"Working Together to Reach a Goal": MSM's Perceptions of Dyadic HIV Care for Same-Sex Male Couples

• Type of Material: Article
• Authors: Tamar Goldenberg, Emory University; Donato Clarke, Georgia Department of Public Health; Robert Stephenson, Emory University
• Language: English
• Date: 2013-11-01
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: Copyright © 2013 by Lippincott Williams & Wilkins.
• Final Published Version (URL): http://dx.doi.org/10.1097/QAI.0b013e3182a9014a
• Title of Journal or Parent Work: Journal of Acquired Immune Deficiency Syndromes
• ISSN: 1525-4135
• Volume: 64
• Issue: SUPPL. 1
• Start Page: S52
• End Page: S61
• Grant/Funding Information: This work was supported by supplemental funds to the grant 5P30AI087714 for the Enhanced Comprehensive HIV Prevention Planning Initiative (CFAR ECHPP Initiative); and the Center for AIDS Research at Emory University (P30 AI050409).
• Keywords: Life Sciences & Biomedicine; ANTIRETROVIRAL THERAPY; PREVENTION; MSM; SOCIAL SUPPORT; Science & Technology; RWANDA; dyadic HIV care; same-sex male relationships; HAART adherence; PARTNERS; MEDICATION ADHERENCE; DISCORDANT COUPLES; Infectious Diseases; Immunology; MEN
• Research Categories: Health Sciences, Public Health

Abstract

INTRODUCTION: Same-sex serodiscordant male dyads represent a high-priority risk group, with approximately one to two thirds of new HIV infections among men who have sex with men attributable to main partnerships. Early initiation and adherence to highly active antiretroviral therapy is a key factor in HIV prevention and treatment; however, adherence to highly active antiretroviral therapy in the United States is low, with poor retention throughout the continuum of care. This study examines the perceptions of dyadic HIV treatment of men who have sex with men across the continuum of care to understand the preferences for how care may be sought with a partner. METHODS: We conducted 5 focus group discussions in Atlanta, GA, with 35 men who reported being in same-sex male partnerships. Participants discussed perceptions of care using scenarios of a hypothetical same-sex male couple who recently received serodiscordant or seroconcordant HIV-positive results. Verbatim transcripts were segmented thematically and systematically analyzed to examine patterns in responses within and between participants and focus group discussions. RESULTS: Participants identified the need for comprehensive dyadic care and differences in care for seroconcordant HIV-positive versus serodiscordant couples. Participants described a reciprocal relationship between comprehensive dyadic care and positive relationship dynamics. This combination was described as reinforcing commitment, ultimately leading to increased accountability and treatment adherence. DISCUSSION: Results indicate that the act of same-sex male couples "working together to reach a goal" may increase retention to HIV care across the continuum if care is comprehensive, focuses on both individual and dyadic needs, and promotes positive relationship dynamics.