Enhanced STI/HIV Partner Notification in South Africa

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DESCRIPTION (provided by applicant): This 5-year study will conduct a randomized clinical trial of a culturally tailored theory-based behavioral risk reduction and enhanced partner notification intervention for men and women who are receiving sexually transmitted infection (STI) diagnostic and treatment services in South Africa. Among the world's most severe HIV epidemics, as many as one in five South Africans living in the most affected areas are HIV positive. The experimental intervention in this study is grounded in social-cognitive theories of health behavior change and has been pre-tested in preliminary research. The intervention consists of a single 60-minute risk reduction counseling session with behavioral skills building components to enhance partner communication skills for improved partner notification. The study design includes two comparison conditions: behavioral risk reduction counseling without partner communication and notification skills enhancement, and a standard didactic health information condition. We will recruit 525 men and 525 women from a large STI clinic in Cape Town. Participants will be STI clinic patients age 18 or older who are receiving STI services. Participants will be baseline assessed and randomized to receive either (a) the 60-minute theory-based and culturally tailored risk reduction and partner communication/notification intervention; (b) a 60-minute risk reduction counseling intervention without partner communication/notification components; or (c) a time and contact matched 60-minute standard didactic health information session. Participants will be followed for 12 months post intervention. The study will test intervention effects on two primary endpoints: contracting new STI and objectively measured partner notification events. The randomized trial will determine the efficacy of the risk reduction intervention for South African men and women receiving STI clinic services. We will also test the mediating effects of partner notification on STI outcomes. Results of this research will therefore test a clinic-based HIV prevention intervention model that is urgently needed in South Africa.