The Couples Health CoOp intervention addresses risk for HIV, gender-based violence, & drug use in South African couples

Couples-based interventions provide an opportunity to address interpersonal and dyadic factors attributed to gender-based violence, alcohol and other drug use, safe sex and condom use, and communication and negotiation skills in a format that engages both partners. This partnered approach may reduce the risk for HIV acquisition. However, few intersectional couples-based interventions exist or have been proven efficacious. RTI researchers implemented and assessed the impact of using the Couples Health CoOp (CHC) intervention to reduce gender-based violence, drug use, and HIV risk in couples in South Africa.

The Couples Health CoOp (CHC) intervention is a cue-card delivered couples-based intervention approach based on the evidence-based Women’s Health CoOp (WHC), developed by Dr. Wendee Wechsberg, and is grounded in feminist theory. The study tested the efficacy of the CHC intervention compared to women’s-only and men’s-only interventions.

This CHC study was a three-arm randomized-cluster design conducted by RTI in the Western Cape township of Khayelitsha. Participants were 300 couples who met the study’s eligibility criteria recruited from taverns and shebeens (informal drinking establishments). The CHC extended the WHC intervention through couples workshops facilitated by both men and women that addressed topics like communication and sexual expectations and provided participating couples with take-home exercises and a handbook to bolster what was covered in the workshops.

Since 2015, RTI has published several articles evaluating different aspects of the CHC, including the intervention’s long-term effects, the importance of the couple’s workshop format, reduction in alcohol consumption, partner HIV status and testing disclosure, and gender-based violence. Examples of reported findings as a result of the couples-based intervention include:

• Participants reported an increase in male condom use and a decrease in HIV incidence rate compared to those who did not receive the CHC intervention.
• Women reported increased levels of empowerment when they participated in the CHC intervention, but larger gains in relationship equity were reported by participants who received the WHC/MHC separately.
• Long-term effects of the CHC intervention include positive changes in communication and healthier sexual behaviors.

Learn more about the RTI Global Gender Center and the Substance Use, Gender, and Applied Research Program.

Adapting an evidence-based HIV behavioral intervention for South African couples

Contextualizing gender differences and methamphetamine use with HIV prevalence within a South African community

The male factor: Outcomes from a cluster randomized field experiment with a couples-based HIV prevention intervention in a South African township

Relationship power, communication, and violence among couples: results of a cluster-randomized HIV prevention study in a South African township

Seek, test and disclose: Knowledge of HIV testing and serostatus among high-risk couples in a South African township

A South African Couple-Based HIV Prevention Program: Preliminary Evidence of the Long-Term Effects

Substance use, gender inequity, violence and sexual risk among couples in Cape Town

The intersecting risks of substance use and HIV risk among substance-using South African men and women

Couple-Based Behavioral HIV Interventions: Placing HIV Risk-Reduction Responsibility and Agency on the Female and Male Dyad