# Partners-based HIV Treatment for Sero-concordant Couples attending Antenatal Care

> **NIH NIH R01** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2021 · $601,334

## Abstract

Project Summary: In severely resource-limited rural settings, scale-up of services to eliminate mother-to-child
transmission of HIV (EMTCT) has failed to provide effective HIV testing and antiretroviral therapy (ART)
coverage for women in highest prevalence southern African regions. All HIV-infected pregnant women are now
eligible for life-long antiretroviral therapy (ART), regardless of CD4+ cell count (Option B+) but retention among
women enrolled through Option B+ programs remains sub-optimal. In sub-Saharan Africa (SSA) it is common
for women to require male partner approval to access and remain engaged in HIV-related health services.
Despite the likelihood that male involvement would improve program coverage and adherence, the evidence
base for effective interventions to involve male partners in HIV testing and treatment through ANC point of care
is very limited. Furthermore, whether such strategies are indeed cost-effective for improving outcomes of HIV-
diagnosis and treatment in pregnancy is unknown. Our proposal seeks to address these key gaps in the
evidence base and guide scale-up by evaluating a promising male engagement intervention (“Homens para
Saúde” (HoPS)+ [Men for Health]) targeting EMTCT in Mozambique through a clinic-randomized trial. We will
engage 24 ANC clinics; 12 intervention and 12 standard of care, with 40 HIV-infected couples per clinic where
currently >60% of couples attend their first ANC visit together. The planned intervention addresses social-
structural and cultural factors influencing EMTCT through the creation of couples-centered integrated HIV
services, including: (1) ANC-based couples HIV testing, ART enrollment, and care for sero-concordant HIV+
expectant couples; (2) Couple-based treatment in the post-partum period; (3) Couple-based education and
skills building; and (4) Treatment continuity with the support of expert-patient (peer) supporters from couples
who have successfully navigated EMTCT. Given that 8.0% of all pregnant women and 7.2% of their partners
tested HIV-positive during ANC visits in 2015 (FGH monitoring and evaluation [M&E] data), our pioneering
work in Mozambique's rural Zambézia province suggests that innovative strategies are essential to
engaging HIV-infected male partners in antenatal care (ANC) in order to achieve EMTCT and to improve
substantially the health of the mothers. Our team of Mozambican and U.S. investigators has a proven record of
international HIV research success and we have specific recent experience with EMTCT cluster randomized
trials, male-engagement in ANC services, and cost-effectiveness analysis of HIV programs. The specific aims
of this study are: (1) To implement and evaluate the impact of male-engaged, couples-centered services on
retention in care, adherence to ART, and early infant diagnosis among HIV+ pregnant women and their HIV+
male partners through a cluster-randomized RCT; (2) To investigate the impact of HoPS+ on hypothesized
mechanisms of change; and ...

## Key facts

- **NIH application ID:** 10148813
- **Project number:** 5R01MH113478-05
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** Carolyn Audet
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $601,334
- **Award type:** 5
- **Project period:** 2017-05-12 → 2023-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10148813

## Citation

> US National Institutes of Health, RePORTER application 10148813, Partners-based HIV Treatment for Sero-concordant Couples attending Antenatal Care (5R01MH113478-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10148813. Licensed CC0.

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