In South Africa, a five-year research programme will test whether treating HIV, sexually transmitted infections, and diabetes together in couples works better than treating each person alone. This matters because South Africa faces overlapping epidemics: one of the world’s worst HIV outbreaks, rising STIs with severe reproductive consequences, and diabetes as the second leading cause of death by 2015. Yet most health interventions target individuals, not couples—despite evidence that partners sharing a diagnosis may sustain behaviour changes longer when supported together. Couples-focused studies in sub-Saharan Africa are rare, and few have been rigorously evaluated. If successful, the programme could reshape how clinics deliver care. Instead of separate appointments for HIV testing, STI treatment, and diabetes management, a single couples-based approach might improve testing rates, treatment adherence, and long-term health outcomes. The research will also build local capacity to design and evaluate complex behavioural interventions, potentially enabling other African research sites to adopt similar methods. The ultimate goal is a practical, scalable model that helps adults in partnerships manage multiple chronic conditions together—not in isolation.
View original technical description
The colliding epidemics of adult communicable and non-communicable diseases in sub-Saharan Africa (SSA) mean increasing numbers of men and women are living with more than one diagnosis and managing multi-morbidities and increasingly complex health needs. In working towards a global health goal that all adults are able to live healthy and productive lives, feasible and effective programmes and policies of treatment and prevention are required for markedly different health conditions. Thus, identifying behavioural change strategies that can be incorporated into a range of interventions targeting different diseases has potential for considerable public health benefits. Central to this proposed research programme are the value of couples-focused behaviour change strategies for health intervention research and practice in sub-Saharan Africa. The aim of this five-year programme is to contribute to the design and evaluation of interventions for couples affected by HIV, other STIs and, diabetes in South Africa. What is the rationale for focusing on couples and health behaviour change? The majority of adults are in a partnership and to varying degrees will live shared lives. Evidence suggests that couple-focused interventions may be more effective than individual interventions in facilitating long-term maintenance of behavioural changes in one or both members of a couple. Despite strong rationales that couple-focused interventions could be effective globally, in SSA couples studies are seldom undertaken and few couple-focused health interventions have been rigorously evaluated. Why concentrate on HIV, STIs and diabetes in couples-focused health research in South Africa? South Africa has experienced one of the most severe generalised HIV epidemics in the world. Achieving high rates of regular HIV testing is a priority as HIV treatment is now recommended to start on diagnosis. The high rates of other STIs also have sexual and reproductive health consequences, including genital symptoms, pregnancy complications, infertility, and enhanced HIV transmission. By 2015, diabetes was the second largest cause of death in South Africa. The proportion of people living with diabetes in SSA is relatively low but is increasing more quickly than in other regions due to rapid changes in adult life-expectancy, population ageing, diets and lifestyles. The proposed research is a partnership between the University of Southampton and two South African institutions: Human Sciences Research Council and University of Cape Town. The research has three strands: 1) adapting an existing intervention to substantially enhance promotion of couples HIV testing and counselling among couples who have never tested together for HIV or mutually disclosed their status; 2) developing a couples-focused intervention for couples where one partner has diabetes; and, 3) establishing a research agenda in couples-focused health research in SSA. The programme also seeks to develop capacity in the design of complex interventions, models and theory of behavioural change, quantitative dyadic analyses and, will support other research sites in SSA to prepare for couples-focused research and evaluation.
Plain English summaries and category classifications on this site are generated by AI and may not perfectly reflect the original research.
Is something wrong? Let us know