title: Adaptation of the African couples HIV testing and counseling model for men who have sex with men in the United States: an application of the ADAPT-ITT framework.
abstract: To respond to the need for new HIV prevention services for men who have sex with men (MSM) in the United States, and to respond to new data on the key role of main partnerships in US MSM epidemics, we sought to develop a new service for joint HIV testing of male couples. We used the ADAPT-ITT framework to guide our work. From May 2009 to July 2013, a multiphase process was undertaken to identify an appropriate service as the basis for adaptation, collect data to inform the adaptation, adapt the testing service, develop training materials, test the adapted service, and scale up and evaluate the initial version of the service. We chose to base our adaptation on an African couples HIV testing service that was developed in the 1980s and has been widely disseminated in low- and middle-income countries. Our adaptation was informed by qualitative data collections from MSM and HIV counselors, multiple online surveys of MSM, information gathering from key stakeholders, and theater testing of the adapted service with MSM and HIV counselors. Results of initial testing indicate that the adapted service is highly acceptable to MSM and to HIV counselors, that there are no evident harms (e.g., intimate partner violence, relationship dissolution) associated with the service, and that the service identifies a substantial number of HIV serodiscordant male couples. The story of the development and scale-up of the adapted service illustrates how multiple public and foundation funding sources can collaborate to bring a prevention adaptation from concept to public health application, touching on research, program evaluation, implementation science, and public health program delivery. The result of this process is an adapted couples HIV testing approach, with training materials and handoff from academic partners to public health for assessment of effectiveness and consideration of the potential benefits of implementation; further work is needed to optimally adapt the African couples testing service for use with male-female couples in the United States.
authors.affiliation: Department of Epidemiology, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA 30322 USA.
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Sullivan
authors.affiliation: Hubert Department of Global Health, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA 30322 USA.
authors.forename: Rob
authors.initials: R
authors.lastname: Stephenson
authors.affiliation: Howard Brown Health Center, 4025 N Sheridan Rd, Chicago, IL 60613 USA.
authors.forename: Beau
authors.initials: B
authors.lastname: Grazter
authors.affiliation: Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA 30322 USA.
authors.forename: Gina
authors.initials: G
authors.lastname: Wingood
authors.affiliation: Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA 30322 USA.
authors.forename: Ralph
authors.initials: R
authors.lastname: Diclemente
authors.affiliation: Department of Pathology and Laboratory Medicine, Emory University School of Medicine, 1364 Clifton Road, Atlanta, GA 30322 USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Allen
authors.affiliation: Center for Research and Education on Gender and Sexuality, San Francisco State University, 835 Market Street, Suites 523-525, San Francisco, CA 94103 USA.
authors.forename: Colleen
authors.initials: C
authors.lastname: Hoff
authors.affiliation: Institute for Public Health, Georgia State University, One Park Place, Suite 700, 30303 Atlanta, GA USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Salazar
authors.affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333 USA.
authors.forename: Lamont
authors.initials: L
authors.lastname: Scales
authors.affiliation: Licensed Family and Martial Therapist, 2200 Century Pkwy NE Suite 200, Atlanta, GA 30345 USA.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Montgomery
authors.affiliation: Center for Health and Behavioral Training, University of Rochester Medical Center, Rochester, NY USA.
authors.forename: Ann
authors.initials: A
authors.lastname: Schwartz
authors.affiliation: Department of Epidemiology, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA 30322 USA.
authors.forename: Jasper
authors.initials: J
authors.lastname: Barnes
authors.affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333 USA.
authors.forename: Kristina
authors.initials: K
authors.lastname: Grabbe
keywords: ADAPT-ITT; AIDS; Adaptation; Counseling; Couples; HIV; MSM; Prevention; Testing