Symposia
Couples / Close Relationships
Michael Newcomb, Ph.D. (he/him/his)
Associate Professor
Northwestern University
Chicago, Illinois
Kathryn Macapagal, Ph.D.
Research Associate Professor
Northwestern University
Chicago, Illinois
Elissa L. Sarno, Ph.D.
Research Assistant Professor
Northwestern University Feinberg School of Medicine
Chicago, Illinois
Sarah Whitton, Ph.D.
Professor
University of Cincinnati
Cincinnati, Ohio
Brian Mustanski, Ph.D.
Professor
Northwestern University
Chicago, Illinois
Background: Young sexual minority men are heavily impacted by HIV and many new infections occur in their serious romantic relationships. Romantic relationships also provide myriad benefits to individual health, but minority stress can deteriorate these promotive effects. Thus, optimizing relationship functioning via behavioral intervention may effectively reduce HIV infections. 2GETHER is a 5-session relationship education and HIV prevention program for young male couples, consisting of 3 didactic group sessions and 2 couple-based skills coaching sessions.
Method: We evaluated the efficacy of 2GETHER delivered via videoconference to couples across the US. We randomized 200 young male couples (N=400), aged 18-29, to either 2GETHER or control (i.e., couple-based HIV testing and risk reduction counseling) from 2017-2020. Primary biomedical (i.e., Chlamydia/Gonorrhea infection) and behavioral outcomes (i.e., condomless anal sex) were measured at 12-months post-intervention. Secondary outcomes were indicators of relationship quality (i.e., satisfaction, communication). Multilevel regression was used to model intervention outcomes to account for clustering within couples. Post-intervention change over time in outcomes was modeled as a latent linear growth curve at the within-persons level, with intervention condition predicting change in growth curve slopes.
Results: We observed significantly larger declines across 12-months in various sexual behavior outcomes in 2GETHER relative to control, including the likelihood of having had condomless anal sex (CAS) (beta =-.44, p< .001) and the number of partners with whom CAS occurred (beta=-.44, p< .05) in the prior 3 months. 2GETHER participants also had a significantly greater reduction in having an STI (beta=-2.28, p< .001) at 12-months relative to control. We observed no intervention effects on indicators of relationship quality.
Conclusions: Overall, 2GETHER participants had larger declines in behavioral and biomedical indicators of HIV risk relative to control. This is particularly impressive because the control condition specifically taught couple-based HIV prevention skills. While we observed no intervention effects on relationship quality, mean scores on these indicators were high at baseline, leaving little room for improvement. Importantly, our videoconference-based required very minimal adaptations after the onset of COVID, pointing to the great potential of telehealth and eHealth to meet the needs of vulnerable populations in crisis-based contexts.