This application presents a program of research and training that focuses on religious and cultural factors relevant for HIV secondary prevention and mental health in India. The training objectives are to develop expertise in: (1) qualitative research methods that will be used to build a culturally integrated theory for HIV secondary prevention and mental health in India; (2) the development and implementation of secondary prevention interventions for HIV in India; and (3) the use of advanced quantitative methods for evaluating interventions. The training will be supervised by Dr. Suniti Solomon at YRG Center for AIDS Research and Education (CARE) in India and Drs. Michael Merson and Kathleen Sikkema at Yale University in the US. The training will be used to design, implement, and evaluate a pilot intervention for promoting HIV secondary prevention and mental health among serodiscordant couples (HIV-positive males and uninfected wives) in India.
The specific aims of the study to be conducted at YRG CARE are: (1) To undertake formative research to refine a formative theoretical model for HIV secondary prevention and mental health that includes religious and cultural factors. Quantitative measures of model constructs will be pilot tested. Elicitation interviews will be conducted with 20 serodiscordant couples and separate focus groups with HIV-positive males and wives whose partners have HIV; (2) To develop an HIV secondary prevention intervention based on the model; and (3) To pilot test the intervention among 40 serodiscordant couples at YRG CARE and evaluate the feasibility of conducting a couple's intervention within the treatment setting. Assessments will be completed at baseline, post-intervention, and 3-month follow-up. A Within subjects Multiple Analyses of Variance will be used to assess changes. The award will provide a culturally sensitive theory and intervention protocol for HIV secondary prevention intervention that can be evaluated through a randomized, controlled intervention trial. The award will support the long-term goal of conducting research on mental health interventions that are comprehensive, effective, and sustainable in developing countries. ? ?
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