This 5-year study will conduct a randomized clinical trial of a culturally tailored theory-based behavioral risk reduction and enhanced partner notification intervention for men and women who are receiving sexually transmitted infection (STI) diagnostic and treatment services in South Africa. Among the world's most severe HIV epidemics, as many as one in five South Africans living in the most affected areas are HIV positive. The experimental intervention in this study is grounded in social-cognitive theories of health behavior change and has been pre-tested in preliminary research. The intervention consists of a single 60-minute risk reduction counseling session with behavioral skills building components to enhance partner communication skills for improved partner notification. The study design includes two comparison conditions: behavioral risk reduction counseling without partner communication and notification skills enhancement, and a standard didactic health information condition. We will recruit 525 men and 525 women from a large STI clinic in Cape Town. Participants will be STI clinic patients age 18 or older who are receiving STI services. Participants will be baseline assessed and randomized to receive either (a) the 60-minute theory-based and culturally tailored risk reduction and partner communication/notification intervention;(b) a 60-minute risk reduction counseling intervention without partner communication/notification components;or (c) a time and contact matched 60-minute standard didactic health information session. Participants will be followed for 12 months post intervention. The study will test intervention effects on two primary endpoints: contracting new STI and objectively measured partner notification events. The randomized trial will determine the efficacy of the risk reduction intervention for South African men and women receiving STI clinic services. We will also test the mediating effects of partner notification on STI outcomes. Results of this research will therefore test a clinic-based HIV prevention intervention model that is urgently needed in South Africa.

Public Health Relevance

Sexually transmitted infections are prevented when sex partners of infected patients are notified, diagnosed and treated. This intervention trial will tes a theory-driven risk reduction counseling intervention enhanced to improve partner notification. The results of this study will have direct implications for clinic-based HIV prevention.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Research Project (R01)
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Behavioral and Social Science Approaches to Preventing HIV/AIDS Study Section (BSPH)
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Newcomer, Susan
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University of Connecticut
Schools of Arts and Sciences
United States
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Kalichman, Seth; Mathews, Catherine; Kalichman, Moira et al. (2018) Male circumcision for HIV prevention: Awareness, risk compensation, and risk perceptions among South African women. Glob Public Health 13:1682-1690
Wood, Julia M; Harries, Jane; Kalichman, Moira et al. (2018) Exploring motivation to notify and barriers to partner notification of sexually transmitted infections in South Africa: a qualitative study. BMC Public Health 18:980
Mathews, Catherine; Kalichman, Moira O; Laubscher, Ria et al. (2018) Sexual relationships, intimate partner violence and STI partner notification in Cape Town, South Africa: an observational study. Sex Transm Infect 94:144-150
Kalichman, Seth C; Mathews, Catherine; Kalichman, Moira et al. (2017) Perceived barriers to partner notification among sexually transmitted infection clinic patients, Cape Town, South Africa. J Public Health (Oxf) 39:407-414
Pellowski, Jennifer; Mathews, Catherine; Kalichman, Moira O et al. (2016) Advancing Partner Notification Through Electronic Communication Technology: A Review of Acceptability and Utilization Research. J Health Commun 21:629-37
Lurie, Mark N; Kirwa, Kipruto; Daniels, Johann et al. (2014) High burden of STIs among HIV-infected adults prior to initiation of ART in South Africa: a retrospective cohort study. Sex Transm Infect 90:615-9
Lurie, Mark N; Williams, Brian G (2014) Migration and Health in Southern Africa: 100 years and still circulating. Health Psychol Behav Med 2:34-40