Couple-focused intervention boosts safe-sex habits

An intervention program based on the African concept of eban — which emphasizes safety, security and love within one’s relationships — is showing promise in reducing risky behaviors among black couples in which a partner is HIV-positive, according to a study published in September’s Archives of Internal Medicine (Vol. 170, No. 17).

The multi-site study, funded by the National Institute of Mental Health, examined the effects of a couples-based HIV/STD risk-reduction intervention in four cities with high HIV-infection rates: Atlanta, Los Angeles, New York and Philadelphia. Throughout the eight-week program, facilitators taught heterosexual black couples eban-based interventions such as how to improve their communication about their HIV-related concerns and make safer behaviors such as condom use more appealing. They found that those who received the intervention reported more frequent and consistent condom use and fewer acts of unprotected sex compared with couples in an intervention that focused on general health promotion.

“In the past, what we’ve done is recommend that individuals use condoms,” says study co-author Gail Wyatt, PhD, director of the University of California, Los Angeles, Center for Culture, Trauma and Mental Health Disparities and associate director of the UCLA AIDS Institute. “What we tried to do here was promote couples’ commitment to their relationship and that using condoms was a way to show their love to their partner.”

In addition to Wyatt, principal investigators on the study included Nabila El Bassel, DSW, a professor of social work at Columbia University; John Jemmott, PhD, director of the Center for Health Behavior and Communication Research at the University of Pennsylvania’s Annenberg Public Policy Center; and Gina Wingood, ScD, director of social and behavioral science at the Center for AIDS Research at Emory University. Willo Pequegnat, PhD, a scientific adviser at NIMH, led the study.

Blacks are disproportionately affected by HIV and other sexually transmitted diseases, according to the Centers for Disease Control and Prevention. Although blacks make up 13 percent of the U.S. population, they account for nearly half of the more than 1 million Americans estimated to be living with HIV.

Psychologists have an important role to play in reversing this trend, Wyatt says.

“We test for depression and ask about other general health problems, and I think it’s important for us to also recognize that HIV status has a huge impact on health, mental health and relationship problems,” she says. “It’s an area that we need to incorporate into our everyday practice and into our everyday research designs.”

—A. Novotney