Alcohol use and relationship quality among South African couples

Abstract

Objective: The HIV literature has largely ignored the importance of alcohol use in the quality of intimate relationships in sub-Saharan Africa (SSA), despite evidence of alcohol’s role in relational behaviors that increase risk for HIV infection and other harms. The present study explored the association of alcohol use with relationship functioning among heterosexual couples from rural South Africa. Method: Dyadic analyses were conducted with 443 sexually active, heterosexual, South African couples (886 individuals) to examine the association between male partners’ alcohol use (abstinent, non-hazardous, hazardous) and male and female partners’ reports of relationship intimacy, trust, mutually constructive communication, demand/withdraw communication, and satisfaction. Five structural equation models were fit using male partner alcohol use as a predictor of male and female reports of relationship quality. Results: Women with a hazardous-drinking male partner (compared to an abstainer) reported significantly higher levels of intimacy (p <.05) and significantly more demand/withdraw communication (p <. 001); men who were hazardous drinkers reported significantly less trust in their relationship compared to men who were abstainers (p < .01). Conclusions: Hazardous alcohol use among South African couples is positively correlated with women’s relationship intimacy and maladaptive communication patterns, yet negatively correlated with men’s perceived trust.

Couples motivational interviewing with mobile breathalysers to reduce alcohol use in South Africa: a pilot randomised controlled trial of Masibambisane

“…If both members of the couple report heavy alcohol use during screening and are on ART, the male partner will be assigned to be the index patient given that drinking among men is generally more frequent than women in similar types of couples 18 49. For the MI-plus arm, only the index patient will receive the breathalyser and mobile app as the tester; their partner will only receive SMS text notifications of their BAC levels.…”

Development and empirical test of the research‐informed South African Relationship Functioning Assessment (SARFA)

“…Higher values indicate greater levels of trust in the partner. This measure has previously been used with populations in South Africa and Malawi (Conroy et al, 2021; Woolf‐King et al, 2019).…”

“…All items were rated on a 9‐point Likert scale ranging from 1 ( very unlikely ) to 9 ( very likely ), with higher scores indicating more resolution and collaborative discussion. This measure has been used previously with South African and Ugandan couples (Ruark et al, 2018; Woolf‐King et al, 2019). One item (“After a discussion of a relationship problem, you and your partner withdraw”) did not covary well with the other items; additional inspection of the item revealed that the translation was unclear.…”