It Takes Two to Combat HIV Transmission
A new study from Columbia University’s Social Intervention Group confirms the success of couple-based intervention in reducing risky sexual behaviors in criminal justice settings.
Columbia University’s Social Intervention Group (SIG), led by Dr. Nabila El-Bassel, has successfully proven a new approach to reducing sexual risk behaviors among men in community supervision programs—often assigned as alternatives to incarceration programs—and their female sex partners. Participants in the novel couple-based intervention, called PACT (Protect and Connect), were less likely to engage in risky sexual behaviors. The findings, published this week by JAMA Network Open, suggest that a couple-based intervention may curb the HIV/STI epidemic among men in community supervision programs.
“I cannot overstate the significance of this study,” said Dr. El-Bassel, director of SIG. “By bringing men from community supervision programs and their female partners to learn together as a dyad about safe sex practices, and to build communication skills and healthy relationships, they reduced their sexual risk behaviors and improved communication skills. These outcomes indicate that it takes two to combat the HIV epidemic.”
The findings by Dr. El-Bassel and her team at SIG were detailed in a paper titled, “Effectiveness of a Couple-Based HIV and Sexually Transmitted Infection Prevention Intervention for Men in Community Supervision Programs and Their Female Sexual Partners.” JAMA Network Open is a journal of the American Medical Association.
The five-year randomized clinical trial conducted in New York City included 230 drug-involved men in community supervision programs and their primary female partners. Couples in the control arm received one session of HIV counseling, testing, and referral (CTR) to different services. Those in the PACT intervention arm received five sessions, which included CTR in addition to a robust round of intervention components on communication skills, condom negotiation skills, safe sex practices, healthy relationship strategies, linkage to HIV and drug use services, and exposure to biomedical prevention strategies such as PEP, PrEP, etc. Participants in the PACT arm reported substantial and consistent reductions in behaviors leading to HIV and STI acquisition and transmission, including sex without a condom, multiple sexual partners, and sex under the influence of drugs and alcohol.
The PACT intervention’s strength is in addressing the intersections of HIV, drug use, and the criminal justice system, as well as men’s agency in their healthcare. Because the intervention approach engages the couple together as a dyad, the female is not left with the burden of negotiating safer sex alone, which Dr. El-Bassel’s prior research has shown can lead to violence.
A recent commentary on behalf of JAMA Network Open praised the study: “In an innovative move, El-Bassel and colleagues apply their extensive experience with relationship-based HIV and sexually transmitted infection (STI) prevention for heterosexual couples to men under community supervision and their female partners.”
Dr. El-Bassel and her team conclude that the PACT approach can be successfully scaled up to curb the HIV epidemic in community supervision programs and other criminal justice settings, as well as in community-based organizations, primary care and healthcare clinics, drug treatment programs, and other settings.
For almost 30 years, SIG has developed and implemented evidence-based sustainable solutions to emerging health and social issues affecting diverse populations domestically and globally. SIG also houses two training programs to mentor and train the next generation of scientists from underrepresented affected communities to address these issues. Learn more at sig.columbia.edu.
