Efficacy of a Telehealth Delivered Couples’ HIV Counseling and Testing (CHTC) Intervention to Improve Formation and Adherence to Safer Sexual Agreements Among Male Couples in the US: Results from a Randomized Control Trial

• Type of Material: Article
• Authors: Robert Stephenson, Emory University; Stephen P Sullivan, University of Michigan School of Nursing; Jason W Mitchell, Florida International University; Brent A Johnson, University of Rochestor Medical Center; Patrick S Sullvian, Emory University
• Language: English
• Date: 2022-08-01
• Publisher: Springer Nature
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022
• Final Published Version (URL): http://dx.doi.org/10.1007/s10461-022-03619-3
• Title of Journal or Parent Work: AIDS and Behavior
• Volume: 26
• Issue: 8
• Start Page: 2813
• End Page: 2824
• Grant/Funding Information: This study funded by Foundation for the National Institutes of Health (R01HD078131).
• Keywords: HIV Infections; Sexual agreements; Sexual Partners; Chitinases; HIV prevention; Risk reduction; Humans; Telemedicine; Male; Plant Proteins; RCT; Counseling; Male couples; Telehealth
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Nursing; Biology, Biostatistics

Abstract

This paper reports the results of a randomized controlled trial (RCT) to assess the efficacy of Nexus, a telehealth delivered intervention that combines Couples’ HIV counseling and testing (CHTC) with home-based HIV-testing, examining the impact of the intervention on the couples’ formation and adherence to safer sexual agreements. Between 2016 and 2018, 424 couples were recruited online from the U.S and randomized to the intervention arm (a telehealth delivered CHTC session with two home HIV-testing kits) or a control arm (two home HIV-testing kits), with study assessments at baseline, 3 and 6 months. Outcomes were the formation and adherence to safer sexual agreements, dyadic discordance in sexual agreements, breakage of sexual agreements, and perceptions of PrEP. Couples in the intervention arm had significantly greater odds of reporting a safer sexual agreement (3 months OR 1.87, p-value 0.005, and 6 months OR 1.84, p-value 0.007), lower odds of reporting discordant sexual agreements at 6 months (OR 0.62, p-value 0.048), and a significantly lower odds of reporting breaking their sexual agreement (3 months OR 0.51, p-value 0.035, and 6 months OR 0.23, p-value 0.000). By 6 months, couples in the intervention arm were less likely to say PrEP was beneficial to one (RRR 0.33, P = 0.000) or both of them (RRR 0.29, P = 0.000) than being beneficial to neither of the partners. The high levels of acceptability and efficacy of the intervention demonstrate strong potential for the scale-up of this efficacious intervention that is delivered through a low-cost telehealth platform.