Couple-Based HIV Prevention and Treatment: State of Science, Gaps, and Future Directions

Systematic Review of Couple-Based HIV Intervention and Prevention Studies: Advantages, Gaps, and Future Directions

“…Expanding the scope of dissemination and scaling up couple-based HIV interventions will require commitment by governments and donors to fund research on dissemination and implementation as well as training for providers in couple-based approaches. With the increased emphasis and use of a “seek, treat, and retain” HIV prevention and treatment paradigm [13, 89], a couple-based modality can be used at each stage on the continuum of this process. Engaging the couple together at each stage may lead to better outcomes where the responsibility is placed on the dyad and not simply on recruiting a partner to treatment, while also engaging them in forging linkages with support in their community, and improving retention in treatment and care.…”

“…HIV prevention efforts where the micro-social context serves as the foundation for sexual- and drug-risk reduction strategies may be more effective in reducing risk behaviors, strengthening healthy behaviors [5–7], and increasing HIV testing and treatment adherence [13]. There are several advantages to using a couple-based approach: it allows for both members to recognize their mutual responsibility in protecting each other from HIV transmission and encourages them to work together to stay healthy; it highlights the relationship’s context (i.e.…”

“…There are several advantages to using a couple-based approach: it allows for both members to recognize their mutual responsibility in protecting each other from HIV transmission and encourages them to work together to stay healthy; it highlights the relationship’s context (i.e. commitment, love, trust) and its connection to HIV acquisition, subsequently drawing attention to the value and power of the relationship in behavioral change; it aids in the creation of a safe environment to discuss sensitive topics such as sexual concurrency, power imbalances, and sexual coercion; it allows for couples to learn about and practice important skills such as communication and problem-solving with the support and guidance of others, such as the facilitator; and finally, it promotes accountability and increases commitment to change [9, 13]. Couple-based prevention has also been shown to increase adherence to ART and has the potential to not only improve the health of persons living with HIV, but also lowering the risk of transmission within the pair by reducing the viral load of the infected partner [9, 13].…”

Behavioural interventions to reduce sexual risk for HIV in heterosexual couples: a meta-analysis

“…Nonetheless, among interventions that provided skills training, condom use increased more to the extent that participants practiced condom use skills with their partner. It is possible that interventions that promote condom use, and include active condom use skills training to both members of a couple simultaneously, may lead to more positive condom attitudes and more supportive social norms,5 25 53 54 as well as shared responsibility for risk reduction 55…”

“…The small number of available couple-based HIV interventions and increasing calls for couple-based prevention strategies9–11 55 suggest that researchers are likely to target prevention efforts toward couples in the near future. Additionally, in its global health sector strategy on HIV/AIDS, 2011–2015, WHO outlined plans to increase HIV counselling and testing for couples in an effort to reduce transmission between serodiscordant partners1 and has recently published guidelines on couple-based VCT 24.…”