‘It [HIV] is part of the relationship’: exploring communication among HIV-serodiscordant couples in South Africa and Tanzania

Abstract

In many sub-Saharan African countries, a high proportion of people living with HIV are in long-term serodiscordant relationships. This paper explores how HIV serodiscordance shapes communication among couples in long-term HIV-serodiscordant relationships. A total of 36 couples were purposively recruited through healthcare providers and civil society organisations in South Africa (26) and Tanzania (10). We explored couples' portrayal of living in a serodiscordant relationship by conducting semi-structured interviews with each partner separately, followed by a joint interview with both partners. Using an adaptation of Persson's model on sero-silence and sero-sharing, we categorised coping style as 'sero-silent' if partners reported that they did not talk much with each other about issues related to their serodiscordant status or as 'sero-sharing' if they portrayed HIV as being an issue which they dealt with together. Some couples exhibited features of both coping styles and, at times, partners differed in their ways of coping.

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

“…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.…”

“I never thought that it would happen … ” Experiences of HIV seroconverters among HIV-discordant partnerships in a prospective HIV prevention study in Kenya

“…Understanding the experience of HIV seroconversion, through behaviors before and after and corresponding emotions, such as blame or shame and feelings of fatality and despair (Rispel et al, 2012), may provide insight into novel approaches to support people at risk of HIV and improve targeted prevention delivery. In the context of a prospective HIV prevention trial among HIV serodiscordant couples, we conducted qualitative interviews with recent HIV seroconverters and their chronically HIV infected partners to gain a better understanding of the gaps that led to failure to use condoms consistently and their experience becoming a couple where both members are HIV infected.…”

HIV disclosure, sexual negotiation and male involvement in prevention-of-mother-to-child-transmission in South Africa

“…Although potentially serving as a catalyst to engagement in treatment (Peltzer and Mlambo 2010), disclosure may be marred by stigma and rejection (Rispel et al 2012; Ujiji et al 2011 ; Wyrod 2011). The positive effects of disclosure, such as facilitating entry into care, may also be overshadowed by intimate partner violence (IPV), abandonment and rejection by loved ones and social discrimination (Peltzer and Mlambo 2010).…”