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What motivates serodiscordant couples to prevent HIV transmission within their relationships: findings from a PrEP implementation study in Kenya.
Cult Health Sex. 2018 06; 20(6):625-639.CH

Abstract

With the planned scale-up of pre-exposure prophylaxis (PrEP) for HIV prevention among serodiscordant couples in resource-limited settings, gaining an understanding of what motivates serodiscordant couples to prevent HIV is critical. We conducted 44 semi-structured, in-depth individual or couple interviews with 63 participants (33 HIV-infected and 30 HIV-uninfected participants) enrolled in a prospective implementation study of oral antiretroviral-based prevention in Kisumu, Kenya. Transcripts were iteratively analysed using inductive content analysis. Findings point to the importance of maintaining the emotional and economic stability of the partnership and family as motivators in preventing HIV transmission. Female participants identified fear of blame or potential violence for transmitting HIV as a motivator. Furthermore, couples primarily held the HIV-infected individual responsible for HIV prevention, but also held women more accountable for the use of prevention methods such as condoms. These themes substantiate traditional gender norms but also reveal how dyadic interdependence challenges these norms. As programmes in resource-limited settings scale up PrEP access, they should simultaneously capitalise on HIV serodiscordant couples' motivations for HIV prevention and address gender norms so women do not find themselves unduly responsible for the prevention of HIV transmission.

Authors+Show Affiliations

a Division of Allergy and Infectious Diseases, Department of Medicine , University of Washington , Seattle , WA , USA.b Department of Health, Behavior and Society , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA.c Centre for Microbiologic Research , Kenya Medical Research Institute , Nairobi , Kenya.d Center for Global Health Sciences , University of California , San Francisco , CA , USA.e School of Medicine , University of California , San Francisco , CA , USA.c Centre for Microbiologic Research , Kenya Medical Research Institute , Nairobi , Kenya.c Centre for Microbiologic Research , Kenya Medical Research Institute , Nairobi , Kenya. f Departments of Obstetrics and Gynecology and Global Health , University of Washington , Seattle , WA , USA.g Departments of Epidemiology, Global Health, and Medicine , University of Washington , Seattle , WA , USA.h Departments of Epidemiology and Biostatistics and Obstetrics, Gynecology, and Reproductive Sciences , University of California , San Francisco , CA , USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28903628

Citation

Patel, Rena C., et al. "What Motivates Serodiscordant Couples to Prevent HIV Transmission Within Their Relationships: Findings From a PrEP Implementation Study in Kenya." Culture, Health & Sexuality, vol. 20, no. 6, 2018, pp. 625-639.
Patel RC, Leddy AM, Odoyo J, et al. What motivates serodiscordant couples to prevent HIV transmission within their relationships: findings from a PrEP implementation study in Kenya. Cult Health Sex. 2018;20(6):625-639.
Patel, R. C., Leddy, A. M., Odoyo, J., Anand, K., Stanford-Moore, G., Wakhungu, I., Bukusi, E. A., Baeten, J. M., & Brown, J. M. (2018). What motivates serodiscordant couples to prevent HIV transmission within their relationships: findings from a PrEP implementation study in Kenya. Culture, Health & Sexuality, 20(6), 625-639. https://doi.org/10.1080/13691058.2017.1367421
Patel RC, et al. What Motivates Serodiscordant Couples to Prevent HIV Transmission Within Their Relationships: Findings From a PrEP Implementation Study in Kenya. Cult Health Sex. 2018;20(6):625-639. PubMed PMID: 28903628.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - What motivates serodiscordant couples to prevent HIV transmission within their relationships: findings from a PrEP implementation study in Kenya. AU - Patel,Rena C, AU - Leddy,Anna M, AU - Odoyo,Josephine, AU - Anand,Keerthana, AU - Stanford-Moore,Gaelen, AU - Wakhungu,Imeldah, AU - Bukusi,Elizabeth A, AU - Baeten,Jared M, AU - Brown,Joelle M, Y1 - 2017/09/14/ PY - 2017/9/15/pubmed PY - 2019/6/14/medline PY - 2017/9/15/entrez KW - HIV prevention KW - Kenya KW - Motivations KW - gender norms KW - serodiscordant couples SP - 625 EP - 639 JF - Culture, health & sexuality JO - Cult Health Sex VL - 20 IS - 6 N2 - With the planned scale-up of pre-exposure prophylaxis (PrEP) for HIV prevention among serodiscordant couples in resource-limited settings, gaining an understanding of what motivates serodiscordant couples to prevent HIV is critical. We conducted 44 semi-structured, in-depth individual or couple interviews with 63 participants (33 HIV-infected and 30 HIV-uninfected participants) enrolled in a prospective implementation study of oral antiretroviral-based prevention in Kisumu, Kenya. Transcripts were iteratively analysed using inductive content analysis. Findings point to the importance of maintaining the emotional and economic stability of the partnership and family as motivators in preventing HIV transmission. Female participants identified fear of blame or potential violence for transmitting HIV as a motivator. Furthermore, couples primarily held the HIV-infected individual responsible for HIV prevention, but also held women more accountable for the use of prevention methods such as condoms. These themes substantiate traditional gender norms but also reveal how dyadic interdependence challenges these norms. As programmes in resource-limited settings scale up PrEP access, they should simultaneously capitalise on HIV serodiscordant couples' motivations for HIV prevention and address gender norms so women do not find themselves unduly responsible for the prevention of HIV transmission. SN - 1464-5351 UR - https://www.unboundmedicine.com/medline/citation/28903628/What_motivates_serodiscordant_couples_to_prevent_HIV_transmission_within_their_relationships:_findings_from_a_PrEP_implementation_study_in_Kenya_ L2 - http://www.tandfonline.com/doi/full/10.1080/13691058.2017.1367421 DB - PRIME DP - Unbound Medicine ER -