Transgender women are among the populations at highest risk for HIV infection in the United States and in many international settings. HIV risk among transgender women has been attributed to condomless sex with primary male partners. This study, by associate professor of behavioral and social sciences in the Brown University School of Public Health Dr. Don Operario, pilot tested a couples-focused HIV intervention program for transgender women and their primary male partners. Entitled CHIP (Couples HIV Intervention Program), the study was adapted from Project CONNECT, a couples-focused counseling program designed to be delivered in three to five sessions to improve relationship communication, partner interpersonal dynamics, and HIV risk reduction behaviors.
[Photo: Dr. Don Operario]
The intervention consisted of three counseling sessions: two couples-focused sessions, which discussed relationship dynamics, communication, and HIV risk, and one individual-focused session on HIV prevention concerns. The sessions sought to reduce HIV risk for individuals in the context of a primary partnership. This program differs from individual-focused HIV prevention interventions by focusing on the relationship context, and by acknowledging the partnership as the unit for intervention and behavior change. In addition to reducing condomless sex among primary partners, couples-focused HIV prevention programs may also aim to promote partner communication about safer sex and to align partners’ agreements about sex outside of the relationship.
The study’s findings provide support for the feasibility and promise of a couples-focused HIV prevention intervention for transgender women and their primary male partners. At three-month follow-up, researchers found that both transgender women and cisgender male participants in the intervention group reported significant reductions in the odds of having condomless sex with their primary partners compared with those in the control, and that transgender women in the intervention group reported significant reductions in their number of partners outside the primary relationship. These data are a promising indication that the CHIP intervention facilitated couples’ communication about HIV risk reduction.
The study was published June in AIDS and Behavior.