HIV and dyadic intervention: an interdependence and communal coping analysis.
HIV and dyadic intervention: an interdependence and communal coping analysis.
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DOI：
10.1371/journal.pone.0040661
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Pool R
中科院分区：
文献类型：
--
作者：
Montgomery CM;Watts C;Pool R
在撒哈拉以南非洲，最常见的艾滋病毒传播形式是两个伴侣之间的异性性行为。虽然大多数艾滋病毒预防干预措施是针对个人的，但越来越多的证据表明双重干预措施的可行性、可接受性和有效性。然而，通过双元水平的干预措施取得成功的机制仍然很少探索。我们通过使用Lewis等人的夫妻共同应对和行为改变的相互依赖模型来分析乌干达和赞比亚参与艾滋病毒预防试验的伴侣的数据，从而解决了这一差距。我们采用深度访谈的方法进行了比较定性研究。共进行了33次访谈；10对夫妇和23对工作人员在两个地点。乌干达网站招募了一组血清不一致的夫妇，而赞比亚网站只招募了女性。配偶的动机转变是强烈的，当夫妻被招募时，双方都可以通过参与研究获得相当大的收益；在没有这种情况的地方，它会更弱。因此，这两个地方的应对机制不同；在乌干达血清不一致的夫妇中，通过共同同意参与、定期夫妻咨询和讲习班、分享艾滋病毒检测结果以及配偶对坚持和保留艾滋病毒的大力支持，证明了共同应对。相比之下，赞比亚的情况则主要由女性个人来处理，而且是在相互不信任和男性权利被剥夺的背景下发生的。我们讨论这些发现在实际和伦理考虑招募夫妇艾滋病毒的研究。我们认为有必要考虑行为变化发生的更广泛的背景，并建议未来的二元研究位于“风险环境”的框架内。
The most common form of HIV transmission in sub-Saharan Africa is heterosexual sex between two partners. While most HIV prevention interventions are aimed at the individual, there is mounting evidence of the feasibility, acceptability, and efficacy of dyadic interventions. However, the mechanisms through which dyadic-level interventions achieve success remain little explored. We address this gap by using Lewis et al’s interdependence model of couple communal coping and behaviour change to analyse data from partners participating in an HIV prevention trial in Uganda and Zambia. We conducted a comparative qualitative study using in-depth interviews. Thirty-three interviews were conducted in total; ten with couples and twenty-three with staff members at the two sites. The Ugandan site recruited a sero-discordant couple cohort and the Zambian site recruited women alone. Spouses’ transformation of motivation is strong where couples are recruited and both partners stand to gain considerably by participating in the research; it is weaker where this is not the case. As such, coping mechanisms differ in the two sites; among sero-discordant couples in Uganda, communal coping is evidenced through joint consent to participate, regular couple counselling and workshops, sharing of HIV test results, and strong spousal support for adherence and retention. By contrast, coping at the Zambian site is predominantly left to the individual woman and occurs against a backdrop of mutual mistrust and male disenfranchisement. We discuss these findings in light of practical and ethical considerations of recruiting couples to HIV research. We argue for the need to consider the broader context within which behaviour change occurs and propose that future dyadic research be situated within the framework of the ‘risk environment’.
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影响因子：
3.2
作者：
Carlander, Ida;Ternestedt, Britt-Marie;Sandberg, Jonas
通讯作者：
Sandberg, Jonas
影响因子：
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通讯作者：
Orne-Gliemann, Joanna
影响因子：
4.4
作者：
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Operario, Don