Connect

Connect: A Couples-level Intervention for Heterosexual Couples at Risk for HIV/STIs

The Research

The Science Behind the Package
Connect is a relationship-based intervention that teaches couples techniques and skills to enhance the quality of their relationship, communication, and shared commitment to safety and health. The program is based on the AIDS Risk Reduction Model, which organizes behavior change into three phases—recognize risk, commit to change, and act on strategies—and on the Ecological Perspective which emphasizes the personal, relational, and societal influences on behavior. Connect also is influenced by counseling techniques used at the Ackerman Institute for the Family, which allow couples to harness their strengths and resources, and to work together to solve shared problems.

Target Population
Heterosexual women along with their main male sex partners, who have been together at least 6 months

Intervention
A counselor conducts a session with each partner separately to orient them to the program and to determine whether the partnership is a safe one for the intervention. The couple then attends five weekly 2-hour sessions together in a private office with the counselor. The intervention seeks to enhance the couple’s relationship by exploring their gender and power dynamics and focuses on the link between the couple’s behavior and their community commitment. During the sessions, HIV/STI information is delivered by videos and exercises. Communication, problem-solving, and negotiation skills are learned through videos, discussion, coaching, goal setting, and practice during the sessions and at home. Condom use skills are demonstrated, and condoms are given to the couple. The couple also identifies social supports to maintain their safer sex behaviors.

Research Results
Connect produced the following results among participating couples at 3- and 12-months after the intervention:

• Significantly increased the proportion of protected sex acts
• Significantly increased the rates of 100% condom use

For Details on the Research Design
El-Bassel N, Witte S, Gilbert L, Wu E, Chang M, Hill J, and Steinglass P. (2003). The efficacy of a relationship-based HIVSTD prevention program for heterosexual couples. American Journal of Public Health 93(6):963-969.

The Intervention

A Package Developed from Science
Replicating Effective Programs (REP) is a Centers for Disease Control and Prevention (CDC)-initiated project that supports the translation of evidence-based HIV/ AIDS prevention interventions into everyday practice, by working with the original researchers in developing a user-friendly package of materials designed for prevention providers. Connect is one of the REP interventions and is the product of extensive collaboration among researchers at the Columbia University Social Intervention Group (SIG), educational technologists at the Columbia Center for New Media Teaching and Learning (CCNMTL), and CDC program staff. The package has been field-tested by non-research staff in agencies serving couples at risk for HIV/STI.

Core Elements
Core elements are intervention components that must be maintained without alteration to ensure program effectiveness.

The core elements of Connect include:

1. Working with male and female partners together in three to five facilitated sessions.
2. Emphasizing the relationship as the target of change: redefining sexual risk reduction from individual protection to protecting and preserving the relationship between two intimate partners: “protecting us.”
3. Discussing ideas about relationship fidelity and the need to reduce HIV/STI risk among couples.
4. Identifying how gender differences, stereotypes, and power imbalances influence safer sex decision-making and behaviors.
5. Using video-based scenarios to model good communication and negotiation of safer sex to stimulate discussions and role-plays.
6. Using modeling, role-play, and feedback to teach, practice, and promote mastery in couple communication, negotiation, and problem-solving and social support enhancement.
7. Applying couple communication, negotiation, problem-solving, and goal-setting skills to the learning, performance, and maintenance of behaviors to reduce HIV/STI risk.

Package Contents

• An implementation manual covering intervention planning, implementation, maintenance, and evaluation.
• Intervention overview video and a collection of intervention topic videos on a single diskette.
• A training self-refresher, including a collection of training video vignettes on another diskette.
• Materials for reproduction, such as readiness assessment and evaluation forms, myth/fact cards, commitment contract, and educational posters.

Timeline for Availability
Development of the REP package is complete in English and Spanish. The intervention package and training will be made available in both languages in the future.

For More Information on the Connect Package
To find out more about future trainings, please visit Effective Interventions.