Couples-Based Intervention Aims to Enhance HIV Outcomes in Malawi

A new couples-based HIV intervention in Malawi, named Timasamalirana, aims to improve health outcomes for pregnant women and their male partners living with HIV. Developed by Dr. Nora Rosenberg and her team at UNC Gillings School of Global Public Health, this program highlights the effectiveness of joint counseling sessions. Results indicate improvements in treatment adherence and viral suppression, benefiting the health of couples and preventing transmission risks.

A recent initiative aims to enhance HIV health outcomes in Malawi by utilizing a couples-based intervention. While access to antiretroviral therapy (ART) during pregnancy and breastfeeding has improved noticeably in sub-Saharan Africa, notable challenges persist. Pregnant women and their male counterparts often fail to meet recommended targets for vital aspects such as HIV testing, treatment retention, and viral suppression. This troubling trend is the focus of Dr. Nora Rosenberg, an associate professor at the UNC Gillings School of Global Public Health, and her research team, who have pioneered a couples-based HIV program, now published in the Journal of Acquired Immune Deficiency Syndrome.

The couples-based approach involves providing HIV treatment counseling to both partners simultaneously. The initiative, referred to as Timasamalirana, operates within Malawi and targets couples where the woman is pregnant and living with HIV, while the male counterpart is usually her husband. By participating in joint sessions, these couples become informed about their respective HIV statuses, navigate the implications for their family, and develop strategies for mutual support concerning HIV treatment and prevention behaviors.

Data from this innovative approach reveal significant improvements in various HIV health metrics, from diagnosing male partners to achieving viral suppression in both partners. This study contributes to the growing evidence supporting coupled interventions over singular individual care. Dr. Rosenberg emphasized the effectiveness of dual learning, stating, “A couple learning their HIV status together is more valuable than each individual learning their HIV status separately.”

The couples-based intervention has shown promise in assisting both women and men maintain adherence to their HIV medication, which reduces the viral load. The positive impacts of this adherence are multifold: improving the health of the person living with HIV, minimizing the risk of transmission to an infant, and preventing further transmission to sexual partners. Dr. Rosenberg succinctly noted the advantages by saying, “Essentially, you can think of this single intervention as three for the price of one.”

These findings are particularly critical for the approximately 1.2 million women living with HIV in sub-Saharan Africa who become pregnant yearly, alongside their male partners. By the end of 2024, Rosenberg and her team disseminated these findings at World Health Organization meetings, leading to the development of a toolkit designed for governments and implementing partners. Their overarching goal is to aid African Ministries of Health and NGOs in the wider adoption of similar initiatives.

In summary, the couples-based intervention Timasamalirana represents a significant advancement in HIV management in Malawi. It not only addresses the immediate health needs of couples living with HIV but also enhances broader public health outcomes. By encouraging mutual support and fostering shared understanding of HIV status, this approach holds promise for improving treatment adherence and health conditions for both partners. As efforts progress, there is hope that similar models can be adopted more widely across sub-Saharan Africa to further combat the challenges presented by HIV.

Original Source: sph.unc.edu