By Bunmi Yekini
A groundbreaking study led by Dr. Nora Rosenberg, associate professor at the UNC Gillings School of Global Public Health, has found that a couples-based HIV counseling program significantly improves health outcomes for pregnant women and their male partners living with HIV in sub-Saharan Africa.
The intervention, known as Timasamalirana—which means “we take care of each other” in Chichewa—was piloted in Malawi and involves joint HIV counseling sessions for pregnant women with HIV and their male partners. The program is designed to foster mutual understanding, encourage joint treatment adherence, and reduce HIV transmission within families.
“The message is simple,” said Rosenberg. “A couple learning their HIV status together is more valuable than each individual learning their HIV status separately.”
Despite near-universal access to antiretroviral therapy (ART) during pregnancy and breastfeeding in sub-Saharan Africa, many families still fall short of achieving key treatment goals, such as retention in care and viral suppression. This new approach aims to change that by strengthening communication and shared responsibility between partners.
The results, published in the Journal of Acquired Immune Deficiency Syndrome, show improvements across the board—from increased HIV diagnosis among male partners to greater rates of viral suppression in both partners.
“Essentially, you can think of this single intervention as three for the price of one,” Rosenberg explained. “It keeps the person living with HIV healthy, prevents transmission to infants, and reduces the risk of infecting sexual partners.”
The findings are particularly significant for the estimated 1.2 million women living with HIV in sub-Saharan Africa who become pregnant each year, as well as their male partners.
In late 2024, Rosenberg and her team presented their findings at World Health Organization meetings, which resulted in the creation of a global toolkit to guide governments and NGOs in adopting similar strategies. Their goal is to work alongside Ministries of Health across Africa to scale up the program and improve family-centered HIV care.