A scoping review and thematic analysis of social and behavioural research among HIV-serodiscordant couples in high-income settings

BMC Public Health

Ted Myers⁴  Mona Loutfy³  Adam Bourne²  Dan Allman⁴  Joel Pidutti⁴  Sanjana Mitra⁴  Amrita Daftary¹  Liviana Calzavara⁴  Joshua B Mendelsohn⁴ 

[1] Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu Natal, Durban, South Africa;Sigma Research Group, London School of Hygiene and Tropical Medicine, London, UK;Women’s College Research Institute, Women’s College Hospital, University of Toronto, Toronto, ON, Canada;Dalla Lana School of Public Health, University of Toronto, Toronto, Canada

关键词: Behavioural;    Social;    Review;    Relationships;    Serodiscordant;    AIDS;    HIV;    High-income settings;   

Others  :  1138427
DOI  :  10.1186/s12889-015-1488-9

 received in 2014-09-16, accepted in 2015-01-28,  发布年份 2015

【 摘 要 】

Background

While HIV incidence has stabilized in many settings, increases in health and wellbeing among many people living with HIV/AIDS suggest that the number of HIV-serodiscordant relationships is growing. Given the deficit of reviews addressing social and behavioural characteristics of HIV-serodiscordant couples within high-income settings, our objective was to understand the scope of the published literature, identify evidence gaps, and suggest future research needs.

Methods

Ten electronic databases were searched. Studies were included if they were reported in English, used primary data, were from the combination antiretroviral (cART) era (>1996), reported on social or behavioural aspects, included any fraction of primary (i.e., stable) relationships, and were conducted in high-income settings. Studies that identified their unit of analysis as either the dyad or individual member of the couple were included. Studies were coded according to a thematic framework.

Results

Included studies (n = 154) clustered into eight themes: risk behaviours (29%), risk management (26%), reproductive issues (12%), relationship quality (9%), serostatus disclosure (7%), adherence to antiretroviral therapy (7%), vulnerability (5%), and social support (3%). The proportion of studies conducted among heterosexual couples, same-sex male couples, and mixed cohorts were 42%, 34%, and 24%, respectively. Most studies (70%) were conducted in the United States, 70% of all studies were quantitative (including interventions), but only one-third were focused on couples (dyads) where both partners are recruited to a study. Over 25% of studies focused on sexual risk among same-sex male couples.

Conclusions

Future research efforts should focus on the interrelationship of risk management strategies and relationship quality, social determinants of health and wellbeing, HIV testing, vulnerable populations, reproductive issues among same-sex couples, disclosure of serodiscordant status to social networks, dyadic studies, population-based studies, and interventions to support risk management within couples. Additional population-based studies and studies among marginalized groups would be helpful for targeting research and interventions to couples that are most in need. As HIV-positive partners are typically the link to services and research, innovative ways are needed for reaching out to HIV-negative partners. Our review suggests that significantly more research is needed to understand the social and behavioural contexts of HIV-serodiscordant relationships.

【 授权许可】

   
2015 Mendelsohn et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

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