*Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA; and †Georgia Department of Public Health, Office of HIV Prevention, Atlanta, GA.
J Acquir Immune Defic Syndr. 2013 Nov 1;64 Suppl 1(0 1):S52-61. doi: 10.1097/QAI.0b013e3182a9014a.
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.
简介:同性性伴侣的男男性行为者是一个高优先级的风险群体,大约有三分之一到三分之二的男男性行为者的新 HIV 感染归因于主要伴侣关系。早期开始并坚持使用高效抗逆转录病毒疗法是 HIV 预防和治疗的关键因素;然而,美国的高效抗逆转录病毒疗法的依从性很低,在整个护理连续体中保留率很差。本研究考察了男男性行为者对同性性伴侣 HIV 治疗的看法,以了解他们对与伴侣一起寻求护理的偏好。
方法:我们在佐治亚州亚特兰大市进行了 5 次焦点小组讨论,共有 35 名报告处于同性男性伴侣关系的男性参加。参与者使用一对最近收到血清不一致或血清一致的 HIV 阳性结果的假设同性男性伴侣的情景讨论了对护理的看法。逐字记录被分段进行主题和系统分析,以检查参与者和焦点小组讨论内部和之间的反应模式。
结果:参与者确定了对综合同性伴侣护理的需求以及对血清一致 HIV 阳性与血清不一致伴侣护理的差异。参与者描述了综合同性伴侣护理和积极关系动态之间的互惠关系。这种组合被描述为增强承诺,最终导致增加问责制和治疗依从性。
讨论:结果表明,如果护理是全面的、关注个人和伴侣的需求并促进积极的关系动态,那么同性男性伴侣“共同努力实现目标”的行为可能会增加整个 HIV 护理连续体的保留率。
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