Evaluating Mlambe A Couples-Based Economic and Relationship Program to Reduce Alcohol Use and Support HIV Care in Malawi

What this Trial Is About

Researchers are evaluating an intervention called Mlambe designed to reduce heavy alcohol use among married or cohabitating couples affected by HIV in Malawi. The study addresses how alcohol use, intimate partner violence, and economic insecurity affect health outcomes and HIV treatment adherence. This trial is the first to combine economic support and relationship skills to help couples break the cycle of poverty and reduce harmful drinking. Participants are randomly assigned to either standard HIV care with brief alcohol advice or the Mlambe intervention. Mlambe includes incentivized savings accounts, financial literacy training, and relationship skills education aimed at improving couple communication and support. The trial will compare the effectiveness and cost-effectiveness of Mlambe versus usual care over several months. During the study, researchers will assess alcohol use through questionnaires and biomarker tests at 11, 15, and 20 months. They will also monitor HIV viral suppression, medication adherence, appointment attendance, and relationship dynamics. Participants will be followed up over nearly two years to measure changes in drinking behavior, HIV outcomes, and couple support.

An Economic and Relationship-strengthening Intervention to Reduce Alcohol Use in Malawi