Marital infidelity, food insecurity, and couple instability: A web of challenges for dyadic coordination around antiretroviral therapy.
Marital infidelity, food insecurity, and couple instability: A web of challenges for dyadic coordination around antiretroviral therapy.
复制标题
婚姻不忠，粮食不安全和情侣不稳定：抗逆转录病毒疗法周围二元协调的挑战网络。
DOI：
10.1016/j.socscimed.2018.08.006
复制
发表时间：
2018-10
期刊：
影响因子：
--
通讯作者：
Mkandawire J
中科院分区：
文献类型：
--
作者：
Conroy AA;McKenna SA;Comfort ML;Darbes LA;Tan JY;Mkandawire J
尽管主要伙伴对健康很重要，但人们对限制夫妇合作进行艾滋病毒护理和治疗（二人协调）的能力的因素知之甚少。本研究探讨了马拉维的婚姻不忠、粮食不安全和夫妻不稳定对抗逆转录病毒治疗（ART）的协调和依从性的相互作用。2016年，我们对25对至少有一个伴侣接受抗逆转录病毒治疗的夫妇进行了80次深入访谈。这些夫妇在参加诊所预约时被招募到宗巴区的两个艾滋病诊所。参与者被问及他们的关系史，关系动态（爱，信任，冲突），艾滋病毒护理和治疗的经验，以及合作伙伴如何参与。使用一种创新的分析方法，我们通过检查夫妇内部和夫妇之间的模式来分析夫妇层面的数据。出现了三种模式。对于一些夫妇来说，在男性终止他们的婚外伴侣关系以换取爱和支持后，ART导致了他们关系的积极变化。对于其他权力不平衡和持续冲突的夫妇，男性的不忠在ART后继续存在，并对二元协调产生负面影响。最后，一些夫妇同意保持"忠诚"，但无法克服与粮食无保障有关的压力，这直接影响到他们的忠诚。以夫妇为基础的干预措施，针对抗逆转录病毒疗法的坚持，应提高关系质量，同时也解决人际压力，如婚姻不忠和粮食不安全。对于粮食严重无保障的夫妇，可能需要采取多层次的干预措施，既解决二元问题，也解决结构问题。
Despite the importance of primary partners for health, little is known about factors that constrain the ability of couples to work collaboratively towards HIV care and treatment (dyadic coordination). This study examined the interplay of marital infidelity, food insecurity, and couple instability on dyadic coordination and adherence to antiretroviral therapy (ART) in Malawi. In 2016, we conducted 80 in-depth interviews with 25 couples with at least one partner on ART. Couples were recruited at two HIV clinics in the Zomba district when attending clinic appointments. Participants were asked about their relationship history, relationship dynamics (love, trust, conflict), experiences with HIV care and treatment, and how partners were involved. Using an innovative analysis approach, we analyzed the data at the couple-level by examining patterns within and between couples. Three patterns emerged. For some couples, ART led to positive changes in their relationships after men terminated their extramarital partnerships in exchange for love and support. For other couples with power imbalances and ongoing conflict, men’s infidelity continued after ART and negatively affected dyadic coordination. Finally, some couples agreed to remain “faithful”, but could not overcome stressors related to food insecurity, which directly impacted their adherence. Couples-based interventions targeting ART adherence should improve relationship quality, while also addressing interpersonal stressors such as marital infidelity and food insecurity. Multi-level interventions that address both dyadic and structural levels may be necessary for couples with severe food insecurity.
登录
查看更多内容
影响因子：
8.1
作者：
Heestermans T;Browne JL;Aitken SC;Vervoort SC;Klipstein-Grobusch K
通讯作者：
Klipstein-Grobusch K
DOI：
10.1097/qai.0000000000000553
发表时间：
2015-05-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Fox MP;Rosen S
通讯作者：
Rosen S
影响因子：
5.4
作者：
Conroy, Amy A.;Wong, Lauren H.
通讯作者：
Wong, Lauren H.
高度边缘化妇女代理权的概念化： 极端环境下的亲密伴侣暴力
影响因子：
3.3
作者：
Campbell, Catherine;Mannell, Jenevieve
通讯作者：
Mannell, Jenevieve
影响因子：
4.4
作者：
Blashill, Aaron J.;Bedoya, C. Andres;Mayer, Kenneth H.;O'Cleirigh, Conall;Pinkston, Megan M.;Remmert, Jocelyn E.;Mimiaga, Matthew J.;Safren, Steven A.
通讯作者：
Safren, Steven A.