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- Title
Development of an Economic and Relationship-Strengthening Intervention for Alcohol Drinkers Living with HIV in Malawi.
- Authors
Conroy, Amy A.; Tebbetts, Scott; Darbes, Lynae A.; Hahn, Judith A.; Neilands, Torsten B.; McKenna, Stacey A.; Mulauzi, Nancy; Mkandawire, James; Ssewamala, Fred M.
- Abstract
Heavy alcohol use among people with HIV in sub-Saharan Africa is driven by household economics such as poverty and unemployment and has negative impacts on couple relationships. Multilevel interventions have the potential to reduce alcohol use and improve relationship outcomes by addressing the web of co-occurring economic, social, and dyadic factors. This objective of this study was to develop an economic and relationship-strengthening intervention for couples in Malawi, consisting of matched savings accounts with financial literacy training and a couples counseling component to build relationship skills. Informed by the ADAPT-ITT framework, we collected multiple rounds of focus group data with key stakeholders and couples to gain input on the concept, session content, and procedures, held team meetings with field staff and an international team of researchers to tailor the intervention to couples in Malawi, and refined the intervention manual and components. The results describe a rigorous adaptation process based on the eight steps of ADAPT-ITT, insights gained from formative data and modifications made, and a description of the final intervention to be evaluated in a pilot randomized clinical trial. The economic and relationship-strengthening intervention shows great promise of being feasible, acceptable, and efficacious for couples affected by HIV and heavy alcohol use in Malawi.
- Subjects
MALAWI; HIV-positive persons; HIV infections; SOCIAL theory; COUPLES therapy; ECONOMICS; HUMAN services programs; HIGHLY active antiretroviral therapy; CONCEPTUAL structures; ALCOHOL drinking; INTERPERSONAL relations; RESEARCH funding; DESCRIPTIVE statistics; FINANCIAL management; DATA analysis software; DRUG abusers
- Publication
AIDS & Behavior, 2023, Vol 27, Issue 7, p2255
- ISSN
1090-7165
- Publication type
Article
- DOI
10.1007/s10461-022-03956-3