The Benefits Of Couple Therapy
Biomedical prevention pre-exposure prophylaxis, PrEP and treatment antiretroviral therapy, ART can provide benefits to sexual partners and can be The Benefits Of Couple Therapy to prevent infection within HIV serodiscordant couples. However, research is typically focused on individuals, not dyads, even when the intervention may directly or indirectly impact sexual partners.
Gaps remain in understanding best practices for Media Issues, informed consent, and intervention implementation in studies involving HIV prevention and treatment among heterosexual serodiscordant couples. This qualitative study was undertaken to understand and describe decision-making and dyadic-level influence among members of serodiscordant couples regarding 1 participation in a dyadic-based research study involving HIV self-testing and access to PrEP, and 2 utilization of PrEP and ART. Interviews were transcribed verbatim and translated from Kiswahili into English.
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Data were analyzed using thematic analysis. Conclusions The study found that couples made joint decisions regarding study participation and uptake of HIV-related medication. Relational autonomy and dyadic-level influence should be considered within research and programs involving HIV serodiscordant couples. Peer Review reports Background An estimated 1.
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Research has found rates of HIV seroconversion within married couples in Tanzania are higher than within the general population, with incidence rates among married women significantly greater than for married men [ 3 ]. This finding reflects the significant gender differences regarding HIV infection and risk seen across sub-Saharan Africa, [ 45 ] with girls and women disproportionately affected due to The Benefits Of Couple Therapy, social, cultural, and economic factors [ 6789 ].
Several PrEP and early antiretroviral therapy ART trials and demonstration article source have signaled that partner support is a major consideration for study participation and medication adherence [ 161718 ]. Follow-up interviews with participants found that decisions were strongly influenced by perceived support or disapproval from partners, families, and communities [ 2122 ].
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Research among heterosexual couples in sub-Saharan Africa have found several distinct patterns of partner influence on ART adherence—both positive e. Despite these examples of partner influence on uptake of and adherence to HIV prevention and treatment, decision-making is traditionally conceptualized as an individual process [ eBnefits ]. As most life decisions are influenced by our social context, particularly influence from a partner or other significant relationship, gaps exist in our understanding of how to incorporate and allow for dyadic-level influence in research and programs while still promoting autonomy among couples [ 27 ]. This is especially true for interventions O dyadic participation, or for those directly affecting both members of a couple, thus requiring some level of joint decision making.
The concept of relational autonomy, which values and acknowledges the social influences and interdependence that realistically inform decision-making, [ 2728 ] is particularly salient for research involving HIV. Although HIV prevention and treatment are most frequently conceptualized individually, these decisions are often made within dyadic relationships.
Research has shown that taking protective measures against HIV, such as using condoms, can create mistrust between partners or serve as a tacit admission of infidelity, thus pitting love and trust against prevention [ 2930 Coupld, 31 ]. Couple-based interventions for HIV prevention have demonstrated that strengthening interpersonal communication can lead to increased HIV testing and reduced sexual risk behavior [ 333435 ]. These findings, along with a growing body of research, [ 13232433343536373839404142 ] demonstrate The Benefits Of Couple Therapy importance of dyadic-level influence on HIV prevention and treatment.
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Relational autonomy is particularly relevant to HIV because methods of prevention and treatment are uniquely intertwined as the actions of one person may directly affect another. Additionally, gender roles and norms dictate how men and women interact in heterosexual relationships. Women often have less power to negotiate in sexual Mencius Summary as sexual-decision making is male-dominated, [ 47 ] have less access to education and resources, [ 48 ] and often face physical and sexual violence [ 749 ]. As related to HIV risk, these masculinities often manifest themselves through high-risk sexual behavior, engaging in age-disparate relationships, intimate partner violence, and Couplle sex [ 7495152 ].
These factors all play a role in shaping HIV-related risk, as well as The Benefits Of Couple Therapy partner communication and decision-making within couples.
Given the expanding HIV prevention options for heterosexual serodiscordant couples that leverage the interconnectedness between prevention and treatment, it is critical to understand how serodiscordant couples make decisions to protect their own health and that of their partner sand it is equally critical to understand how to honor and appropriately involve both members of couples in Cokple studies affecting them.
Although research has demonstrated dyadic-level influence in decision-making regarding uptake of ART and PrEP when viewed as separate interventions among HIV serodiscordant couples http://rmt.edu.pk/nv/custom/analysis-of-paulo-freire-s-the-pedogogy/motifs-in-emily-brontes-wuthering-heights.php sub-Saharan Africa, [ 232436374142 ] to our knowledge no study has examined decision-making among couples who were offered dyadic enrollment in a research study involving access to both PrEP and ART simultaneously.
Methods Study context This qualitative sub-study was nested within a larger observational cohort study taking The Benefits Of Couple Therapy in Kisarawe, Tanzania to Theraoy the feasibility, safety, and impact of a dyadic-based HIV self-testing and dyadic care component for serodiscordant couples. Couples who learned The Benefits Of Couple Therapy their serodiscordance through self-testing and couples who already knew of their serodiscordance were eligible to enroll in the dyadic care portion of the study.]
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