Abstract #235  -  I have chosen to be in love with someone who understands me: disclosure, support and condom use in relationships where both partners take ART
Authors:   Presenting Author:   Mrs Alison Stanley - London School of Hygiene & Tropical Medicine
Additional Authors:  Dr Victoria Hosegood, Prof Ian Timaeus,
Aim: There has been little research in the sub-Saharan African context into the influence of ART on decisions about sexual activities and relationships based on own and partners HIV status (sero-sorting). In-depth interviews conducted with ART patients in KwaZulu-Natal, South Africa, suggested that some participants were actively choosing partners on the basis of their ART status, preferring to have a partner who was also taking treatment. A better understanding of how and why ART patients negotiate sexual relationships with one another is needed as more and more people in South Africa and elsewhere start the therapies and potentially seek new partners.
Method / Issue: Repeated in-depth interviews were conducted with twenty-nine (29) patients receiving ART through two government clinics in northern KwaZulu-Natal, South Africa. Participants were invited to discuss their experiences of taking ART for HIV, with particular reference to the effects of ART on their family and couple relationships. Interview transcripts and field notes were analysed using thematic content analysis to identify themes and sub-themes.
Results / Comments: Of the twenty-nine participants, seven (7) had a partner who was also on ART. Four (4) of these participants had met their partner in their treatment support group. Five (5) participants were currently single but considering starting a new relationship in the near future. Four (4) of these participants said that they would actively choose a partner who was also taking ART. Participants cited ease of disclosure, ease of communication about condom use, and provision of emotional and adherence support as reasons for choosing a partner who was also on ART.
Discussion: Disclosure of HIV status and the negotiation of condom use are complex issues within both new and established partnerships, and can entail emotional and physical risk. Such discussions can be easier in relationships where both partners share a common experience of taking ART. This shared experience may mean that these difficult conversations are not necessary, with sero-positivity and the need to use condoms taken as given. Alternatively, the knowledge that one�s partner is also taking ART could provide a freedom to discuss such issues fully and without fear of negative consequence. Partners who both take ART could be an important source of emotional support to one another, particularly where disclosure within wider social networks has been limited. Practical support offered by a partner who is also taking ART, such as sharing travel to the clinic or taking pills at the same time as one another, could promote good adherence to treatment regimens. Results have the potential to inform initiatives to address the needs of people taking ART who are either in relationships with fellow patients or considering starting such relationships.
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