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Project Stronger Together: Protocol to Test a Dyadic Intervention to Improve Engagement in HIV Care Among Sero-Discordant Male Couples in Three US Cities.
JMIR Res Protoc. 2017 Aug 31; 6(8):e170.JR

Abstract

BACKGROUND

An estimated one- to-two-thirds of new human immunodeficiency virus (HIV) infections among US men who have sex with men (MSM) occur within the context of primary partnerships. Despite this fact, there remains a lack of prevention interventions that focus on male sero-discordant dyads. Interventions that provide male couples with skills to manage HIV risk, and to support each other towards active engagement in HIV prevention and care, are urgently needed.

OBJECTIVE

The objective of this paper is to describe the protocol for an innovative dyadic intervention (Stronger Together) that combines couples' HIV testing and dyadic adherence counseling to improve treatment adherence and engagement in care among HIV sero-discordant male couples in the United States.

METHODS

The research activities involve a prospective randomized controlled trial (RCT) of approximately 165 venue- and clinic-recruited sero-discordant male couples (330 individuals: 165 HIV sero-negative and 165 HIV sero-positive). Couples randomized into the intervention arm receive couples' HIV counseling and testing plus dyadic adherence counseling, while those randomized to the control arm receive individual HIV counseling and testing. The study takes place in three cities: Atlanta, GA (study site Emory University); Boston, MA (study site The Fenway Institute); and Chicago, IL (study site Ann & Robert H. Lurie Children's Hospital of Chicago). Cohort recruitment began in 2015. Couples are followed prospectively for 24 months, with study assessments at baseline, 6, 12, 18, and 24 months.

RESULTS

Stronger Together was launched in August 2014. To date, 160 couples (97% of the target enrollment) have been enrolled and randomized. The average retention rate across the three sites is 95%. Relationship dissolution has been relatively low, with only 13 couples breaking up during the RCT. Of the 13 couples who have broken up, 10 of the 13 HIV-positive partners have been retained in the cohort; none of these HIV-positive partners have enrolled new partners into the RCT.

CONCLUSIONS

The intervention offers a unique opportunity for sero-discordant couples to support each other towards common HIV management goals by facilitating their development of tailored prevention plans via couples-based HIV testing and counseling, as well as problem-solving skills in Partner Strategies to Enhance Problem-solving Skills (STEPS).

TRIAL REGISTRATION

ClinicalTrials.gov NCT01772992; https://clinicaltrials.gov/ct2/show/NCT01772992 (Archived by WebCite at http://www.webcitation.org/6szFBVk1R).

Authors+Show Affiliations

Center for Sexual and Health Disparities, University of Michigan, Ann Arbor, MI, United States. Department of Health Behaviors and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, United States.Center for Sexual and Health Disparities, University of Michigan, Ann Arbor, MI, United States. Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States.Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States. Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States.Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States. Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States.Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States. Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States.Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States.Center for Health Equity Research, Brown University, Providence, RI, United States. Departments of Behavioral and Social Health Sciences and Epidemiology, School of Public Health, Brown University, Providence, RI, United States. Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, United States. The Fenway Institute, Fenway Health, Boston, MA, United States.The Fenway Institute, Fenway Health, Boston, MA, United States.Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States.Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States.Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28860107

Citation

Stephenson, Rob, et al. "Project Stronger Together: Protocol to Test a Dyadic Intervention to Improve Engagement in HIV Care Among Sero-Discordant Male Couples in Three US Cities." JMIR Research Protocols, vol. 6, no. 8, 2017, pp. e170.
Stephenson R, Suarez NA, Garofalo R, et al. Project Stronger Together: Protocol to Test a Dyadic Intervention to Improve Engagement in HIV Care Among Sero-Discordant Male Couples in Three US Cities. JMIR Res Protoc. 2017;6(8):e170.
Stephenson, R., Suarez, N. A., Garofalo, R., Hidalgo, M. A., Hoehnle, S., Thai, J., Mimiaga, M. J., Brown, E., Bratcher, A., Wimbly, T., & Sullivan, P. (2017). Project Stronger Together: Protocol to Test a Dyadic Intervention to Improve Engagement in HIV Care Among Sero-Discordant Male Couples in Three US Cities. JMIR Research Protocols, 6(8), e170. https://doi.org/10.2196/resprot.7884
Stephenson R, et al. Project Stronger Together: Protocol to Test a Dyadic Intervention to Improve Engagement in HIV Care Among Sero-Discordant Male Couples in Three US Cities. JMIR Res Protoc. 2017 Aug 31;6(8):e170. PubMed PMID: 28860107.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Project Stronger Together: Protocol to Test a Dyadic Intervention to Improve Engagement in HIV Care Among Sero-Discordant Male Couples in Three US Cities. AU - Stephenson,Rob, AU - Suarez,Nicolas A, AU - Garofalo,Robert, AU - Hidalgo,Marco A, AU - Hoehnle,Samuel, AU - Thai,Jennie, AU - Mimiaga,Matthew J, AU - Brown,Emily, AU - Bratcher,Anna, AU - Wimbly,Taylor, AU - Sullivan,Patrick, Y1 - 2017/08/31/ PY - 2017/04/18/received PY - 2017/07/21/accepted PY - 2017/07/10/revised PY - 2017/9/2/entrez PY - 2017/9/2/pubmed PY - 2017/9/2/medline SP - e170 EP - e170 JF - JMIR research protocols JO - JMIR Res Protoc VL - 6 IS - 8 N2 - BACKGROUND: An estimated one- to-two-thirds of new human immunodeficiency virus (HIV) infections among US men who have sex with men (MSM) occur within the context of primary partnerships. Despite this fact, there remains a lack of prevention interventions that focus on male sero-discordant dyads. Interventions that provide male couples with skills to manage HIV risk, and to support each other towards active engagement in HIV prevention and care, are urgently needed. OBJECTIVE: The objective of this paper is to describe the protocol for an innovative dyadic intervention (Stronger Together) that combines couples' HIV testing and dyadic adherence counseling to improve treatment adherence and engagement in care among HIV sero-discordant male couples in the United States. METHODS: The research activities involve a prospective randomized controlled trial (RCT) of approximately 165 venue- and clinic-recruited sero-discordant male couples (330 individuals: 165 HIV sero-negative and 165 HIV sero-positive). Couples randomized into the intervention arm receive couples' HIV counseling and testing plus dyadic adherence counseling, while those randomized to the control arm receive individual HIV counseling and testing. The study takes place in three cities: Atlanta, GA (study site Emory University); Boston, MA (study site The Fenway Institute); and Chicago, IL (study site Ann & Robert H. Lurie Children's Hospital of Chicago). Cohort recruitment began in 2015. Couples are followed prospectively for 24 months, with study assessments at baseline, 6, 12, 18, and 24 months. RESULTS: Stronger Together was launched in August 2014. To date, 160 couples (97% of the target enrollment) have been enrolled and randomized. The average retention rate across the three sites is 95%. Relationship dissolution has been relatively low, with only 13 couples breaking up during the RCT. Of the 13 couples who have broken up, 10 of the 13 HIV-positive partners have been retained in the cohort; none of these HIV-positive partners have enrolled new partners into the RCT. CONCLUSIONS: The intervention offers a unique opportunity for sero-discordant couples to support each other towards common HIV management goals by facilitating their development of tailored prevention plans via couples-based HIV testing and counseling, as well as problem-solving skills in Partner Strategies to Enhance Problem-solving Skills (STEPS). TRIAL REGISTRATION: ClinicalTrials.gov NCT01772992; https://clinicaltrials.gov/ct2/show/NCT01772992 (Archived by WebCite at http://www.webcitation.org/6szFBVk1R). SN - 1929-0748 UR - https://www.unboundmedicine.com/medline/citation/28860107/Project_Stronger_Together:_Protocol_to_Test_a_Dyadic_Intervention_to_Improve_Engagement_in_HIV_Care_Among_Sero_Discordant_Male_Couples_in_Three_US_Cities_ DB - PRIME DP - Unbound Medicine ER -
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