A UCLA-led project to implement a unique HIV intervention program aimed at reducing sexually risky behaviors and promoting healthier living among heterosexual African American couples has received a $2.5 million grant from the National Institute of Mental Health.
The program, based on Eban — a Yoruban concept from West Africa that symbolizes "safety, security and love within one's family and community" — is designed not only to reduce the risk of HIV and other sexually transmitted diseases but to increase couples' ability to communicate with each other, make safer behaviors more appealing, stay in healthy relationships and respect their communities. The culturally congruent program takes into consideration participants' cultural beliefs, traditions and practices.
The project's lead investigator, Gail E. Wyatt, a professor of psychiatry and biobehavioral sciences at the Semel Institute for Neuroscience and Human Behavior at UCLA and co-director of the UCLA AIDS Institute, previously developed and led a four-city study testing the Eban intervention with 535 heterosexual African American couples that were serodiscordant — one partner had HIV and the other did not.
In that controlled trial, Eban helped couples significantly reduce the incidence of unprotected sex by increasing condom use. The researchers estimated that if the Eban participants had not received the intervention, six women and four men would have become infected with HIV in one year, and 25 women and 15 men would have become infected over five years.
Based on the successful outcomes in that trial, the researchers will now assess how well the intervention works in the "real world" — as delivered by community-based agencies that serve African American clients. The new grant-funded Eban II Project study will support an in-depth assessment of the barriers and facilitators to community-based implementation and the cost-effectiveness of treating HIV-positive and negative individuals in a relationship.
"The Eban II Project aims to deepen our understanding of how to best help African American couples enhance their health," Wyatt said. "We hope that the project will create a comfortable space for romantic partners to talk about their health concerns while encouraging each other to lead healthier lives."
The program is targeted toward African American couples in an effort to reduce the severe impact that HIV and AIDS have had on the African American community. In 2009, according to the Centers for Disease Control and Prevention, African American men accounted for 42 percent of new HIV infections among men, and African American women accounted for 64 percent of new infections among women, despite representing only 11 percent and 12 percent of the U.S. population, respectively. Over the course of their lives, UCLA researchers say, approximately one in 16 African American men will be diagnosed with HIV, as will one in 32 African American women.
"The Eban II Project is tailored to address the realities of urban African American couples affected by HIV," said Dr. Hector F. Myers, co-investigator and a professor of psychology at UCLA. "We want to help couples make meaningful decisions about their physical, emotional and sexual health; cope with the HIV infection; and strengthen their relationships."
The project will involve 10 community-based organizations in Northern and Southern California and will focus on how to incorporate the evidence-based intervention into usual care. These organizations serve a larger number of African Americans than any other community-based organizations in the state of California.
The research team will include intervention and implementation experts, as well as cost-effectiveness and statistical experts. The team is also supported by the State of California Implementation Network, which comprises statewide stakeholders in the fight against HIV/AIDS.
Should the Eban II Project be successful, the next step will be to disseminate the intervention nationally using the Eban implementation model, the researchers say. They hope that by doing so, more couples will be reached and, ultimately, the incidence of heterosexually transmitted HIV among African Americans will be reduced.
The UCLA AIDS Institute, established in 1992, is a multidisciplinary think tank drawing on the skills of top-flight researchers in the worldwide fight against HIV and AIDS, the first cases of which were reported in 1981 by UCLA physicians. Institute members include researchers in virology and immunology, genetics, cancer, neurology, ophthalmology, epidemiology, social sciences, public health, nursing and disease prevention. Their findings have led to advances in treating HIV, as well as other diseases, such as hepatitis B and C, influenza and cancer.