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

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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.

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Acknowledgements

The authors thank the dedicated staff of FACES who contributed their time and logistical support to this project. The authors acknowledge the important role of the KEMRI-UCSF Collaborative group, the Director of KEMRI, the Director of KEMRI’s Centre for Microbiology, and the Nyanza Provincial Ministries for their support in conducting this research. The research described in this manuscript was supported by the U.S. National Institute of Mental Health (NIMH), though Grant R34MH102103. This work was also supported in part by the University of Alabama at Birmingham Center for AIDS Research (P30 AI027767). The content is solely the responsibility of the authors and does not necessarily represent the official views of the U.S. National Institutes of Health.

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Authors and Affiliations

  1. Division of HIV/AIDS, Department of Medicine, University of California, 995 Potrero Avenue, Building 80, San Francisco, CA, 94110, USA

    Abigail M. Hatcher

  2. School of Public Health, University of Witwatersrand, Johannesburg, South Africa

    Abigail M. Hatcher

  3. Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA

    Lynae Darbes

  4. Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya

    Zachary Kwena, George Owino & Elizabeth A. Bukusi

  5. Department of Global Health and Obstetrics and Gynecology, University of Washington, Seattle, WA, USA

    Pamela L. Musoke, Anna Joy Rogers & Elizabeth A. Bukusi

  6. Department of Reproductive Health Sciences, University of California San Francisco, San Francisco, CA, USA

    Elizabeth A. Bukusi

  7. Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA

    Anna Helova & Janet M. Turan

  8. Sparkman Center for Global Health, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA

    Anna Helova, Jami L. Anderson & Janet M. Turan

  9. Research Care and Training Programme, Family AIDS Care and Educational Services, Kisumu, Kenya

    Patrick Oyaro

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  1. Abigail M. Hatcher
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Hatcher, A.M., Darbes, L., Kwena, Z. et al. Pathways for HIV Prevention Behaviors Following a Home-Based Couples Intervention for Pregnant Women and Male Partners in Kenya. AIDS Behav 24, 2091–2100 (2020). https://doi.org/10.1007/s10461-019-02774-4

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