Evaluating the efficacy of annual CHTC retesting among male couples at high risk of HIV infection

项目总结

Project Summary Sexual minority men (SMM), including gay, bisexual, and other men who have sex with men, account for 69% of new HIV infections in the US. Primary partnerships have been linked to up to as many as 68% of new HIV infections among SMM. This rate is highest among emerging adult SMM (aged 18-29), where estimates suggest 79% to 84% of HIV infections are transmitted by primary partners. In response to the concerns posed by primary partner transmission, couples HIV testing and counseling (CHTC) has been acknowledged as an established HIV prevention strategy. During CHTC, couples complete HIV testing and prevention planning together. Current CHTC guidance includes the recommendation that all couples routinely retest every 6 to 12 months. Despite the standard nature of this retesting recommendation, no study has empirically evaluated the effects of CHTC retesting. This competitive revision capitalizes on NIH investment in the parent study (DA050508) to obtain the first outcomes data on annual CHTC retesting. DA050508 is currently enrolling 240 male couples living in the US in which at least one partner: is age 17 to 29; is HIV-negative; and reports recent (past 30 days) drug use (e.g., cannabis, cocaine/crack, amphetamines, ecstasy, gamma hydroxybutyric acid, ketamine, or nitrates), and recent (past 3 months) sexual HIV transmission risk behavior. As part of their participation in DA050508, all couples complete a CHTC session after baseline. They subsequently complete follow-up assessments at 3, 6, 9, and 12-months post- baseline. The purpose of this revision is to evaluate the benefits associated with CHTC resting. After their 12- month follow-up, those participants who remain in the same relationship they were in at the time of their baseline will be offered the opportunity to continue in the components proposed in this revision. Those who consent will be randomized to either complete a second session of CHTC or to a comparison condition in which both partners receive a routine individual HIV test. HIV positive partners in serodiscordant couples randomized to the control condition will receive information about ART adherence and U=U. Given potential attrition and rates of relationship dissolution, we anticipate randomizing 200 couples (80% of the original sample). Follow-up assessments will be conducted 3 and 6 months after retesting (15 and 18 months after the participants’ original baseline appointment).