Couple-Centered HIV Prevention and Care: Endorsement, Practice and Uncertainty among US Healthcare Providers in Western-Central Upstate New York

Given the influence of provider perspective and practice in the uptake of HIV/STI prevention and care strategies, this qualitative description design study sought to illuminate perspectives of couples HIV testing and counseling (CHTC), and describe couple/partner-based practices among health providers in New York State. We utilized a purposive sampling strategy to recruit health providers (N = 27). Semi-structured in-depth interviews were conducted from Sept. 2019 to Feb. 2021. Four themes emerged: perspectives on engaging partners and couples-centered sexual health promotion; providers' experiences with patients and partners in HIV prevention and care; provider endorsement of CHTC; and perceived CHTC implementation determinants. CHTC endorsement was prominently due to the perception of CHTC as a facilitator to enhance patient-provider engagement in HIV/STI treatment and care, especially in the communication and dissemination of information among partners. Providers reported that health literacy needs regarding HIV/STI testing and diagnosis, but primarily STIs treatment regimens warranted a joint approach. CHTC endorsement entailed the strategy’s perceived ability to enhance sexual health literacy among patients and patient’s partners. Lastly, CHTC endorsements entailed provider beliefs that it ensured knowledge equity and joint literacy in the communication of health information among health consumers. Determinants of CHTC implementation were factors that providers perceived to have a bearing on the facilitation or posed as barriers to jointly engaging partners in HIV/STI prevention and care, and was subsequently a source of provider uncertainty. These determinants ranged from provider-level factors to organizational capacity issues that could impact CHTC implementation. Recommendations for CHTC are discussed. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement Yes ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: University of Rochester IRB. Study ID: 00002055 I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All relevant data are within the manuscript and its Supporting Information files.