Community Health clinic model for Agency in Relationships and Safer Microbicide Adherence (CHARISMA)

Rationele

Gender-based violence is widespread—as many as 1 in 3 women worldwide are subjected to some or multiple forms. Research to date suggests that male partner approval or active support is often desired, required, or culturally indicated for women’s microbicide use, although use is female initiated and designed to empower women to protect themselves from HIV autonomously. Indeed, participants in microbicide studies have described a wide spectrum of ways in which product use and partner relationships interact with one another, from improving sexual pleasure and communication to being perceived as a threat to male power, thereby challenging gender norms, increasing risk of exposure to social harms (SH), and exacerbating intimate partner violence (IPV). Given that the availability of safe and effective microbicides is close to reality, it is an important priority to identify ways that the factors listed earlier, which differentially affect women’s ability to uptake and consistently adhere to microbicide use, are effectively measured and addressed. Microbicide open-label studies offer an opportune setting to identify promising ways to intervene and harness the beneficial influences of male partners constructively, to optimize adherence in research settings, generate important lessons for real-world scenarios, and offer broader social and public health benefits by challenging gender norms, reducing IPV risk, and improving partner communication and engagement in HIV prevention research.

In response to Objective 2 of the U.S. Agency for International Development Annual Program Statement for Microbicides, Round 3, CHARISMA aims to increase women’s agency to consistently and safely use microbicides and mitigate IPV through three specific objectives:

To identify improved approaches to measure and address the beneficial impacts and harmful social effects—particularly IPV—of microbicide use;

To develop and pilot test the Community Health clinic model for Agency in Relationships and Safer Microbicide Adherence (CHARISMA) intervention, which has clinic- and community-based components; and

To disseminate knowledge generated and promote uptake of promising practices for future microbicide and multipurpose prevention technology implementation projects

Primary Objectives

Secondary analyses of existing data from key microbicide trials (e.g., VOICE, ASPIRE, CAPRISA 004, FACTS 001), cross-sectional studies, and IPV interventions;

Development and testing of a novel social benefits-harms tool (SBHT); primary data collection from former ASPIRE trial participants and their male partners on personal experiences of exposure to SH and possible areas of intervention; focus group discussions with health care providers from research, public health, and service delivery organizations;

Pilot testing and evaluation of CHARISMA at the Johannesburg site of the MTN 025 OLE study—HOPE;

Study Population

ASPIRE and HOPE participants

Invetigators

  • Thesla Palanee-Phillips, Wits RHI
  • Elizabeth Montgomery, RTI, Women’s Global Health Imperative (WGHI) USA
  • Betsy Tolley, FHI360, North Carolina, USA
  • Jared Baeten, University of Washington (UW), USA
  • Dean Peacock, Sonke Gender Justice, SA

Donor

USAID

Latest Update: 15 February 2021

For more about CHARISMA please email rhicomms@wrhi.ac.za