Adaptation of the African couples HIV testing and counseling model for men who have sex with men in the United States: an application of the ADAPT-ITT framework

• Type of Material: Article
• Authors: Patrick Sullivan, Emory University; Robert Stephenson, Emory University; Beau Grazter, Howard Brown Health Center; Gina Wingood, Emory University; Ralph Diclemente, Emory University; Susan Allen, Emory University; Colleen Hoff, San Francisco State University; Laura Salazar, Georgia State University; Lamont Scales, Centers for Disease Control and Prevention; Jeanne Montgomery, Licensed Family and Martial Therapist; Ann Schwartz, University of Rochester; Jasper Barnes, Emory University; Kristina Grabbe, Centers for Disease Control and Prevention
• Language: English
• Date: 2014-05-16
• Publisher: SpringerOpen
• Publication Version: Final Published Version
• Copyright Statement: © 2014 Sullivan et al.; licensee Springer.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/2193-1801-3-249
• Title of Journal or Parent Work: SpringerPlus
• ISSN: 2193-1801
• Volume: 3
• Issue: 1
• Start Page: 1
• End Page: 13
• Grant/Funding Information: This work was supported by the National Institute of Mental Health (grant number R34-MH086331), the Emory Center for AIDS Research (grant number P30-AI050409), and the MAC AIDS Fund. We thank AID Atlanta for providing space for the research activities, and Adam Carpenter and Erik Schwab for editorial support.
• Keywords: INTERVENTION; Science & Technology; Testing; AIDS; GAY; AGREEMENTS; MSM; PARTNERS; ADAPT-ITT; BEHAVIOR; PREVENTION; Counseling; HIV; Adaptation; US CITIES; Couples; Multidisciplinary Sciences; Science & Technology - Other Topics; Prevention; DISCORDANT COUPLES; WOMEN
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Public Health

Abstract

To respond to the need for new HIV prevention services for men who have sex with men (MSM) in the United States, and to respond to new data on the key role of main partnerships in US MSM epidemics, we sought to develop a new service for joint HIV testing of male couples. We used the ADAPT-ITT framework to guide our work. From May 2009 to July 2013, a multiphase process was undertaken to identify an appropriate service as the basis for adaptation, collect data to inform the adaptation, adapt the testing service, develop training materials, test the adapted service, and scale up and evaluate the initial version of the service. We chose to base our adaptation on an African couples HIV testing service that was developed in the 1980s and has been widely disseminated in low- and middle-income countries. Our adaptation was informed by qualitative data collections from MSM and HIV counselors, multiple online surveys of MSM, information gathering from key stakeholders, and theater testing of the adapted service with MSM and HIV counselors. Results of initial testing indicate that the adapted service is highly acceptable to MSM and to HIV counselors, that there are no evident harms (e.g., intimate partner violence, relationship dissolution) associated with the service, and that the service identifies a substantial number of HIV serodiscordant male couples. The story of the development and scale-up of the adapted service illustrates how multiple public and foundation funding sources can collaborate to bring a prevention adaptation from concept to public health application, touching on research, program evaluation, implementation science, and public health program delivery. The result of this process is an adapted couples HIV testing approach, with training materials and handoff from academic partners to public health for assessment of effectiveness and consideration of the potential benefits of implementation; further work is needed to optimally adapt the African couples testing service for use with male-female couples in the United States.