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Individual and Interpersonal Characteristics that Influence Male-Dominated Sexual Decision-Making and Inconsistent Condom Use Among Married HIV Serodiscordant Couples in Gujarat, India: Results from the Positive Jeevan Saathi Study

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Abstract

Approximately 40 % of new infections occur among married women. No studies have examined the factors that may contribute to HIV transmission among HIV-negative wives in HIV serodiscordant relationships in Gujarat, India. In 2010, a cross-sectional survey with 185 HIV serodiscordant, married couples (i.e. 185 HIV-positive husbands and their 185 HIV-negative wives) in Gujarat was conducted. Socio-demographic, individual, and interpersonal characteristics of HIV-positive husbands and their HIV negative wives were examined. The association of these characteristics with inconsistent condom use and male-dominated sexual decision-making, were examined using multivariate logistic regression analyses. Approximately 10 % of couples reported inconsistent condom use in the past 3 months and 20 % reported intimate partner violence (IPV). Reports of IPV were associated with a higher odds of inconsistent condom use among HIV-positive husbands (aOR = 6.281). Husbands who reported having received couples counseling had a lower odds of male-dominated decision making about condom use (aOR = 0.372). HIV-negative wives who reported sex communication had a lower odds of male-dominated decision making about condom use (aOR = 0.322) with their HIV-positive husbands. Although condom use is a traditional measure of risk behavior, other factors that facilitate risk, such as male-dominated sexual decision-making need to be considered in analyses of risk.

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Acknowledgments

The authors would like to thank the Gujarat State AIDS Control Society, all the staff at Network of Surat Positives (NSP+), and the Voluntary Counseling and Testing Center at Civil Hospital for their support of this research. Also, many thanks to an incredible staff including Nisha Patel, Sylvester Alvares, Mahendra Ghaskata, Dinesh Das, and Hiteshbhai. In addition, we would like to thank Dr. Alap Mehta, Dr. Vikas Desai and Dr. S. L. Kantharia for their support of this research. Lastly, the authors would like to sincerely thank Dr. Anna Rubtsova for reviewing and editing the paper.

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Authors and Affiliations

  1. Department of Behavioral Sciences & Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road Northeast, Atlanta, GA, 30329, USA

    Shilpa N. Patel, Gina M. Wingood & Michael Windle

  2. Hubert Department of Global Health, Emory University, Atlanta, GA, USA

    Kathryn Yount & Monique Hennink

  3. Department of Preventive and Social Medicine, Government Medical College, Surat, India

    J. K. Kosambiya

  4. Institute of Public Health, Georgia State University, Atlanta, GA, USA

    Frances McCarty

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  1. Shilpa N. Patel
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  2. Gina M. Wingood
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  3. J. K. Kosambiya
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  4. Frances McCarty
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  6. Kathryn Yount
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Correspondence to Shilpa N. Patel.

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Patel, S.N., Wingood, G.M., Kosambiya, J.K. et al. Individual and Interpersonal Characteristics that Influence Male-Dominated Sexual Decision-Making and Inconsistent Condom Use Among Married HIV Serodiscordant Couples in Gujarat, India: Results from the Positive Jeevan Saathi Study. AIDS Behav 18, 1970–1980 (2014). https://doi.org/10.1007/s10461-014-0792-1

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  • DOI: https://doi.org/10.1007/s10461-014-0792-1

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