Living In A Serodiscordant Relationship Knowledge Challenges And Coping Strategies Among Hiv Discordant Couples In Addis Ababa

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Background: HIV discordant couples, where the male and female have different HIV test results,rnare the largest at-risk group for transmission in sub-Saharan Africa. Research in 12 countries inrneastern and southern Africa shows that prevalence of discordant couples is high. rangingrnbel1Veen 36% and 85% (UNAIDS Report on the Global AIDS Epidemic: 2010).So far. mostrnstudies on discordant couples emphasized on the bio-medical aspect of the couples 'with onlyfewrnoj'them concerned with hovlI the couples managed the discordance. The present study shadedrnlight on the pS,vcho-social aspect qfliving in discordant relationshljJ.rnAims: The major aim of this study was to explore the experiences of HIV discordant couples in arnsteady relationship.rnMethods: A qualitative approach was utitized to achieve the o~iective of this study. Twenty twornin-depth interviews were conducted with discordant couples and with an intention to elaborate inrnmore detail the experiences of discordant couples; two oral histOlY case studies were conducted.rnThese two cases were selectedfrom the in-depth interviews as they were found to be exemplaryrncases reflecting the communalities among discordant couples. Further, ten in-depth interviewsrnwere carried with key informants in order to assess health professionals' and counselors'rnexplanation for HIV discordance and their experience with discordant couples. The samplesrnwere drawn using purposive sampling. The data were analyzed using the successivernapproximat ion approach.rnFindings: The study revealed that there were widespread misconceptions about J-/IVrndiscordance among both HIV discordant couples and key informants (health care providers andrncounselors). These misconceptions in turn made HIV discordant couples to engage in riskyrnsexual behaviors. HIV discordant couples experienced varieties of psycho-social problems suchrnas fear of infecting and being infected, blame, neglect, guilt, and uncertainty. The couples alsornfaced challenges regarding their sexual life like exhaustion with condom use, reduction in sexualrndesire and pleasure, reduction infrequency of sex and alteration in reproductive plan. Safer sex,rncoitus interrupts, non-penetrative sex, abstinence, communication, disclosure, silence, secrecy,rncooperation, and religion were found to be the coping strategies of the couples. Finally, it wasrnfound that for some couples the presence of HIV did not bring any change in their relationship.rnConclusion: Commonly, it might be assumed that at least the negative partner in HIV discordantrnre lationship makes every effort to avoid infection. But, the .findings oj' the present studyrnconfirmed that this is a mere speculation that significant number of informants failed to employrnany preventive strategies and if any some of them were found to be ineffective like, coitusrninterrupts. Several factors which operate at different levels may contribute to such risk takingrnbehavior indicating the utility of an integrated model to understand individuals ' health behavior.rnThe extensive misconceptions about HIV discordance and ineffective coping strategies utilizedrnby the informants suggesT the needfor micro, mezzo, and macro level interventions

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Living In A Serodiscordant Relationship Knowledge Challenges And Coping Strategies Among Hiv Discordant Couples In Addis Ababa

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