Couples with HIV/AIDS.

Abstract

Couples affected by AIDS face a plethora of challenges, some of which are common to many life-threatening illnesses and others of which are unique to AIDS. HIV infection is in many ways a disease of couple relationships. Today, nearly all adults living with HIV infection in industrialized nations became infected with the virus through interpersonal relations, by either a sexual or syringe-sharing partner. In many cases, the relationship within which a person became HIV infected dissolves, only to be followed by new relationships. Partners of people living with HIVlAIDS may or may not themselves be HIV infected. Couples living with HIVlAIDS therefore are complex in terms of psychological and social challenges. In this chapter, I iliscuss the factors associated with couples living with HIV/AIDS and how these factors interact with HIVlAIDS disease-related processes. Issues facing couples in which both partners are HIV positive as well as mixed-HIV-status cciuples are discussed. Two case vignettes also are included to illustrate the issues facing many couples with HIV/AIDS. Finally, this chapter provides an overview of psychologically assessing and treating couples affected by AIDS Niltiondl Institute of Mental Health Grant R01-MH57624 and Center Grant P30 MH52776 supported thc prcpararicm of this chapter.

Keeping safe, keeping connected: A qualitative study of HIV-positive women's experiences of partner relationships

“…Kalichman (2000) proposed that one explanation for the finding that HIV-infected men and women in relationships reported significantly less symptoms of somatic distress than those without partners, was that the partner-relationship might buffer and thus offer some protection from the emotional distress of living with HIV by providing both tangible and emotional social support (Kalichman, 2000). This study suggests the picture is more complex, and that the benefits provided by a partner-relationship may not necessarily be in the form of tangible or emotional support.…”

“…One empirical study, by Kalichman (see Kalichman, 2000) found that HIV-infected men and women in relationships reported significantly fewer symptoms of somatic distress than those without partners. A suggested explanation for this was that the partner-relationship might buffer and thus offer some protection from the emotional distress of living with HIV by providing both tangible and emotional social support.…”

Notes on the concepts of ‘serodiscordance’ and ‘risk’ in couples with mixed HIV status

“…Over the years, they have identified links between unprotected sex and, for example, an absence of illness symptoms (Skurnick et al 1998), greater HIV optimism (van de Ven et al 2005, the impact of an undetectable viral load on perceptions of infectivity (van de Ven et al 2005), duration of the relationship (Milam et al 2006), lower depression scores (Bradley et al 2008), lower education levels, unemployment and drug use (Buchacz et al 2001), lack of condom availability (Lau et al 2012), negative attitudes to condoms (Israel et al 2005), and refusal by male partners to use condoms (Semple et al 2002, Dave et al 2006, Milam et al 2006, Peretti-Watel et al 2006, Stevens and Galvao 2007. Some studies have also observed that HIV-negative partners tend to be the primary initiators of unprotected sex ( Van der Straten et al 1998, Kalichman 2000, Palmer and Bor 2001, and that repeated negative HIV tests for the uninfected partner reinforce a sense of low risk ( Van der Straten et al 1998, Persson and Richards 2008a, Reis and Gir 2009. Overall, the research findings are so mixed and contradictory that this, in itself, suggests that a range of complex factors are at play in serodiscordant relationships (Crepaz and Marks 2002), which in turn raises questions around how HIV 'risk' is defined and whether it means the same in all settings.…”

HIV-Negativity in Serodiscordant Relationships: The Absence, Enactment, and Liminality of Serostatus Identity

“…The small body of literature that goes beyond risk to explore the experiences of serodiscordance tends to focus on tensions in such relationships, describing how couples struggle with numerous social, sexual, and emotional challenges and stressors (Kalichman 2000;VanDevanter et al 1999;Van der Straten et al 1998;Jarman, Walsh, and De Lacey 2005;Pomeroy, Green, and Van Laningham 2002;Knight et al 1997;Moore et al 1998;Remien et al 2003;Palmer and Bor 2001). The word itself, discordance, suggests disharmony and friction.…”