Couples' communication on sexual and relational issues among the Akamba in Kenya

Miller, Ann Neville; Golding, Lenette; Ngula, Kyalo Wa; Wambua, MaryAnne; Mutua, Evans; Kitizo, Mary N; Teti, Caroline; Booker, Nancy; Mwithia, Kinya; Rubin, Donald L.

doi:10.2989/ajar.2009.8.1.6.719

Cited by 18 publications

(15 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our findings are also consistent with other spousal reports on HIV-related behavior. In Kenya, Miller and colleagues (2009) found that when husbands and wives were discordant about whether they communicated about AIDS, men were generally more likely to say “yes” while women were more likely to say “no”. Together, these results highlight the role that gender plays in reporting of HIV disclosure, suggesting that future efforts focus on addressing the issue of social desirability among men.…”

Section: Discussionmentioning

confidence: 99%

How reliable are self-reports of HIV status disclosure? Evidence from couples in Malawi

Conroy

Wong

2015

Social Science & Medicine

View full text Add to dashboard Cite

Introduction The majority of research on human immunodeficiency virus (HIV) disclosure utilizes the perspective from a single individual, which cannot be substantiated in the absence of supporting data such as from a primary partner. Objectives The objectives of this study were to evaluate: (1) the extent to which self-reported HIV disclosure was confirmed by a primary partner; (2) individual and relationship-level predictors of self-reported versus confirmed disclosure; and (3) whether confirmed disclosure was a stronger predictor of correctly assessing a partner's HIV status compared to self-reported disclosure. Methods As part of an 8-wave longitudinal study from 2009-2011 in southern Malawi, 366 individuals (183 couples) were interviewed about their primary relationship (wave 3), individually tested for HIV (wave 4), and then asked whether they disclosed to their primary partner (wave 5). Results While 93% of respondents reported that they disclosed, only 64% of respondents had confirmed reports from their partner. Having communicated with partner about HIV was positively associated with self-reported disclosure; this association remained significant but became more precise in the models for confirmed disclosure. Confirmed disclosure, but not self-report, was a significant predictor of correctly assessing a partner's HIV status. Being male, having lower perceived partner infidelity, having higher relationship unity, and testing HIV-negative were positively and significantly associated with correct assessment. Dyadic data from two partners provide an improved measure of disclosure as compared to a single individual's self-report and could be used to identify behavioral and biomedical opportunities to prevent HIV transmission within couples.

show abstract

Section: Discussionmentioning

confidence: 99%

How reliable are self-reports of HIV status disclosure? Evidence from couples in Malawi

Conroy

Wong

2015

Social Science & Medicine

View full text Add to dashboard Cite

show abstract

“…Results provide support for the use of both methods, and highlight the mutual influence of partners and communication on sexual barrier use among couples in sub-Saharan Africa. 28,29 Future prevention studies should incorporate both products and partners to achieve optimal outcomes.…”

Section: Discussionmentioning

confidence: 99%

Risk Reduction Among HIV-Seroconcordant and -Discordant Couples: The Zambia NOW2 Intervention

Jones

Kashy

Chitalu

et al. 2014

AIDS Patient Care and STDs

View full text Add to dashboard Cite

Heterosexual HIV transmission remains the leading cause of HIV incidence in adult men and women in sub-Saharan Africa. This study assessed whether an HIV risk-reduction intervention would be more likely to increase sexual barrier acceptability and decrease risk behavior when delivered to couples in gender concordant groups or in an individual format. This study also examined the mutual impact of couple members as a source of influence on acceptability, and assessed whether product acceptability, intimate partner violence (IPV), and/or partner communication predicted sexual barrier use. HIV seroconcordant and serodiscordant couples (n=216) were recruited in Lusaka, Zambia, and randomized to a four session gender-concordant intervention. Participants were assessed at baseline, 6, and 12 months. Willingness to use barriers (p=0.012), acceptability (p<0.001), and barrier use (p<0.001) increased over time in both conditions, and were influenced by gender preferences. IPV decreased (p=0.040) and positive communication increased (p<0.001) in both conditions. Individual and gender concordant group sessions achieved similar increases in sexual barrier use following the intervention. Results highlight the influence of partners as well as product acceptability as predictors of sexual barrier use among couples in sub-Saharan Africa. Future prevention studies should consider both product acceptability and partner influence to achieve optimal sexual risk behavior outcomes.

show abstract

“…Miller et al (2009) found that Akamba couples in Kenya sought to address sensitive issues with caution using intermediaries (such as church members, friends or family) or a circuitous approach “until the bull’s eye at the centre of their own relationship was reached” (2009: 56). Like Miller et al’s study participants, our participants used caution in addressing HIV risk in their relationships and deployed indirect strategies to draw their partners into the core issues that concerned them.…”

Section: Methodsmentioning

confidence: 99%

“…While men were often expected to initiate sexual relationships, women were generally expected to initiate discussions of HIV (cf. Miller et al 2009). As Sibongile in Vulindlela asserted,

It is not easy for a male person to think that they need to test because commonly males do not really care that much about [testing].

…”

Section: Methodsmentioning

confidence: 99%

Looking to the future: South African men and women negotiating HIV risk and relationship intimacy

Mindry¹,

Maman

Chirowodza

et al. 2011

Culture, Health & Sexuality

View full text Add to dashboard Cite

This paper examines the approaches heterosexual men and women in South Africa use to engage their partners in discussions of HIV and risk factors in their relationships. These strategies entail balancing the risks of infection while managing the challenges of maintaining a relationship. In a context in which there is a great deal of insecurity in relationships it is especially challenging to discuss HIV risks with partners. Our findings reveal that concerns about children or the desire to have children provided a legitimate basis for discussing HIV risk with partners. The focus of these discussions is on the future for their children. Research in South Africa should attend to men's and women's desires to have and to raise children. HIV prevention and treatment programs can capitalise on concerns regarding children, and the future of the family, to engage men and women in discussing mutually acceptable strategies for preventing infection and ensuring safe conception.

show abstract

Couples' communication on sexual and relational issues among the Akamba in Kenya

Cited by 18 publications

References 27 publications

How reliable are self-reports of HIV status disclosure? Evidence from couples in Malawi

How reliable are self-reports of HIV status disclosure? Evidence from couples in Malawi

Risk Reduction Among HIV-Seroconcordant and -Discordant Couples: The Zambia NOW2 Intervention

Looking to the future: South African men and women negotiating HIV risk and relationship intimacy

Contact Info

Product

Resources

About