Amsterdam 2015
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| Abstract #2239 - Family matters: Relationships and HIV | ||||
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Session: 28.7: Family matters: Relationships and HIV (Parallel) on Thursday @ 11.30-13.00 in C002 Chaired by Eline Op de Coul, Francine Cournos Authors: Presenting Author: Ms Anna Joy Rogers - University of Alabama at Birmingham School of Public Health, United States |
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| Additional Authors: | ||||
| Aim: Couple relationship factors have been shown to impact health and longevity. However, less is known about the impact of relationship dynamics on health behavior decisions in sub-Saharan African couples. The majority of new HIV infections in this region occur within long-term partnerships, making dyads a key target for future HIV interventions. Thus, understanding and improving couple relationship dynamics may improve HIV outcomes, alongside potential for improved sexual health and relationship quality. Strengthening family health is particularly crucial during pregnancy since there is an increased risk of vertical and horizontal HIV transmission. | ||||
| Method / Issue: We conducted qualitative interviews to inform how couples would respond to home-based couples HIV testing and counseling (CHTC) and to explore how couple dynamics impact both willingness to accept an intervention and engage in positive health behavior decisions. In-depth interviews were conducted with forty pregnant women (half of whom were HIV-positive) and forty male partners, in the Nyanza region of Kenya, an area of high HIV prevalence. The women were recruited from antenatal care clinics, and male partners were invited to participate. Participants were interviewed separately by a gender-matched interviewer in the local language. Audio recordings were then transcribed and translated into English. Drawing from the Interdependence Model of Health Behavior Change, we analyzed the interview transcripts using thematic analysis in Dedoose software. | ||||
| Results / Comments: Couples reported that relationship dynamics impacted their decisions regarding HIV testing, serostatus disclosure, and adherence to antiretroviral therapy. Factors such as trust and respect helped build a foundation where outside sexual partnerships were less likely, reducing risk of exposure to HIV from other partners, and improved openness with their partner, allowing for sexual health negotiations. Other relationship dynamics such as good communication, honesty, humor, and listening skills, as well as engaging in the partner’s daily life and practicing good conflict resolution methods, helped to transform their motivation for health-seeking behaviors from being person-centered to relationship-centered. Conversely, couples identified several challenges to couple communication such as polygamous marriages, long-distance relationships, and financial difficulties. Participants also expressed the strain that HIV-related stigma could place on their relationship, sometimes resulting in mistrust, false accusations, violence, and even separation. Most participants stated that they would participate in the home-based couples intervention, believing that a trained counselor could encourage serostatus disclosure and, if one or more partner tests HIV-positive, support them to live openly and positively with HIV. Consistent with interdependence theory, it appears that strong couple relationships encourage health-enhancing behavior changes, such as willingness to engage in CHTC, as well as act cooperatively in terms of medication and clinic appointment adherence. | ||||
| Discussion: Understanding couple relationship dynamics and utilizing positive aspects of couple relationships may aid in addressing some of the barriers to HIV testing, disclosure, and adherence. Intervening to improve relationship quality could help couples better navigate HIV-related health behavior decisions. Couples counseling, such as that proposed as part of a home-based couples intervention, may be an acceptable and effective way of encouraging interdependence and thus resulting in beneficial HIV-related behaviors. | ||||
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