Overview of the evidence for couples-basedHIV preventionNew evidence is challenging the conventional approach to HIV preventionthrough individual behavior change. First, epidemiological trends indicatethat half of new HIV infections in some sub-Saharan countries are amongmarried and cohabitating couples1. Secondly, nationally representativestudies confirming that fewer lifetime sexual partners and faithfulness tospousal partners strongly associates with reduced risk of HIV infection havebeen verified at the population level through well-established individual riskfrom multiple relationships2. Third, findings from the large multinationalHIV Prevention Trials Network (HPTN) 052 study showed that HIV-infectedindividuals receiving antiretroviral therapy (ART) had a 96% reduction in risk oftransmitting HIV to their uninfected sexual partners3.These studies underscore the need for a couples-based approach to HIVprevention. In Uganda, the nationally representative survey found that 12.9%of men and 43.9% of women reported lifetime faithfulness to their spouse. Thegender gap in marital faithfulness was consistent across four countries, leadingto the study conclusion that âHIV prevention programs should focus more onpromoting partner reduction and partner faithfulness, especially for menâ. Whilethe HPTN 052 study provides significant substantiation of the importance oftreatment as prevention, the public health benefits of the findings can be betterrealized by increasing couples testing and treatment.Overview of Catholic Relief Services and itscouples-based interventions in UgandaCatholic Relief Services (CRS) and Maternal Life International/Ugandacollaboratively created The Faithful House program (TFH) as a couples-basedapproach to HIV prevention. TFH is a faith-based, skills-building curriculum thataims to strengthen the family through enhanced couple communication achievedby skills building, positive peer mentoring, and provision of a safe environmentfor couples to dialogue around quality-of-relationship issues and other attitudesand behaviors that contribute to sexual risk behavior. Currently, the curriculum isused in 11 countries.