Background: Couples-based HIV counseling and testing (CHCT) is a proven strategy to reduce the risk of HIV
transmission between partners, but uptake of CHCT is low. We describe the study protocol for a randomized controlled
trial aimed to increase participation in CHCT among heterosexual couples in rural KwaZulu-Natal, South Africa.
Methods: Heterosexual couples (N=350 couples-700 individuals) are being recruited to participate in a randomized trial of
a couples-based intervention comprising two group sessions (one mixed gender, one single-gender), and four couples’
counseling sessions. Couples must have been in a relationship together for at least six months. Quantitative assessments
are conducted via mobile phones by gender-matched interviewers at baseline, 3-, 6-, and 9-month post-randomization.
Intervention content is aimed to improve relationship dynamics, and includes communication skills and setting goals
regarding CHCT.
Discussion: The Uthando Lwethu (“Our love”) intervention is the first couples-based intervention to have CHCT as its
outcome. Improving rates of CHCT has the potential to improve rates of HIV testing, disclosure of HIV status, sexual risk
reduction, and ART initiation for heterosexual couples in a rural area of South Africa that is highly impacted by HIV.
Other innovations of the intervention include the use of mobile caravans for provision of counseling services, intervention
activities and CHCT, and the use of mobile phones for data collection.