Enhanced HIV Prevention in Couples: Feasibility Study #1
Condition: Human Immunodeficiency Virus (HIV); Acquired Immune Deficiency Syndrome (AIDS)
MeSH terms: Acquired Immunodeficiency Syndrome; HIV Infections; Immunologic Deficiency Syndromes
Study type: Observational

Summary: 
      The purpose of this study is to gather information needed to develop a large prevention trial
      to decrease the risk for HIV transmission among HIV-discordant couples (where one person is
      HIV-positive and the other is HIVnegative) in Lesotho. The protocol team would like to learn
      more about men, women and couples in Lesotho and what they think about various topics related
      to HIV, including HIV testing and counseling, male circumcision and HIV treatment.

      There will be three parts to the study including 1) a survey 2) focus group discussions; and
      3) in-depth interviews. Two hundred pregnant or recently postpartum women will be recruited
      to participate in the survey. Women who answer the questionnaire will also be asked to
      participate in the focus groups. A total of 6-8 groups consisting of 6-12 women each will be
      conducted. Thirty men from the community will be recruited to participate in an in-depth
      individual interview.
    

Detailed description: 
      Studies to date indicate that HIV negative partners within HIV-discordant couples (where one
      partner is HIV+ and the other is HIV-) are at substantial risk of acquiring HIV infection and
      that such transmission may play animportant role in heterosexual transmission of HIV in
      countries with high seroprevalence in sub-Saharan Africa. The purpose of this study is to
      conduct preparatory research needed to design and implement an HIV-prevention intervention
      trial aimed at decreasing the risk for HIV infection among HIV-discordant couples in Lesotho.

      Using both quantitative and qualitative research methods, the study aims to:

        -  Establish baseline characteristics of the proposed study population, speciﬁcally
           pregnant and recently postpartum women and of men in Lesotho

        -  Explore the types of sexual and social relationships that exist between men and women in
           Lesotho

        -  Assess individual knowledge, understanding and perceptions around different HIV
           prevention strategies, including HIV testing and treatment, couples counseling and male
           circumcision

        -  Identify interpersonal and individual-level barriers to accessing these types of HIV
           prevention interventions.

      There will be three study components including 1) quantitative survey 2) focus group
      discussions; and 3) in-depth individual interviews. A quantitative cross-sectional survey
      will be administered to 200 pregnant and recently postpartum women. Qualitative components
      will be based on open-ended iterative inquiry via focus group discussions and in-depth
      interviews with two groups: (1) pregnant and recently postpartum women; and (2) men. Data
      gathered during this study will inform the study design and intervention components of the
      proposed prevention intervention study.
    

Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Pregnant and postpartum women within 6 months of delivery and men will be enrolled.

        This feasibility study is targeting women seeking care in ANCs as these clinics are where
        large numbers of women learn their HIV status and become engaged in HIV prevention and/or
        care and treatment services. It is through these women that men from the community will be
        recruited for participation in the study.
      
Keywords: Discordant; Lesotho; Couples; Enhanced Prevention Package (EPP); ART; Counseling; Male Circumcision