‘I told her this is your life’: relationship dynamics, partner support and adherence to antiretroviral therapy among South African couples

Conroy, Amy A.; Leddy, Anna M.; Johnson, Mallory O.; Ngubane, Thulani; Rooyen, Heidi van; Darbes, Lynae A.

doi:10.1080/13691058.2017.1309460

Cited by 61 publications

(71 citation statements)

References 48 publications

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“…Então, conviver com o companheiro(a) fortalece as relações entre o casal e aumenta o apoio mútuo com os cuidados de sua saúde. Esse apoio destaca os aspectos positivos da relação como o amor, o compromisso e a confiança (7) .…”

Section: Resultsunclassified

“…Estudo desenvolvido com casais que vivem com o HIV na África do Sul, demonstra o papel importante da dinâmica positiva do relacionamento e do parceiro(a) no apoio à adesão. Dos 18 pacientes em TARV que foram questionados sobre o suporte social durante seu tratamento, 50% relataram que o parceiro era seu principal apoio ao tratamento (7) . Tais evidências implicam na prática clínica a partir da anamnese do usuário quando as características sociodemográficas são questionadas, além daquelas que compõem as questões clínicas da condição de saúde.…”

Section: Resultsunclassified

“…Aponta, ainda, a importância desse apoio num cenário de vulnerabilidade social. Indica, assim, que investir em ações de saúde que contemplem o casal e não apenas um indivíduo poderá fortalecer as relações e incentivar a oferta de suporte social (7)(8) .…”

Section: Introductionunclassified

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A influência da situação conjugal no suporte social em pessoas infectadas pelo HIV

Padoin

Marchi

Santos

et al. 2018

R. Enferm. Cent. O. Min.

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RESUMOObjetivo: Avaliar a influência da situação conjugal no suporte social percebido por pessoas infectadas pelo vírus da imunodeficiência humana (HIV). Método: Estudo de delineamento transversal, realizado com 179 participantes. Para coleta de dados, utilizou-se a Escala de Suporte Social para pessoas infectadas pelo HIV. Como variável dependente, o suporte social percebido, e como variáveis independentes, as características sociais, demográficas e clínicas. Realizada análise descritiva das variáveis, Teste de Jonckheere-Terpstra e regressão logística. Resultados: Conviver com esposo(a) ou companheiro(a) é fator de proteção quando comparado a ser solteiro(a) ou separado(a), divorciado(a) ou viúvo(a), de forma que a chance de proteção é de 8,84 vezes (IC: 3,43 -14,25) para o suporte social geral, 5,54 vezes (IC: 2,54 -8,54) para suporte social emocional, e 4,31 vezes (IC: 0,97 -7,65) para suporte social instrumental. Conclusão: Ter companheiro(a) é fator de proteção para manutenção do suporte social. Essa avaliação contribui para identificar dificuldades na adesão ao tratamento antirretroviral e elaborar estratégias de enfrentamento da doença e manutenção de comportamentos favoráveis à adesão. ABSTRACTObjective: To evaluate the influence of the conjugal situation on the social support perceived by people infected by the human immunodeficiency virus. Method: A cross-sectional study with 179 participants. To collect data, the Social Support Scale was used for people infected with HIV. As a dependent variable, perceived social support, and as independent variables, social, demographic and clinical characteristics. Descriptive analysis of the variables, Jonckheere-Terpstra test and logistic regression. Results: Living with a spouse or partner is a protective factor when compared to being single or separated, divorced or widowed, so the chance of protection is 8, 84 times (CI: 3.43 -14.25) for general social support, 5.54 (CI: 2.54 -8.54) times higher for social emotional support, and 4.31 (CI: 0, 97 -7.65) times greater for social instrumental support. Conclusion: Having a partner is a protective factor for maintaining social support. This evaluation contributes to identify difficulties in adherence to antiretroviral treatment and to develop coping strategies and maintenance of adherence behaviors. RESUMENObjetivo: Evaluar la influencia del estado civil en el apoyo social percibido por personas infectadas por el virus de inmunodeficiencia humana (VIH). Método: Estudio transversal, realizado con 179 participantes. Para la recolección de datos se utilizó la Escala de Soporte Social para las personas infectadas por el VIH. Como variable dependiente, el suporte social percibido y como variables independientes, las características sociodemográficas y clínicas. Realizado análisis descriptivo de las variables, prueba de Jonckheere-Terpstra y regresión logística. Resultados: Convivir con su cónyuge o pareja es un factor protector en comparación con ser soltero(a) o separado(a), divorciado(a) o viudo(a), por lo que la probab...

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Section: Resultsunclassified

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A influência da situação conjugal no suporte social em pessoas infectadas pelo HIV

Padoin

Marchi

Santos

et al. 2018

R. Enferm. Cent. O. Min.

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“…Some qualitative evidence suggests that serosorting occurs and has substantial benefits in heterosexual couples. HIV‐positive seroconcordant couples report having increased bonding and support for each other, resulting in better healthcare access and treatment adherence . A qualitative study in South Africa reported that women living with HIV might seek HIV‐positive partners, who could share the same fertility goals .…”

Section: Introductionmentioning

confidence: 99%

HIV seroconcordance among heterosexual couples in rural KwaZulu‐Natal, South Africa: a population‐based analysis

et al. 2020

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Introduction High levels of HIV seroconcordance at the population level reduce the potential for effective HIV transmission. However, the level of HIV seroconcordance is largely unknown among heterosexual couples in sub‐Saharan Africa. We aimed to quantify the population level HIV seroconcordance in stable heterosexual couples in rural South Africa. Methods We followed adults (≥15 years old) using a population‐based, longitudinal and open surveillance system in KwaZulu‐Natal, South Africa, from 2003 to 2016. Sexual partnerships and HIV status were confirmed via household surveys and annual HIV surveillance. We calculated the proportions of HIV seroconcordance and serodiscordance in stable sexual partnerships and compared them to the expected proportions under the assumption of random mixing using individual‐based microsimulation models. Among unpartnered individuals, we estimated the incidence rates and hazard of sexual partnership formation with HIV‐positive or HIV‐negative partners by participants' own time‐varying HIV status. Competing risks survival regressions were fitted adjusting for sociodemographic and clinical factors. We also calculated Newman's assortativity coefficients. Results A total of 18,341 HIV‐negative and 11,361 HIV‐positive individuals contributed 154,469 person‐years (PY) of follow‐up. Overall, 28% of the participants were in stable sexual partnerships. Of the 677 newly formed stable sexual partnerships, 7.7% (95% CI: 5.8 to 10.0) were HIV‐positive seroconcordant (i.e. both individuals in the partnership were HIV‐positive), which was three times higher than the expected proportion (2.3%) in microsimulation models based on random mixing. The incidence rates of sexual partnership formation were 0.54/1000PY with HIV‐positive, 1.12/1000PY with HIV‐negative and 2.65/1000PY with unknown serostatus partners. HIV‐positive individuals had 2.39 (95% CI: 1.43 to 3.99) times higher hazard of forming a sexual partnership with an HIV‐positive partner than did HIV‐negative individuals after adjusting for age, opposite‐sex HIV prevalence (by 5‐years age groups), HIV prevalence in the surrounding community, ART coverage and other sociodemographic factors. Similarly, forming a sexual partnership with an HIV‐negative partner was 1.47 (95% CI: 1.01 to 2.14) times higher in HIV‐negative individuals in the adjusted model. Newman's coefficient also showed that assortativity by participant and partner HIV status was moderate (r = 0.35). Conclusions A high degree of population level HIV seroconcordance (both positive and negative) was observed at the time of forming new sexual partnerships. Understanding factors driving these patterns may help the development of strategies to bring the HIV epidemic under control.

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“…Partners also play an important role in determining ART initiation or retention in care but such influence may differ by partner’s HIV status (Morton et al, 2017). While preventing HIV transmission to partners was one of the key motivations for early initiation of ART in HIV sero-discordant couples (Curran et al, 2014), sero-concordant couples were less concerned about HIV transmission, had increased bonding and supported each other to achieve better ART adherence (Conroy et al, 2017; Rogers et al, 2016). It is crucial to understand patients’ priorities and motivations to take preventive therapies to optimize counseling and patient support and achieve better health outcomes among PLWH.…”

Section: Introductionmentioning

confidence: 99%

The effect of partner HIV status on motivation to take antiretroviral and isoniazid preventive therapies: a conjoint analysis

et al. 2018

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Antiretroviral therapy (ART) and isoniazid preventive therapy (IPT) are important to reduce morbidity and mortality among people newly diagnosed of HIV. The successful uptake of ART and IPT requires a comprehensive understanding of patients’ motivation to take such therapies. Partners also play an important role in the decision to be initiated and retained in care. We quantified patients’ motivation to take preventive therapies (ART and IPT) and compared by partner HIV status among people newly diagnosed of HIV. We enrolled and surveyed adults (≥18 years) with a recent HIV diagnosis (<6 months) from 14 public primary care clinics in Matlosana, South Africa. Participants received eight forced-choice tasks comparing two mutually exclusive sub-sets of seven possible benefits related to preventive therapies. A linear probability model was fitted to estimate the probability of prioritizing each benefit. Tests of concordance were conducted across partner HIV status (no partner, HIV− or unknown, or HIV+). A total of 424 people completed surveys. At the time of interview, 272 (64%) were on ART and 334 (79%) had a partner or spouse. Keeping themselves healthy for their family was the most important motivator to take preventive therapies (p < 0.001). Preventing HIV transmission to partners was also highly prioritized among participants with current partners independent of partner’s HIV status (p < 0.001), but it was least prioritized among those without current partners (p = 0.72). Keeping themselves healthy was less prioritized. We demonstrate that social responsibility such as supporting family and preventing HIV transmission to partners may pose greater motivation for ART and IPT initiation and adherence compared to individual health benefits. These messages should be emphasized to provide effective patient-centered care and counseling.

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‘I told her this is your life’: relationship dynamics, partner support and adherence to antiretroviral therapy among South African couples

Cited by 61 publications

References 48 publications

A influência da situação conjugal no suporte social em pessoas infectadas pelo HIV

A influência da situação conjugal no suporte social em pessoas infectadas pelo HIV

HIV seroconcordance among heterosexual couples in rural KwaZulu‐Natal, South Africa: a population‐based analysis

The effect of partner HIV status on motivation to take antiretroviral and isoniazid preventive therapies: a conjoint analysis

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