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

AIDS Behav. 2020 Jul;24(7):2091-2100. doi: 10.1007/s10461-019-02774-4.

Abstract

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.

Keywords: Couples; HIV prevention; Home-based intervention; Kenya; Maternal child health; Pregnancy.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Counseling / methods
  • Family Characteristics
  • Female
  • HIV Infections / epidemiology
  • HIV Infections / prevention & control*
  • Health Behavior
  • Humans
  • Kenya / epidemiology
  • Male
  • Pilot Projects
  • Pregnancy
  • Pregnancy Complications, Infectious / prevention & control*
  • Pregnant Women / psychology*
  • Sexual Partners / psychology*
  • Standard of Care*