New Couples-Based Intervention in Malawi Aims to Enhance HIV Treatment Outcomes

In Malawi, a new couples-based intervention aims to improve HIV health outcomes for pregnant women and their partners. Developed by UNC Gillings School’s Dr. Nora Rosenberg, this program enhances treatment adherence and viral suppression. It highlights joint counseling’s value, addressing critical healthcare gaps in sub-Saharan Africa.

In a significant step forward for HIV care, a recent couples-based intervention in Malawi aims to enhance health outcomes for HIV-positive individuals, particularly during pivotal moments such as pregnancy and breastfeeding. Access to antiretroviral therapy (ART) is now widely available across sub-Saharan Africa (SSA), yet there remains a troubling gap in HIV testing, treatment retention, and viral suppression among women and their male partners, as highlighted by recent findings.

Nora Rosenberg, PhD, an associate professor at UNC Gillings School of Global Public Health, spearheaded a new couples-based approach to HIV treatment. This initiative, detailed in the Journal of Acquired Immune Deficiency Syndrome, focuses on joint counseling for couples. Specifically, they engaged Malawian couples, consisting of pregnant women with HIV and their partners, typically husbands. The intervention, called Timasamalirana, encourages couples to discuss their HIV status and strategize together on prevention and treatment support strategies.

The results from the study are quite promising. Not only did the couples learn one another’s HIV status, but they also reported improved health outcomes, including increased rates of viral suppression—where the virus is undetectable in blood. This underlines an emerging consensus that couple-based interventions may be more beneficial than traditional individualized care. According to Rosenberg, “A couple learning their HIV status together is more valuable than each individual learning their HIV status separately.”

This approach has been shown to enhance adherence to HIV medications, leading to reduced viral loads. This reduction provides multiple critical advantages, namely—maintaining the health of the individuals, preventing the transmission of HIV to infants, and protecting their partners. Rosenberg succinctly described the intervention’s value, stating, “Essentially, you can think of this single intervention as three for the price of one.”

The findings are particularly relevant for the approximately 1.2 million women living with HIV in SSA who become pregnant each year and their partners. As of the end of 2024, Rosenberg and her team discussed the results at World Health Organization meetings, leading to the development of a toolkit aimed at facilitating the adoption of similar strategies by various stakeholders. Their ultimate goal? To support African Ministries of Health and NGOs in broadening the reach and effectiveness of this program.

For full access to the study, you can find the article at the Journal of Acquired Immune Deficiency Syndrome. This work was made possible through funding from the National Institutes of Health (R00 MH104154). For inquiries, contact the UNC Gillings School of Global Public Health communications team directly.

The project, spearheaded by Dr. Nora Rosenberg, emphasizes the effectiveness of a couples-based intervention in combating the challenges faced by HIV-positive couples in Malawi. With enhanced treatment adherence and significant health benefits, this initiative could reshape the landscape of HIV care in sub-Saharan Africa.

Original Source: sph.unc.edu