Couples Advancing Together for Safer Conception (CAT-SC): A couples’-based intervention to improve engagement in sexual and reproductive health services for mobile fisherfolk in Kenya

项目摘要/摘要 肯尼亚西部维多利亚湖沿岸流动渔民和他们的合作伙伴是需要帮助的弱势群体 改善性健康和生殖健康(SRH)/艾滋病毒预防工作，因为它们具有高流动性、高 艾滋病毒流行率，艾滋病毒护理参与度低，以及高危性行为，如关系一致 以及当地的交易性经济。更安全的概念(SC)是一种预防艾滋病毒传播的战略，是 作为终身艾滋病毒预防努力的切入点，但目前提高SC摄入量的干预措施已经 忽视了夫妻关系的动态(例如沟通技巧)。这项K01提案是为了支持 萨拉·古汀博士的长期职业目标是成为一名独立的社会行为科学家 关于夫妻参与和促进男性参与性生殖健康/艾滋病毒预防服务的创新研究。 为了实现这一职业目标，并与一个专门的指导团队合作，古廷博士建议进行培训 对：1)掌握移动人际关系心理学的理论和研究知识 2)开发混合方法技能，以收集、分析和整合二元定性和 量化数据；以及3)获得基于夫妻的行为干预适应、实施和 分析技巧。总体研究目标是适应以夫妻为基础的创新艾滋病毒预防 干预，‘Jamii Bora’，并评估干预措施在促进男性参与SC方面的潜力 流动情侣。具体目标是：1)确定男性参与的二元性障碍和促进者 2)修改Jamii Bora干预措施，以提高肯尼亚渔民在SC中的男性参与度；以及3) 评估干预措施的可行性、可接受性和实施情况。目标1将使用并元混合方法 包括定性深度访谈、调查试点和定量调查。在《目标2》中，古廷博士将 调整Jamii Bora夫妇的干预措施，以适应渔民及其主要女性伴侣的反馈 流动夫妇和医疗保健提供者，他们将参加单独的干预设计研讨会。在AIM 古廷博士将对适应性干预进行初步评估，以评估可行性和 可接受性。这项拟议的研究将采用以夫妇为基础的创新干预方法来 改善关系动态(例如，交流)，这是影响移动伴侣SC的迫切需要 在SRH/HIV服务中的吸收和保留。这一综合培训和研究计划将使古廷博士做好准备 开始独立的研究事业，对不同人群和健康状况的夫妇进行研究 结果，并为试点测试夫妇的干预提供初步数据，随后随机进行 与流动情侣进行试验。通过专注于研究来改善夫妻的关系环境 不成比例地背负着艾滋病毒的负担，有可能限制艾滋病毒的传播风险，并改善长期感染情况 性生殖健康/艾滋病毒预防行为和服务。

PROJECT SUMMARY / ABSTRACT Mobile fishermen and their partners along Lake Victoria in western Kenya are a vulnerable population in need of improved sexual and reproductive health (SRH)/HIV prevention efforts because of their high mobility, high HIV prevalence, poor HIV care engagement, and high-risk sexual behaviors such as relationship concurrency and a local transactional sex economy. Safer conception (SC) is a strategy to prevent HIV transmission and is an entry point for life-long HIV prevention efforts, but current interventions to improve SC uptake have neglected to address couple relationship dynamics (e.g. communication skills). This K01 proposal is to support Dr. Sarah Gutin’s long-term career goal to become an independent social-behavioral scientist conducting innovative research on engaging couples and promoting male engagement in SRH/HIV prevention services. To achieve this career goal, and in collaboration with a dedicated mentorship team, Dr. Gutin proposes training to: 1) gain knowledge of theories and research on the psychology of interpersonal relationships in mobile populations; 2) develop mixed methods skills to collect, analyze, and integrate dyadic qualitative and quantitative data; and 3) acquire couples-based behavioral intervention adaptation, implementation, and analytic skills. The overall research objective is to adapt an innovative couples-based HIV prevention intervention, ‘Jamii Bora’ and assess the interventions’ potential to promote male engagement for SC among mobile couples. The specific aims are to: 1) identify dyadic-level barriers and facilitators to male engagement in SC; 2) adapt the Jamii Bora intervention to improve male engagement in SC among Kenyan fisherfolk; and 3) assess intervention feasibility, acceptability, and implementation. Dyadic mixed methods will be used in Aim 1 including qualitative in-depth interviews, survey piloting, and a quantitative survey. In Aim 2, Dr. Gutin will adapt the Jamii Bora couples’ intervention for fishermen and their primary female partners with feedback from mobile couples and healthcare providers who will take part in separate intervention design workshops. In Aim 3, Dr. Gutin will conduct a preliminary assessment of the adapted intervention to evaluate feasibility and acceptability. The proposed research will employ an innovative couples-based intervention approach to improve relationship dynamics (e.g., communication) that are urgently needed to impact mobile couples’ SC uptake and retention in SRH/HIV services. This integrated training and research plan will prepare Dr. Gutin to launch an independent research career conducting couples research with varied populations and health outcomes, and provide preliminary data for a pilot to test the couples’ intervention, followed by a randomized trial with mobile couples. By focusing on research to improve the relationship context for couples disproportionately burdened by HIV, it is possible to limit HIV transmission risks and improve long-term uptake of SRH/HIV preventive behaviors and services.