Living in a Serodiscordant Relationship: Knowledge, Challenges, and Coping Strategies among HIV Discordant Couples in Addis Ababa
No Thumbnail Available
Date
2011-05
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
AAU
Abstract
Background: HIV discordant couples, where the male and female have different HIV test results,
are the largest at-risk group for transmission in sub-Saharan Africa. Research in 12 countries in
eastern and southern Africa shows that prevalence of discordant couples is high. ranging
bel1Veen 36% and 85% (UNAIDS Report on the Global AIDS Epidemic: 2010).So far. most
studies on discordant couples emphasized on the bio-medical aspect of the couples 'with onlyfew
oj'them concerned with hovlI the couples managed the discordance. The present study shaded
light on the pS,vcho-social aspect qfliving in discordant relationshljJ.
Aims: The major aim of this study was to explore the experiences of HIV discordant couples in a
steady relationship.
Methods: A qualitative approach was utitized to achieve the o~iective of this study. Twenty two
in-depth interviews were conducted with discordant couples and with an intention to elaborate in
more detail the experiences of discordant couples; two oral histOlY case studies were conducted.
These two cases were selectedfrom the in-depth interviews as they were found to be exemplary
cases reflecting the communalities among discordant couples. Further, ten in-depth interviews
were carried with key informants in order to assess health professionals' and counselors'
explanation for HIV discordance and their experience with discordant couples. The samples
were drawn using purposive sampling. The data were analyzed using the successive
approximat ion approach.
Findings: The study revealed that there were widespread misconceptions about J-/IV
discordance among both HIV discordant couples and key informants (health care providers and
counselors). These misconceptions in turn made HIV discordant couples to engage in risky
sexual behaviors. HIV discordant couples experienced varieties of psycho-social problems such
as fear of infecting and being infected, blame, neglect, guilt, and uncertainty. The couples also
faced challenges regarding their sexual life like exhaustion with condom use, reduction in sexual
desire and pleasure, reduction infrequency of sex and alteration in reproductive plan. Safer sex,
coitus interrupts, non-penetrative sex, abstinence, communication, disclosure, silence, secrecy,
cooperation, and religion were found to be the coping strategies of the couples. Finally, it was
found that for some couples the presence of HIV did not bring any change in their relationship.
Conclusion: Commonly, it might be assumed that at least the negative partner in HIV discordant
re lationship makes every effort to avoid infection. But, the .findings oj' the present study
confirmed that this is a mere speculation that significant number of informants failed to employ
any preventive strategies and if any some of them were found to be ineffective like, coitus
interrupts. Several factors which operate at different levels may contribute to such risk taking
behavior indicating the utility of an integrated model to understand individuals ' health behavior.
The extensive misconceptions about HIV discordance and ineffective coping strategies utilized
by the informants suggesT the needfor micro, mezzo, and macro level interventions
Description
Keywords
Living in a serodiscordant Relationship