.25, 0.90) and were more likely to report consistent condom use during the past month (OR 2.66, 95% CI: 1.23, 5.76) than men in the comparison arm. At baseline, 26% of women and 13% of men were HIV-infected; at 6-month follow-up, 16 females and 5 males had seroconverted. HIV incidence was significantly lower among women in the CHC arm (IRR 0.22, 95% CI: 0.04, 1.01) than in the WHC/MHC arm. Conclusions A couples-based intervention focusing on intersecting risks for HIV can improve biobehavioral outcomes, underscoring the importance of engaging couples together in HIV prevention.