Researchers in the Vanderbilt Institute for Global Health are testing whether a unique “couples-centered” intervention developed in the southern African nation of Mozambique can reduce mother-to-child transmission of HIV.
By encouraging men to play a larger role in the health care provided to their HIV-infected pregnant wives, they hope the women will be more adherent to anti-retroviral therapy and less likely to pass the AIDS virus to their children before or during birth.
Supported by a five-year, nearly $3-million grant awarded by the National Institute of Mental Health (NIMH) in May, the study is being conducted in Mozambique’s rugged Zambézia province, where 8 percent of pregnant women tested positive for HIV in 2015.
Without their husbands’ support, more than a third of these women will stop taking their medication within six months, greatly increasing the risk that their babies also will become infected, said Carolyn Audet, Ph.D., M.Sc., the study’s principal investigator.
HIV-infected husbands and wives had been treated in separate locations. But that wasn’t helping treatment adherence or the mother-to-child transmission rate, which hovers around 12 percent.
So the researchers took a bold step: they started treating the men and women together. Couples also receive education and skills building with the help of traditional birth attendants, male community health workers and peer support from other couples. Men are encouraged to help with chores such as hauling water for their pregnant wives and assisting with the laundry.
“The new goal is to … provide clinic and community-based couples counseling in efforts to strengthen relationships and provide adherence strategies to ensure couples can support each other through treatment,” Audet said.
It’s too early to tell whether these measures will reduce HIV infections in newborns. But they’re having a positive effect on couples already.
“We’ve had women come up to us and say in a positive way, ‘What did you do to my husband?’” she said. “It’s changing their relationship. It’s changing what is the accepted role for men in the community.”
Audet, an assistant professor of Health Policy in Vanderbilt’s global health institute and Center for Medicine, Health and Society, discussed her research last week at the International AIDS Conference in Paris.
A graduate of Princeton University, Audet earned her Ph.D. in Anthropology at Vanderbilt in 2006. While at Vanderbilt, she began overseeing service learning programs in Uganda and Kenya focused on HIV, health care delivery and poverty.
In 2008, Audet joined the Vanderbilt Institute for Global Health as a postdoctoral fellow and began research on barriers to HIV testing and treatment uptake in rural Mozambique. In 2013, she completed her M.Sc. in Epidemiology at the London School of Hygiene and Tropical Medicine.
Audet has authored or co-authored 28 scientific papers and has received previous grant support from Vanderbilt University, the U.S. Centers for Disease Control and Prevention and NIMH, including a K01 mentored research scientist career development award to study ways of engaging traditional healers in HIV treatment.
