Skip to main content

Advertisement

SpringerLink
Log in

High Rates of Relationship Dissolution Among Heterosexual HIV-Serodiscordant Couples in Kenya

  • Brief Report
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

HIV-1 serodiscordant couples may experience increased risks of relationship dissolution; however, longitudinal stability of these relationships is poorly understood. We determined rates and correlates of separation among 469 serodiscordant couples in Nairobi and found that 113 (24 %) separated during 2 years of follow-up. Couples with a female HIV-1 infected partner (F+M−) and no income were more likely to separate than M+F− couples without income (HR = 5.0; 95 % CI 1.1–25.0), and F+M− and M+F− couples with income (HR = 2.4; 95 % CI 1.3–4.5 and HR = 2.3; 95 % CI 1.2–4.8, respectively). High separation rates may be important for couple support services and for conducting discordant couple studies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

References

  1. Baeten JM, Donnell D, Ndase P, Mugo NR, Campbell JD, et al. Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Engl J Med. 2012;367:399–410.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  2. Guthrie BL, de Bruyn G, Farquhar C. HIV-1-discordant couples in sub-Saharan Africa: explanations and implications for high rates of discordancy. Curr HIV Res. 2007;5:416–29.

    Article  CAS  PubMed  Google Scholar 

  3. Floyd S, Crampin A. The long-term social and economic impact of HIV on the spouses of infected individuals in northern Malawi. Trop Med Int Health. 2008;13:520–31.

    Article  PubMed  Google Scholar 

  4. Grinstead O, Gregorich S. Positive and negative life events after counselling and testing: the Voluntary HIV-1 Counselling and Testing efficacy study. AIDS. 2001;15:1045–52.

    Article  CAS  PubMed  Google Scholar 

  5. Porter L, Hao L, Bishai D, Serwadda D, Wawer MJ, et al. HIV status and union dissolution in sub-Saharan Africa: the case of Rakai, Uganda. Demography. 2004;41:465–82.

    Article  PubMed  Google Scholar 

  6. Mbonu NC, Van den Borne B, De Vries NK. Gender-related power differences, beliefs and reactions towards people living with HIV/AIDS: an urban study in Nigeria. BMC public health. 2010;10:334.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Connell R. Gender and power: society, the person, and sexual politics. Palo Alto: Stanford Univ Press; 1987. p. 334.

    Google Scholar 

  8. Morris M, Kretzschmar M. Concurrent partnerships and the spread of HIV. AIDS. 1997;11:641–8.

    Article  CAS  PubMed  Google Scholar 

  9. Ndase P, Celum C, Thomas K, Donnell D, Fife KH, et al. Outside sexual partnerships and Risk of HIV Acquisition for HIV uninfected partners in African HIV serodiscordant partnerships. J Acquir Immune Defic Syndr. 2012;59:65–71.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Eaton A, van Der Straten A. Concurrent sexual partnerships among individuals in HIV sero-discordant heterosexual couples. Int J STD AIDS. 2009;20:679–82.

    Article  CAS  PubMed  Google Scholar 

  11. Mah TL, Halperin DT. Concurrent sexual partnerships and the HIV epidemics in Africa: evidence to move forward. AIDS Behav. 2010;14:11–6 dicussion 34–7.

    Article  PubMed  Google Scholar 

  12. Sandøy IF, Dzekedzeke K, Fylkesnes K. Prevalence and correlates of concurrent sexual partnerships in Zambia. AIDS Behav. 2010;14:59–71.

    Article  PubMed  Google Scholar 

  13. Boerma JT, Urassa M, Nnko S, Ng’weshemi J, Isingo R, et al. Sociodemographic context of the AIDS epidemic in a rural area in Tanzania with a focus on people’s mobility and marriage. Sex Transm Infect. 2002;78(Suppl 1):i97–105.

    Article  PubMed  Google Scholar 

  14. Molloy GJ, Perkins-Porras L, Strike PC, Steptoe A. Social networks and partner stress as predictors of adherence to medication, rehabilitation attendance, and quality of life following acute coronary syndrome. Health Psychol. 2008;27:52–8.

    Article  PubMed  Google Scholar 

  15. El-Bassel N, Gilbert L, Witte S, Wu E, Hunt T, et al. Couple-based HIV prevention in the United States: advantages, gaps, and future directions. J Acquir Immune Defic Syndr. 2010;55(Suppl 2):S98–101.

    Article  PubMed  Google Scholar 

  16. Sweat M, Gregorich S, Sangiwa G, Furlonge C, Balmer D, et al. Cost-effectiveness of voluntary HIV-1 counselling and testing in reducing sexual transmission of HIV-1 in Kenya and Tanzania. Lancet. 2000;356:113–21.

    Article  CAS  PubMed  Google Scholar 

  17. Burton J, Darbes LA, Operario D. Couples-focused behavioral interventions for prevention of HIV: systematic review of the state of evidence. AIDS Behav. 2010;14:1–10.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Desgrées-du-Loû A, Orne-Gliemann J. Couple-centred testing and counselling for HIV serodiscordant heterosexual couples in sub-Saharan Africa. Reprod Health Matters. 2008;16:151–61.

    Article  PubMed  Google Scholar 

  19. Remien RH, Stirratt MJ, Dolezal C, Dognin JS, Wagner GJ, et al. Couple-focused support to improve HIV medication adherence: a randomized controlled trial. AIDS. 2005;19:807–14.

    Article  PubMed  Google Scholar 

  20. Simoni JM, Frick PA, Huang B. A longitudinal evaluation of a social support model of medication adherence among HIV-positive men and women on antiretroviral therapy. Health Psychol. 2006;25:74–81.

    Article  PubMed  Google Scholar 

  21. Kiarie JN, Kreiss JK, Richardson BA, John-Stewart GC. Compliance with antiretroviral regimens to prevent perinatal HIV-1 transmission in Kenya. AIDS. 2003;17:65–71.

    Article  PubMed Central  PubMed  Google Scholar 

  22. Farquhar C, Kiarie JN, Richardson BA, Kabura MN, John FN, et al. Antenatal couple counseling increases uptake of interventions to prevent HIV-1 transmission. J Acquir Immune Defic Syndr. 2004;37:1620–6.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Byamugisha R, Astrøm AN, Ndeezi G, Karamagi CA, Tylleskär T, et al. Male partner antenatal attendance and HIV testing in eastern Uganda: a randomized facility-based intervention trial. J Int AIDS Soc. 2011;14:43.

    Article  PubMed Central  PubMed  Google Scholar 

  24. Donnell D, Baeten JM, Kiarie J, Thomas KK, Stevens W, et al. Heterosexual HIV-1 transmission after initiation of antiretroviral therapy: a prospective cohort analysis. Lancet. 2010;375:2092–8.

    Article  PubMed Central  PubMed  Google Scholar 

  25. Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365:493–505.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  26. Kim J, Pronyk P. Exploring the role of economic empowerment in HIV prevention. AIDS. 2008;22:S57–71.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This research was funded by US National Institutes of Health (NIH) Grant AI068431. R. Mackelprang was supported by the Institute for Translational Health Science (TL1), a Roadmap Initiative from the National Institutes of Health/National Center for Research Resources (5TL1RR025016), P. Mitchell & S. Marshall, Program Directors. R. Choi was supported by the International Research Scientist Development Award (K01TW008406). R. Choi, A. Rositch and A Gatuguta were supported by the National Institutes of Health Office of the Director, Fogarty International Center, Office of AIDS Research, National Cancer Center, National Eye Institute, National Heart, Blood and Lung Institute, National Institute of Dental and Craniofacial Research, National Institute on Drug Abuse, National Institute of Mental Health, National Institute of Allergy and Infectious Diseases Health, through the International Clinical Research Fellows Program at Vanderbilt (R24 TW007988). This research was supported by the University of Washington Center for AIDS Research (CFAR), an NIH funded program (P30 AI027757) which is supported by the following NIH Institutes and Centers (NIAID, NCI, NIMH, NIDA, NICHD, NHLBI, NIA). C. Farquhar received support from NIH Grant K24 AI087399.

Author information

Authors and Affiliations

  1. Department of Epidemiology, University of Washington, 325 Ninth Avenue, Seattle, WA, 98104, USA

    Romel D. Mackelprang, Brandon L. Guthrie, Amy Liu & Carey Farquhar

  2. Department of Global Health, University of Washington, 325 Ninth Avenue, Seattle, WA, 98104, USA

    Romel D. Mackelprang & Carey Farquhar

  3. Department of Medicine, University of Washington, 325 Ninth Avenue, Seattle, WA, 98104, USA

    Robert Y. Choi & Carey Farquhar

  4. Centre for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya

    Rose Bosire

  5. Department of Community Health, University of Nairobi, Nairobi, Kenya

    Anne Gatuguta

  6. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Anne F. Rositch

  7. Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya

    James N. Kiarie

Authors
  1. Romel D. Mackelprang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rose Bosire
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Brandon L. Guthrie
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Robert Y. Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Amy Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Anne Gatuguta
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Anne F. Rositch
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. James N. Kiarie
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Carey Farquhar
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Romel D. Mackelprang.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mackelprang, R.D., Bosire, R., Guthrie, B.L. et al. High Rates of Relationship Dissolution Among Heterosexual HIV-Serodiscordant Couples in Kenya. AIDS Behav 18, 189–193 (2014). https://doi.org/10.1007/s10461-013-0529-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-013-0529-6

Keywords

Search

Navigation