Pathways for HIV Prevention Behaviors Following a Home-Based Couples Intervention for Pregnant Women and Male Partners in Kenya

• Published in: AIDS and behavior 2020-07, Vol.24 (7), p.2091-2100
• Main Authors: Hatcher, Abigail M., Darbes, Lynae, Kwena, Zachary, Musoke, Pamela L., Rogers, Anna Joy, Owino, George, Helova, Anna, Anderson, Jami L., Oyaro, Patrick, Bukusi, Elizabeth A., Turan, Janet M.
• Format: Article
• Language: English
• Subjects: Action; Childrens health; Communication; Counseling; Counseling - methods; Couples; Disease prevention; Family Characteristics; Female; Health Behavior; Health education; Health Psychology; Health risk assessment; Health risks; HIV; HIV Infections - epidemiology; HIV Infections - prevention & control; Human immunodeficiency virus; Humans; Infants; Infectious Diseases; Intervention; Kenya - epidemiology; Male; Medicine; Medicine & Public Health; Multivariate statistical analysis; Original Paper; Pilot Projects; Postpartum; Pregnancy; Pregnancy Complications, Infectious - prevention & control; Pregnant Women - psychology; Prevention; Public Health; Regression analysis; Secondary analysis; Sexual Partners - psychology; Standard of Care; Structural equation modeling; Women; Womens health
• ISSN: 1090-7165; 1573-3254
• DOI: 10.1007/s10461-019-02774-4

Pregnancy is a time of heightened HIV risk, but also a phase when a couple can prioritize family health. We conducted secondary analysis of a home-based intervention in rural Kenya to explore couple-level adherence to HIV prevention behaviors. The intervention included health education, relationship-building skills, and Couples HIV Testing and Counseling. Pregnant women were randomized to the intervention (n = 64) or standard care (n = 63) along with male partners. Of 96 couples, 82 (85.0%) were followed to 3 months postpartum, when 31.0% of couples reported perfect adherence to HIV prevention. In logistic regression, intervention condition couples had three-fold higher odds of perfect adherence (AOR = 3.07, 95% CI = 1.01–9.32). A structural equation model found the intervention had moderate effects on couple communication, large effects on couple efficacy to take action around HIV, which in turn improved HIV prevention behaviors (CFI = 0.969; TLI = 0.955; RMSEA = 0.049). Strengthening couple communication and efficacy may help prevent the spread of HIV to infants or partners around the time of pregnancy.