Relationship Power, Communication, and Violence among Couples: Results of a Cluster-Randomized HIV Prevention Study in a South African Township

July 2015 - Structural Prevention

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Minnis, A.M., Doherty, I.A., Kline, T.L., et al. International Journal of Women’s Health (May 2015), Vol. 11, Issue 7, pp. 51–525, doi: 10.2147/IJWH.S77398.

From June 2010 through April 2012, the authors studied 290 heterosexual couples from a high-HIV-prevalence South African township to examine the effects of HIV prevention interventions on power dynamics within relationships. The first intervention, the Couples Health CoOp (CHC), engaged both men and their female partners; in the second intervention, women received the Women’s Health CoOp (WHC), and men received the Men’s Health CoOp (MHC). The interventions consisted of two three-hour sessions delivered one week apart by community peer leaders. Sessions included modules on a variety of topics, including alcohol and other drug use, sexually transmitted infections, HIV, safer sex methods, gender roles, effective communication and conflict resolution skills, dealing with stress, and preventing violence. At the six-month follow-up, only CHC participants reported positive changes in power within their relationships. For the second measure of relationship power— equity in shared decision-making—the most substantial improvements occurred in the WHC model. The authors also found that women from MHC/WHC couples were less likely to report experiencing violence during the follow-up period, compared with women in the CHC arm. This study highlighted the need for both gender-separate and joint couples’ interventions to address gender-based inequities in settings where women remain at high risk of HIV infection.

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