方案：评估在南非夸祖鲁-纳塔尔省农村地区实施优化的以夫妇为重点的干预措施，以增加艾滋病毒检测的效果，该方案以伊古古莱索（“我们的宝贝”）队列研究为基础。

Protocol: evaluation of an optimised couples-focused intervention to increase testing for HIV in rural KwaZulu-Natal, South Africa, the Igugu Lethu ('Our treasure') cohort study.

机构信息

CHERISH programme, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK.

Department of Social Statistics & Demography, Faculty of Social Sciences, University of Southampton, Southampton, UK.

出版信息

BMC Public Health. 2022 Aug 19;22(1):1577. doi: 10.1186/s12889-022-13894-3.

DOI:10.1186/s12889-022-13894-3

PMID:35986344

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9389496/

Abstract

BACKGROUND

Between 2012 and 2015, the Uthando Lwethu (UL) study demonstrated that a theory-based behavioural couples-focused intervention significantly increased participation in couples HIV testing and counselling (CHTC) among South African couples who had never previously tested for HIV together or mutually disclosed their HIV status, 42% compared to 12% of the control group at 9 months follow-up. Although effective, we were nonetheless concerned that in this high prevalence setting the majority (58%) of intervention couples chose not to test together. In response we optimised the UL intervention and in a new study, 'Igugu Lethu', we are evaluating the success of the optimised intervention in promoting CHTC.

METHODS

One hundred eighty heterosexual couples, who have been in a relationship together for at least 6 months, are being recruited and offered the optimised couples-focused intervention. In the Igugu Lethu study, we have expanded the health screening visit offered to couples to include other health conditions in addition to CHTC. Enrolled couples who choose to schedule CHTC will also have the opportunity to undertake a random blood glucose test, blood pressure and BMI measurements, and self-sample for STI testing as part of their health screening. Individual surveys are administered at baseline, 4 weeks and 4 months follow-up. The proportion of couples who decide to test together for HIV will be compared to the results of the intervention arm in the UL study (historical controls). To facilitate this comparison, we will use the same recruitment and follow-up strategies in the same community as the previous UL study.

DISCUSSION

By strengthening communication and functioning within the relationship, the Igugu Lethu study, like the previous UL study, aims to transform the motivation of individual partners from a focus on their own health to shared health as a couple. The Igugu Lethu study findings will answer whether the optimised couples-focused behavioural intervention and offering CHTC as part of a broader health screening for couples can increase uptake of CHTC by 40%, an outcome that would be highly desirable in populations with high HIV prevalence.

TRIAL REGISTRATION

Retrospectively registered. ISRCTN Registry ISRCTN 46162564 Registered on 26th May 2022.

摘要

背景

在 2012 年至 2015 年间，Uthando Lwethu（UL）研究表明，基于理论的行为夫妇为重点的干预措施显著增加了南非夫妇中从未一起接受过 HIV 检测或相互披露 HIV 状况的夫妇参与 HIV 检测和咨询（CHTC），在 9 个月的随访中，干预组的比例为 42%，而对照组为 12%。尽管有效，但我们仍然担心，在这种高流行率的环境下，大多数（58%）干预组的夫妇选择不一起检测。有鉴于此，我们对 UL 干预措施进行了优化，并在一项新的研究“Igugu Lethu”中，我们正在评估优化后的干预措施在促进 CHTC 方面的成功。

方法

180 对已经在一起至少 6 个月的异性夫妇正在接受招募，并提供优化的夫妇为重点的干预措施。在 Igugu Lethu 研究中，我们将向夫妇提供的健康筛查访问扩大到包括 CHTC 以外的其他健康状况。选择安排 CHTC 的参与夫妇也将有机会进行随机血糖测试、血压和 BMI 测量，并作为其健康筛查的一部分进行自我样本性病检测。在基线、4 周和 4 个月的随访时进行个体调查。将比较决定一起接受 HIV 检测的夫妇比例与 UL 研究中的干预组（历史对照）的结果。为了便于进行比较，我们将在与之前 UL 研究相同的社区中使用相同的招募和随访策略。

讨论

通过加强关系中的沟通和功能，Igugu Lethu 研究与之前的 UL 研究一样，旨在将个体伴侣的动机从关注自身健康转变为关注夫妻共同健康。Igugu Lethu 研究的结果将回答，经过优化的夫妇为重点的行为干预措施和将 CHTC 作为夫妻更广泛健康筛查的一部分，是否可以将 CHTC 的接受率提高 40%，这是在 HIV 高流行率人群中非常理想的结果。