Project’s aim is to reduce HIV transmission between serodiscordant couples
The National Institute of Mental Health has awarded a $2.5 million grant for a UCLA-led project designed to implement an evidence-based HIV-risk reduction intervention (“Eban”) that changes sexual risk behaviors and promotes healthier living among heterosexual African American couples.
Dr. Gail E. Wyatt, Professor in the UCLA Department of Psychiatry and Biobehavioral Sciences, Co-Director of the UCLA AIDS Institute, and lead study investigator, previously developed and tested Eban with 535 heterosexual HIV-serodiscordant couples in four cities. The Eban intervention is a highly innovative, culturally congruent program designed for couples rather than individuals. In the controlled trial, Eban helped couples, where one partner was HIV-infected and the other was not, to significantly reduce engaging in unprotected sex by increasing condom use. It was estimated that if Eban participants had not received the intervention, six women and four men would have become infected in one year, and 25 women and 15 men would have become HIV-infected over 5 years. Based on the successful outcomes in that controlled trial, the next step is to assess how well the intervention works in the “real world” – as delivered in community-based agencies that serve African American clients. This newly awarded study, called the Eban II Project, will support a careful, in-depth assessment of the barriers and facilitators to community-based implementation and the cost-effectiveness of treating HIV-positive and negative individuals in a relationship.
“The Eban II Project aims to deepen our understanding of how to best help African American couples enhance their health,” explained Dr. Wyatt. “The word ‘Eban’ means ‘fence’ in Yoruba, a West African language, and represents safety, security and love within one’s family and community,” she added.
Due to the severe impact that HIV and AIDS has had on the African American community, this program is targeted to African American couples. In 2009, African American men accounted for 42% of new HIV infections among men, and African American women accounted for 64% of new infections among women, despite only representing 11% and 12% of the US population respectively. Over the course of their lives, approximately 1 in 16 African American men will be diagnosed with HIV, as will 1 in 32 African American women.
“We hope that the Project will create a comfortable space for romantic partners to talk about their health concerns while encouraging each to lead healthier lives,” said Dr. Wyatt.
“The Eban II Project is tailored to address the realities of urban African American couples affected by HIV,” notes Dr. Hector F. Myers, Co-Investigator and Professor of Psychology at UCLA. “We want to help couples make meaningful decisions about their physical, emotional and sexual health, cope with the HIV infection, and strengthen their relationships.”
The Project will take place in ten community-based organizations in Northern and Southern California, with a focus on how to incorporate this evidence-based intervention into usual care. These organizations serve the largest number of African Americans in the state of California. The research team will include intervention and implementation experts, as well as cost effectiveness and statistical experts. The team is also supported by the State of California Implementation Network, which is comprised of statewide stakeholders in the fight against HIV/AIDS. Should the Eban II Project be successful, the next step will be to nationally disseminate the intervention using the Eban implementation model. It is hoped that by doing so, more couples will be reached and ultimately, the incidence of heterosexually-transmitted HIV among African Americans will be reduced.