AIDS and Behavior

, Volume 23, Issue 9, pp 2407–2420 | Cite as

A Pilot Randomized Trial of Intervention Components Addressing Drug Use in Couples HIV Testing and Counseling (CHTC) with Male Couples

  • Tyrel J. StarksEmail author
  • Trey V. Dellucci
  • Sugandha Gupta
  • Gabriel Robles
  • Rob Stephenson
  • Patrick S. Sullivan
  • Jeffrey T. Parsons
Original Paper


Men who have sex with men (MSM) experience high rates of substance use and HIV infection. Main partners are the source of many (35–68%) of these new HIV infections. This study developed and examined the efficacy of two adjunct components to couples HIV testing and counseling (CHTC)—communication training (CT) videos and a substance use module (SUM)—to reduce drug use and sexual HIV transmission risk in MSM couples. Participants included 70 male couples randomized into one of four conditions: CHTC, CHTC + CT videos, CHTC + SUM, and CHTC + CT videos + SUM. Participants completed a survey pre-intervention and 1-, 3-, and 6-months later. Completion of the SUM in the absence of CT videos was associated with significant immediate decreases in drug use and related problems; however, at 3- and 6-month follow ups, the SUM was only associated with reductions in drug use and related problems among men who also viewed the CT videos. There were no between-condition differences in sexual behavior. CHTC may serve as a vehicle for the delivery of brief substance use intervention for MSM couples. NCT # 03125915


HIV prevention HIV testing Gay couples Men who have sex with men Drug use 



The authors acknowledge the contributions of the We Test Project Team, particularly Mark Pawson, Andrew Cortopassi, Nahuel Smith Bacerra, Ruben Jimenez, Chris Hietikko, and Scott Jones. We also thank Rich Jenkins for his support of the project as well as CHEST staff, recruiters, interns and our participants who volunteered their time.


Collection and analyses of these data were supported by a National Institute on Drug Abuse Grant (R34 DA036419; PI Starks).

Compliance with Ethical Standards

Conflict of interest

Tyrel Starks, Trey Dellucci, Sugandha Gupta, Gabriel Robles, Patrick Sullivan, and Rob Stephenson have no conflicts of interest to declare. Jeffrey Parsons’ spouse is the owner of Mindful Designs, which received a contract to produce the communication skills training video tested.

Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Supplementary material

10461_2019_2455_MOESM1_ESM.doc (217 kb)
Electronic supplementary material 1 (DOC 217 kb)


  1. 1.
    Centers for Disease Control and Prevention, HIV in the United States: at a glance. 2017. U.S. Department of Health & Human Services.Google Scholar
  2. 2.
    Centers for Disease Control and Prevention, HIV Surveillance Report, 2015, Centers for Disease Control and Prevention, Editor. 2015, Centers for Disease Control and Prevention.Google Scholar
  3. 3.
    Arnett JJ. Emerging adulthood: a theory of development from the late teens through the twenties. Am Psychol. 2000;55(5):469–80.PubMedCrossRefGoogle Scholar
  4. 4.
    Goodreau SM, Carnegie NB, Vittinghoff E, et al. What drives the US and Peruvian HIV epidemics in men who have sex with men (MSM)? PLoS ONE. 2012;7(11):e50522.PubMedPubMedCentralCrossRefGoogle Scholar
  5. 5.
    Sullivan PS, Salazar L, Buchbinder S, Sanchez TH. Estimating the proportion of HIV transmissions from main sex partners among men who have sex with men in five US cities. AIDS. 2009;23(9):1153–62.PubMedCrossRefGoogle Scholar
  6. 6.
    Painter TM. Voluntary counseling and testing for couples: a high-leverage intervention for HIV/AIDS prevention in sub-Saharan Africa. Soc Sci Med. 2001;53:1397–411.PubMedCrossRefGoogle Scholar
  7. 7.
    Allen S, Serufilira A, Bogaerts J, et al. Confidential HIV testing and condom promotion in Africa. Impact on HIV and gonorrhea rates. JAMA. 1992;268(23):3338–43.PubMedCrossRefGoogle Scholar
  8. 8.
    Chomba C, Allen S, Kaweka W, et al. Evolution of couples’ voluntary counseling and testing for HIV in Lusaka, Zambia. J Acquir Immune Defic Syndr. 2008;47(1):108–15.PubMedCrossRefGoogle Scholar
  9. 9.
    Farquhar C, Kiarie JN, Richardson BA, et al. Antenatal couple counseling increases uptake of interventions to prevent HIV-1 transmission. J Acquir Immune Defic Syndr. 2004;37(5):1620–6.PubMedPubMedCentralCrossRefGoogle Scholar
  10. 10.
    Guthrie BL, de Bruyn G, Farquhar C. HIV 1 discordant couples in sub-Saharan Africa: explanations and implications for high rates of discordancy. Curr HIV Res. 2007;5(4):416–29.PubMedCrossRefGoogle Scholar
  11. 11.
    Coates TJ. Efficacy of voluntary HIV-1 counselling and testing in individuals and couples in Kenya, Tanzania, and Trinidad: a randomised trial. Lancet (British Edition). 2000;356(9224):103–12.Google Scholar
  12. 12.
    Sullivan PS, White D, Rosenberg ES, et al. Safety and acceptability of couples HIV testing and counseling for US men who have sex with men: a randomized prevention study. J Int Assoc Provid AIDS Care. 2014;13(2):135–44.PubMedCrossRefGoogle Scholar
  13. 13.
    Stephenson R, Vwalika B, Greenberg LS, et al. A randomized controlled trial to promote long-term contraceptive use among HIV-serodiscordant and concordant positive couples in Zambia. J Women’s Health. 2011;20(4):567–74.CrossRefGoogle Scholar
  14. 14.
    Centers for Disease Control and Prevention. Revised guidelines for HIV counseling, testing, and referral. MMWR. Recommendations and reports: morbidity and mortality weekly report. Recommendations and reports 2001. 50 (RR-19): 1.Google Scholar
  15. 15.
    Metsch LR, Feaster DJ, Gooden L, et al. Effect of risk-reduction counseling with rapid HIV testing on risk of acquiring sexually transmitted infections: the AWARE randomized clinical trial. JAMA. 2013;310(16):1701–10.PubMedPubMedCentralCrossRefGoogle Scholar
  16. 16.
    Rusbult CE, Van Lange PA. Interdependence, interaction, and relationships. Annu Rev Psychol. 2003;54:351–75.PubMedCrossRefGoogle Scholar
  17. 17.
    Rusbult CE, Verette J, Whitney GA, Slovik LF, Lipkus I. Accommodation processes in close relationships: theory and preliminary empirical evidence. J Pers Soc Psychol. 1991;60(1):53–78.CrossRefGoogle Scholar
  18. 18.
    Yovetich NA, Rusbult CE. Accommodative behavior in close relationships: exploring transformation of motivation. J Exp Soc Psychol. 1994;30(2):138–64.CrossRefGoogle Scholar
  19. 19.
    Kelley HH, Thibaut TW. Interpersonal relations: a theory of interdependence. New York: Wiley; 1978.Google Scholar
  20. 20.
    Goldenberg T, Finneran C, Andes KL, Stephenson RB. “Sometimes people let love conquer them”: how love, intimacy, and trust in relationships between men who have sex with men influence perceptions of sexual risk and sexual decision-making. Cult Health Sex. 2015;17(5):607–22.PubMedCrossRefGoogle Scholar
  21. 21.
    Starks TJ, Pawson M, Stephenson R, Sullivan P, Parsons JT. Dyadic qualitative analysis of condom use scripts among emerging adult gay male couples. J Sex Marital Ther. 2018;44(3):269–80.PubMedCrossRefGoogle Scholar
  22. 22.
    Hoff CC, Beougher SC. Sexual agreements among gay male couples. Arch Sex Behav. 2010;39(3):774–87.PubMedCrossRefGoogle Scholar
  23. 23.
    Hoff CC, Chakravarty D, Beougher SC, Neilands TB, Darbes LA. Relationship characteristics associated with sexual risk behavior among MSM in committed relationships. AIDS Patient Care STDs. 2012;26(12):738–45.PubMedPubMedCentralCrossRefGoogle Scholar
  24. 24.
    Rew LW, Taylor-Seehafer TA, Smith MA, Lorie R. Sexual health risks and protective resources in gay, lesbian, bisexual, and heterosexual homeless youth. J Spec Pediatr Nurs. 2005;10(1):11–9.PubMedCrossRefGoogle Scholar
  25. 25.
    Decker PJ. Effects of symbolic coding and rehearsal in behavior-modeling training. J Appl Psychol. 1980;65(6):627–34.PubMedCrossRefGoogle Scholar
  26. 26.
    Albarracin D, Gillette JC, Earl AN, et al. A test of major assumptions about behavior change: a comprehensive look at the effects fo passive and active HIV-prevention interventions since the beginning of the epidemic. Psychol Bull. 2005;13(6):856–97.CrossRefGoogle Scholar
  27. 27.
    Baldwin TT. Effects of alternative modeling strategies on outcomes of interpersonal-skills training. J Appl Psychol. 1992;77(2):147–54.PubMedCrossRefGoogle Scholar
  28. 28.
    Taylor PJ, Russ-Eft DF, Chan DWL. A meta-analytic review of behavior modeling training. J Appl Psychol. 2005;90(4):692–709.PubMedCrossRefGoogle Scholar
  29. 29.
    Centers for Disease Control and Prevention, HIV infection risk, prevention, and testing behaviors among men who have sex with men—National HIV Behavioral Surveillance, 20 U.S. Cities, 2014, 15, Editor. 2016.Google Scholar
  30. 30.
    Lewis MA, Gladstone E, Schmal S, Darbes LA. Health-related social control and relationship interdependence among gay couples. Health Educ Res. 2006;21(4):488–500.PubMedCrossRefGoogle Scholar
  31. 31.
    Moos RH. Theory-based processes that promote the remission for substance use disorders. Clin Psychol Rev. 2007;27(5):537–51.PubMedCrossRefGoogle Scholar
  32. 32.
    Parsons JT, Starks TJ. Drug use and sexual arrangements among gay couples: frequency, interdependence and associations with sexual risk. Arch Sex Behav. 2014;43(1):89–98.PubMedCrossRefGoogle Scholar
  33. 33.
    John SA, Starks TJ, Rendina HJ, Grov C, Parsons JT. Should I convince my partner to go on pre-exposure prophylaxis (PrEP)? The role of personal and relationship factors on PrEP-related social control among gay and bisexual men. AIDS Behav. 2018;22(4):1239–52.PubMedPubMedCentralCrossRefGoogle Scholar
  34. 34.
    Feinstein BA, Newcomb ME. Event-level associations among drinking motives, alcohol consumption, and condomless anal sex in a sample of young men who have sex with men. AIDS Behav. 2017;21(7):1904–13.PubMedPubMedCentralCrossRefGoogle Scholar
  35. 35.
    Phillips G, Kalmin MM, Turner B, et al. Condom and substance use at last sex: differences between MSMO and MSWO high school youth. Int J Environ Res Public Health. 2018;15(5):995.PubMedCentralCrossRefGoogle Scholar
  36. 36.
    Saitz R, Palfai TPA, Cheng DM, et al. Screening and brief intervention for drug use in primary care: the ASPIRE randomized clinical trial. JAMA. 2014;312(5):502–13.PubMedPubMedCentralCrossRefGoogle Scholar
  37. 37.
    Samson JE, Tanner-Smith EE. Single-session alcohol interventions for heavy drinking college students: a systematic review and meta-analysis. J Stud Alcohol Drugs. 2015;76(4):530–43.PubMedPubMedCentralCrossRefGoogle Scholar
  38. 38.
    McCambridge J, Strang J. The efficacy of single-session motivational interviewing in reducing drug consumption and perceptions of drug-related risk and harm among young people: results from a multi-site cluster randomized trial. Addiction. 2004;99(1):39–52.PubMedCrossRefGoogle Scholar
  39. 39.
    Borsari B, Carey KB. Effects of a brief motivational intervention with college student drinkers. J Consult Clin Psychol. 2000;68(4):728–33.PubMedCrossRefGoogle Scholar
  40. 40.
    Miller WR, Rollnick S. Motivational interviewing. 3rd ed. New York: Guilford Press; 2013.Google Scholar
  41. 41.
    Kahler CW, Pantalone DW, Mastroleo NR, et al. Motivational interviewing with personalized feedback to reduce alcohol use in HIV-infected men who have sex with men: a randomized controlled trial. J Consult Clin Psychol. 2018;86(8):645–56.PubMedPubMedCentralCrossRefGoogle Scholar
  42. 42.
    Wang Z, Lau JTF, Ip M, et al. A randomized controlled trial evaluating efficacy of promoting a home-based HIV self-testing with online counseling on increasing HIV testing among men who have sex with men. AIDS Behav. 2018;22(1):190–201.PubMedCrossRefGoogle Scholar
  43. 43.
    Parsons JT, Lelutiu-Weinberger C, Botsko M, Golub SA. A randomized controlled trial utilizing motivational interviewing to reduce HIV risk and drug use in young gay and bisexual men. J Consult Clin Psychol. 2014;82(1):9–18.PubMedCrossRefGoogle Scholar
  44. 44.
    Chen J, Li X, Xiong Y, et al. Reducing the risk of HIV transmission among men who have sex with men: a feasibility study of the motivational interviewing counseling method. Nurs Health Sci. 2016;18(3):400–7.PubMedCrossRefGoogle Scholar
  45. 45.
    Prevention, C.F.D.C.A. Couples HIV counseling and testing intervention and training curriculum. 2011. Accessed 26 Feb 2019.
  46. 46.
    Prevention, C.F.D.C.A. Couples HIV testing and counseling (CHTC): in health care facilities, trainer’s manual. 2011. Accessed 26 Feb 2019.
  47. 47.
    Stephenson RB, Finneran C. The IPV-GBM scale: a new scale to measure intimate partner violence among gay and bisexual men. PLoS ONE. 2013;8(6):e62592.PubMedPubMedCentralCrossRefGoogle Scholar
  48. 48.
    Pruitt KL, White D, Mitchell JW, Stephenson R. Sexual agreements and intimate-partner violence among male couples. Int J Sex Health. 2015;27(4):429–41.CrossRefGoogle Scholar
  49. 49.
    Stephenson RB, Freeland R, Finneran C. Intimate partner violence and condom negotiation efficacy among gay and bisexual men in Atlanta. Sex health. 2016;13(4):366–72.CrossRefGoogle Scholar
  50. 50.
    Mimiaga MJ, Pantalone DW, Biello KB, et al. A randomized controlled efficacy trial of behavioral activation for concurrent stimulant use and sexual risk for HIV acquisition among MSM: project IMPACT study protocol. BMC Public Health. 2018;18(1):914.PubMedPubMedCentralCrossRefGoogle Scholar
  51. 51.
    Avivi YE, Laurenceau JP, Carver CS. Linking relationship quality to perceived mutuality of relationship goals and perceived goal progress. J Soc Clin Psychol. 2009;28(2):137–64.CrossRefGoogle Scholar
  52. 52.
    Feeney BC. A secure base: responsive support of goal strivings and exploration in adult intimate relationships. J Pers Soc Psychol. 2004;87(5):631–48.PubMedCrossRefGoogle Scholar
  53. 53.
    Sullivan PS, White D, Rosenberg ES, et al. Safety and acceptability of couples HIV testing and counseling for US men who have sex with men: a randomized prevention study. J Int Assoc Provid AIDS Care. 2014;13(2):135–44.PubMedCrossRefGoogle Scholar
  54. 54.
    Newcomb ME, Macapagal KR, Feinstein BA, et al. Integrating HIV prevention and relationship education for young same-sex male couples: a pilot trial of the 2GETHER intervention. AIDS Behav. 2017;21(8):2464–78.PubMedPubMedCentralCrossRefGoogle Scholar
  55. 55.
    Wu E, El-Bassel N, McVinney LD, et al. Feasibility and promise of a couple-based HIV/STI preventive intervention for methamphetamine-using, black men who have sex with men. AIDS Behav. 2011;15(8):1745–54.PubMedPubMedCentralCrossRefGoogle Scholar
  56. 56.
    Parsons JT, Rendina HJ, Lassiter JM, et al. Uptake of HIV pre-exposure prophylaxis (PrEP) in a national sample of gay and bisexual men in the United States: the motivational PrEP Cascade. JAIDS J Acquir Immune Defic Syndr. 2017;74(3):285–92.PubMedCrossRefGoogle Scholar
  57. 57.
    Starks TJ, Millar BM, Parsons JT. Correlates of individual versus joint participation in online survey research with same-sex male couples. AIDS Behav. 2015;19(6):963–9.PubMedPubMedCentralCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of PsychologyHunter College of the City University of New York (CUNY)New YorkUSA
  2. 2.Health Psychology and Clinical Science Doctoral ProgramGraduate Center of CUNYNew YorkUSA
  3. 3.Center for HIV/AIDS Educational Studies and Training (CHEST)New YorkUSA
  4. 4.Department of Systems, Population and Leadership, School of Nursing, and The Center for Sexuality and Health DisparitiesUniversity of MichiganAnn ArborUSA
  5. 5.Department of Epidemiology, Rollins School of Public HealthEmory UniversityAtlantaUSA

Personalised recommendations