Couples-Based HIV Prevention in South Africa

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DESCRIPTION (provided by applicant): This K08 research career award will facilitate my development into an independent investigator in international behavioral HIV prevention research. Several training objectives will assist in the attainment of this goal. My first training objective is to acquire an advanced knowledge of African history, culture and politics (especially related to South Africa). Other training objectives include gaining the skills and experience necessary to conduct research in collaboration and with support from the local community leaders and organizations, as well as training in research ethics and specific research methodologies. The resources of the Center for AIDS Prevention Studies, and the Institute for Global Health at UCSF, as well as through the Perinatal HIV Research Unit at Chris Hani Baragwanath Hospital in Soweto, South Africa will be available to me for the completion of this project. The specific research project will explore predictors of HIV risk behavior in couples in South Africa. South Africa has the highest number of HIV-positive individuals in the world. The vast majority of HIV-positive individuals in South Africa were infected via heterosexual sex. However, very little information exists regarding the content of communication about sex in couples in South Africa. In addition, more information is needed regarding potential barriers and facilitators for couples to participate in couples-based Voluntary Counseling and Testing (VCT). Ultimately, a dyadic perspective is necessary for HIV prevention, as risk for HIV occurs within the context of a couple. To address these gaps in our knowledge, the proposed study will utilize qualitative (Study I) and dyadic level quantitative methods (Study II) to investigate these issues. The specific aims of the proposed study are to: 1. Identify via qualitative research the content of communication regarding sex with each other (e.g., condom use). 2. Identify via qualitative research the barriers and facilitators of utilizing existing couples-based VCT services. 3. Examine quantitatively how couple-level factors such as communication about sex, relationship factors (e.g., trust), and perception of risk predict couples' sexual risk and participating in couples-based VCT.