Quality of relationship and sexual risk behaviors among HIV couples in Lusaka, Zambia

Abstract

Relationship quality and partner dynamics provide important insights into understanding sexual behavior within HIV sero-positive and -discordant couples. Individuals in long-term partnerships may be vulnerable to HIV/STI infection within their relationships due to misperceptions of their partners risk behaviors and potential concurrent (e.g., extramarital, non-primary) sexual partnerships. This study sought to examine relationship quality among HIV sero-positive and – discordant couples in Zambia, and its association with safer sex behavior. This study utilized data drawn from an ongoing translational study, The Partnership II Project – a couples based sexual risk reduction intervention in Lusaka, Zambia. Couples (n = 240) were assessed on demographics, relationship quality, and sexual risk behavior. Overall, couples perceiving their relationships more positively engaged in less risky sexual behavior (i.e., more condom use (b = .011, t = 3.14, p = .002) and fewer partners (χ2 = 11.4, p = .003). Within the dyad, condom use was “actor driven,” indicating that the association between relationship quality and condom use did not depend on the partner’s evaluation of the relationship. Safer sex behavior was positively influenced by communication about condoms. Results support the paradigm shift from prevention strategies with HIV positive and at-risk individuals to concentrated efforts addressing male-female dyads, and suggest that interventions to address the role of couples’ relationship quality, a modifiable target for decreasing sexual risk behavior, are needed.

Dual Protection and Dual Methods in Women Living with HIV: The Brazilian Context

“…We find dual protection is determined by partner's HIV status. There is a growing body of literature that links the ability of women living with HIV to use condoms and contraception to a positive relationship context (i.e., quality of relationship, partner dynamics, and communication) [ 39 – 41 ]. Our study finds that women with HIV-serodiscordant partners report the most consistent condom use, followed (in order) by women who do not know their partners' HIV status, and women with HIV-seroconcordant partners.…”

Protective Factors and HIV Risk Behavior Among South African Men

“…This pattern of results is consistent with findings from a study in Zambia that found that communication about condoms was associated with safer sexual behavior in couples. 33 Similarly, a study in a township near Cape Town, South Africa also found that discussing condom use with sexual partners was associated with increased condom use. 37 …”

“…27 Communication about condom use is also emphasized as an important factor for reducing exposure to HIV and several studies have tied such communication to increased condom use in men. 28–33 Although public health researchers have long recognized the importance of fatherhood in the promotion of optimum health and the reduction of health problems among men, 34 little is known about the relation between having a child and HIV sexual risk behavior among men. This study was guided by the hypothesis that older age, religiosity, having children, and communication about condoms are associated with South African men’s sexual risk behaviors.…”

Sexual communication self-efficacy, hegemonic masculine norms and condom use among heterosexual couples in South Africa

“…Couple sexual communication self-efficacy (SCSE), defined as a couple’s confidence in their ability to communicate about sexual risk reduction, has the potential to be a key leverage point for HIV prevention interventions for this high risk group (Matseke, Peltzer, Mchunu, & Louw, 2012; Vamos et al, 2013). Past research in this area has typically focused on the impact of condom negotiation self-efficacy on consistent condom use at the individual level (Onoya et al, 2011; Sayles et al, 2006).…”