“Working Together to Reach a Goal”

Abstract

Introduction Same-sex serodiscordant male dyads represent a high priority risk group, with approximately one to two-thirds of new HIV infections among MSM attributable to main partnerships. Early initiation and adherence to highly active antiretroviral treatment (HAART) is a key factor in HIV prevention and treatment; however, adherence to HAART in the U.S. is low, with poor retention throughout the continuum of care. This study examines MSM's perceptions of dyadic HIV treatment across the continuum of care to understand preferences for how care may be sought with a partner. Methods We conducted five focus group discussions (FGDs) in Atlanta, GA with 35 men who report being in same-sex male partnerships. Participants discussed perceptions of care using scenarios of a hypothetical same-sex male couple who recently received serodiscordant or seroconcordant positive HIV results. Verbatim transcripts were segmented thematically and systematically analyzed to examine patterns in responses within and between participants and FGDs. Results Participants identified the need for comprehensive dyadic care and differences in care for seroconcordant positive versus serodiscordant couples. Participants described a reciprocal relationship between comprehensive dyadic care and positive relationship dynamics. This combination was described as reinforcing commitment, ultimately leading to increased accountability and treatment adherence. Discussion Results indicate that the act of same-sex male couples “working together to reach a goal” may increase retention to HIV care across the continuum if care is comprehensive, focuses on both individual and dyadic needs, and promotes positive relationship dynamics.

The Role of the Primary Romantic Relationship in HIV Care Engagement Outcomes Among Young HIV-Positive Black Men Who Have Sex with Men

“…Having a primary romantic partner potentially offers important instrumental as well as emotional support for the HIV-positive partner that enhance his engagement in HIV care and treatment [23, 28]. Notably, the opportunity to engage in dyadic HIV care wherein both HIV-positive partners are involved in each other’s care (e.g., accompanying each other to appointments, establishing routines) may facilitate positive relationship dynamics that enhance HIV care outcomes for both partners, particularly when they make HIV care engagement an explicit relationship goal [21, 27]. …”

An Omitted Level

“…Allowing couples to work together to reach common goals and build solitary around their relationship and health should be incorporated into biomedical strategies, such as TasP and Pre-Exposure Prophylaxis (PrEP), to set the stage for innovative intervention efforts that capitalize on multidimensional approaches to HIV prevention. 34 Future research is necessary to investigate how relational orientations are associated with coping strategies, with other steps in the HIV care continuum, and with couples in other geographic settings.…”

“The More Support You Have the Better”

“…Methods, including recruitment strategy and domains of interest, for this study have been previously described in Goldenberg et al 26 …”

“…A trained data analyst applied codes to all textual data based on reoccurring themes in the transcripts. 26 Segments of data were retrieved using individual codes and intersections of codes to compare and contrast reoccurring themes within and between FGDs and FGD participants. Through close readings of segmented data, we compared themes across different FGD scenarios (dyadic care for a seroconcordant HIV-positive couple versus a serodiscordant couple) and across different stages of the continuum of HIV care.…”

“…Patterns were identified, and agreement and disagreement among participants were examined. Descriptions of challenges and benefits of dyadic HIV care are described in Goldenberg et al 26 For this analysis, we focused on the types of partner support that were described across the continuum of HIV care.…”