title: The male factor: Outcomes from a cluster randomized field experiment with a couples-based HIV prevention intervention in a South African township.
abstract: BACKGROUND
  This study examined the effects of the Couples Health CoOp intervention on heavy drinking, condom use, and HIV incidence.
  
  
  METHODS
  Thirty neighborhoods from one South African township were cluster randomized into three intervention arms: Couples Health CoOp (CHC), Women's Health CoOp/Men's Health CoOp (WHC/MHC), or a comparison arm. We recruited 290 men from informal drinking establishments who reported drinking alcohol regularly. We also recruited their main heterosexual sex partners.
  
  
  RESULTS
  At 6-month follow-up, men in the CHC arm were less likely to report heavy drinking (OR 0.47, 95% CI: 0.25, 0.90) and were more likely to report consistent condom use during the past month (OR 2.66, 95% CI: 1.23, 5.76) than men in the comparison arm. At baseline, 26% of women and 13% of men were HIV-infected; at 6-month follow-up, 16 females and 5 males had seroconverted. HIV incidence was significantly lower among women in the CHC arm (IRR 0.22, 95% CI: 0.04, 1.01) than in the WHC/MHC arm.
  
  
  CONCLUSIONS
  A couples-based intervention focusing on intersecting risks for HIV can improve biobehavioral outcomes, underscoring the importance of engaging couples together in HIV prevention.
authors.affiliation: RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, United States; University of North Carolina, Chapel Hill, NC, United States; Department of Psychology in the Public Interest, North Carolina State University, Raleigh, NC, United States; Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States. Electronic address: wmw@rti.org.
authors.forename: Wendee M
authors.initials: WM
authors.lastname: Wechsberg
authors.affiliation: RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, United States.
authors.forename: William A
authors.initials: WA
authors.lastname: Zule
authors.affiliation: Columbia University School of Social Work, New York, NY, United States.
authors.forename: Nabila
authors.initials: N
authors.lastname: El-Bassel
authors.affiliation: RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, United States; University of North Carolina, Chapel Hill, NC, United States.
authors.forename: Irene A
authors.initials: IA
authors.lastname: Doherty
authors.affiliation: RTI International, 351 California Street, San Francisco, CA, United States.
authors.forename: Alexandra M
authors.initials: AM
authors.lastname: Minnis
authors.affiliation: RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, United States.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Novak
authors.affiliation: Alcohol, Tobacco & Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
authors.forename: Bronwyn
authors.initials: B
authors.lastname: Myers
authors.affiliation: Alcohol, Tobacco & Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa.
authors.forename: Tara
authors.initials: T
authors.lastname: Carney
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D044383:Black People; D017280:Condoms / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control*; D020010:Heterosexuality; D006801:Humans; D015994:Incidence; D008297:Male; D021841:Safe Sex; D012747:Sexual Partners; D013019:South Africa; D055815:Young Adult
keywords: Alcohol use; Condom use; Couples intervention outcomes; HIV incidence; HIV prevention; South Africa