OBJECTIVE: This study evaluated the efficacy of the 2GETHER relationship education and HIV prevention program for young male couples in reducing the risk for HIV. METHOD: We conducted a randomized controlled trial of 2GETHER relative to an attention-matched and highly active positive affect enhancement program for couples. We randomized 128 young male couples (N = 256) to 2GETHER or control from 2017 to 2021. Primary biomedical outcome (i.e., rectal chlamydia and gonorrhea) was measured at baseline and 12 months and self-reported condomless anal sex was measured every 3 months across 12-month follow-up. Secondary outcomes were other HIV prevention and risk behaviors, relationship functioning, and substance use. We used multilevel models in MPlus to account for clustering with dyads and within-person change over time. Effects of time (for self-reported outcomes) were modeled using latent growth curves at the between-couple level. RESULTS: We observed no differences between conditions in outcomes, but there was a significant change in outcomes across 12 months. Rates of rectal sexually transmitted infections and self-reported condomless anal sex decreased significantly in both conditions. We also observed significant increases in HIV testing, improvement in relationship communication, and reduction in alcohol-related problems in both conditions across 12 months. CONCLUSION: Couples in both the 2GETHER and positive affect enhancement programs showed improvement in biomedical and behavioral indicators of HIV risk, as well as improvement in relationship communication, but without a treatment effect we cannot conclude improvement resulted from the interventions. Couple-based programs that promote connectedness, including relationship education and positive affect enhancement, have a strong potential to reduce young couples' HIV risk. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
