Implementation of a couple-based HIV prevention program: a cluster randomized trial comparing manual versus Web-based...

Area of Science:

• Implementation Science
• Public Health
• HIV Prevention

Background:

• Limited HIV prevention implementation studies necessitate efficient dissemination strategies.
• Agencies face resource constraints, requiring cost-effective program delivery.
• Novel training modalities are needed to accelerate the uptake of evidence-based HIV interventions.

Purpose of the Study:

• To compare the adoption and implementation of a couple-based HIV prevention program using web-based versus manual-based training and technical assistance (TA).
• To evaluate the impact of training modality on program reach and fidelity in HIV service agencies.

Main Methods:

• Cluster randomized controlled trial involving 80 HIV service agencies and 253 staff members.
• Agencies were randomized to receive either web-based or manual-based training and TA.
• Outcomes included program adoption, number of couples reached, and intervention fidelity, assessed over 18 months.

Main Results:

• No significant differences in overall program adoption or implementation between web-based and manual-based training groups.
• Agencies receiving web-based training implemented the program with 35% fewer couples compared to manual-based agencies.
• Program use was reported by 33% of web-based agencies versus 48% of manual-based agencies.

Conclusions:

• Web-based training for this couple-based HIV prevention program did not enhance adoption and may reduce reach.
• Manual-based training may offer advantages in program implementation, particularly for agencies with limited resources.
• Further research is needed to optimize web-based modalities for HIV prevention programs.