A Meta-Analysis of Couples-Based Financial and Communication Interventions on Dual Contraception Uptake in Ugandan HIV Serodiscordant Couples, 2007

HIV serodiscordant couples in sub-Saharan Africa face distinct reproductive health challenges, requiring prevention of both HIV transmission and unintended pregnancy. Dual contraception—using condoms alongside a more effective contraceptive method—is a recommended strategy but remains underused. Interventions addressing couples' financial barriers and communication have been suggested to improve uptake. This meta-analysis synthesised evidence on the efficacy of couples-based interventions incorporating financial or communication components in increasing dual contraception uptake among HIV serodiscordant couples in Uganda. A systematic review and meta-analysis was performed. Electronic databases were searched for relevant randomised controlled trials and intervention studies. Eligible studies evaluated couples-based interventions with financial literacy or communication components and reported dual contraception outcomes in Ugandan HIV serodiscordant couples. Data were extracted and pooled using a random-effects model to calculate summary effect estimates. The pooled analysis of three eligible studies found that couples-based interventions significantly improved dual contraception uptake. The combined odds ratio was 2.45 (95% CI 1.78 to 3.38), indicating intervention participants had over twice the odds of using dual contraception compared to controls. Integrated couples-based interventions combining financial literacy and communication skills training are effective in promoting dual contraception use among HIV serodiscordant couples in Uganda. This approach addresses key practical and relational barriers. Reproductive health programmes for serodiscordant couples should incorporate couples-based financial and communication components. Policy should support funding and integration of these holistic interventions into existing HIV and family planning services. HIV serodiscordant couples, dual contraception, couples-based interventions, financial literacy, communication, Uganda, meta-analysis. This meta-analysis provides consolidated evidence on the effectiveness of integrated couples-based interventions, informing programme and policy design for comprehensive reproductive health care in HIV-affected communities.