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




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BMC Public Health

, 15:241

Health behavior, health promotion and society

Abstract

BackgroundWhile 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.

MethodsTen 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.

ResultsIncluded 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.

ConclusionsFuture 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.

KeywordsHigh-income settings HIV AIDS Serodiscordant Relationships Review Social Behavioural Electronic supplementary materialThe online version of this article doi:10.1186-s12889-015-1488-9 contains supplementary material, which is available to authorized users.

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