This study seeks to develop, implement and assess an innovative 15-session couple-based intervention to be delivered in a group format to young parents that aims to strengthen relationships and reduce HIV risk. Few HIV prevention interventions incorporate emotion and relationship factors into risk reduction. Using the guiding framework of Attachment Theory and the principles of Emotion Focused Therapy, we will directly address issues of emotion, intimacy, and relationship functioning to create an intervention that strengthens romantic relationships and reduces HIV risk behavior. Our intervention will be integrated with an existing community based parenting program. The ultimate goal of our intervention is to reduce HIV/STD risk (concurrency, number of partners, unprotected sex), strengthen relationships, and improve parenting among young parenting heterosexual couples. The study will first consist of the development of the intervention. This will be achieved by conducting 4 focus groups of 8-10 young parenting men and women to gather information about the content, structure and implementation of the intervention. We will also conduct 8-10 key informant interviews of clinicians, social workers, and community leaders to assess possible barriers to intervention implementation, as well as information about intervention structure. We will use the results from the focus groups and key informant interviews to develop and modify intervention content and delivery materials. We will conduct a pilot of the intervention with six couples employing rigorous qualitative evaluation before conducting a small pilot randomized controlled trial of 42 parenting couples randomized to either the relationship strengthening HIV prevention intervention or an active control. We will assess couples at baseline, 4-months, and 8-months on sexual risk (concurrency, number of sex partners, unprotected sex) and relationship functioning. We will also assess the feasibility, acceptability and fidelity of the intervention.
This study develops a couple-based HIV prevention intervention that is innovative and important because it integrates an intervention that improves sexual health, relationship functioning, family planning skills, and parenting skills. By targeting high risk heterosexual couples experiencing an important life transition that increases their stress, conflict, and sexual risk, we can provide maximum benefit to the men, women, and children in our communities.