A group-based intervention to increase condom use among HIV serodiscordant couples in India, Thailand, and Uganda

Abstract

This study assessed the feasibility of a group-based couples intervention to increase condom use in HIV serodiscordant couples in three countries (India, Thailand and Uganda). The intervention focused on communication, problem solving, and negotiation skills. Forty-three couples enrolled in the intervention (15 in India, 14 in Thailand, and 14 in Uganda) and 40 couples completed all study activities. Participants were interviewed at baseline and at one and three months post- intervention. The intervention consisted of two same sex sessions and two couples sessions with ‘homework’ to practice skills between sessions. The same intervention modules were used at each site, tailored for local appropriateness. Participants at each site were enthusiastic about the intervention, citing information about HIV serodiscordancy and the opportunity to meet couples ‘like us’ as important features. Participants reported increased comfort discussing sex and condoms with their partner, although some participants remain concerned about situations when condoms might not be used (e.g. when drunk). At three-month follow up 90% of the participants reported having been able to use the skills from the intervention with their partner. Our results highlight the feasibility of this couples group-based intervention and the need for ongoing support for discordant couples.

Acknowledgments

Partial support for this study was provided by Family Health International (FHI) with funds from the National Institutes of Allergy and Infectious Diseases, NIH (NIAID), although the views expressed in this paper do not necessarily reflect those of FHI or NIAID. The Uganda site also received support from the Center for AIDS Research at CWRU (NIH Grant no. AI36219, M. Lederman, PI). We also wish to express our thanks to the study teams at each site and to the study participants.

Notes

1. The intervention manual, with all the modules and sample text for the facilitators, is available from the authors upon request.