University of North Carolina Project, Lilongwe, Malawi.
Centers for Disease Control and Prevention, Atlanta, USA.
Afr J AIDS Res. 2021 Mar;20(1):61-69. doi: 10.2989/16085906.2021.1872664.
: Limited information exists about relationship dynamics and their role in HIV acquisition, HIV disclosure, hormonal contraceptive uptake, and condom use among women in Malawi.: Ninety-seven women aged 18-45 years were randomly assigned to initiate the depot medroxyprogesterone acetate injectable or levonorgestrel implant from May 2014 to April 2015 in Lilongwe, Malawi. Women were recruited after randomisation to participate in semi-structured interviews about HIV and family planning using purposive sampling. Interviews were thematically analysed using within and between group comparisons.: We conducted individual interviews and/or focus group discussions with 41 women: 30 (73%) women living with HIV and 11 (27%) women not living with HIV. Most women living with HIV who participated in in-depth interviews disclosed their status to their partners, and most partners agreed to get HIV tested only after disclosure. Nearly all women said their partners agreed to use condoms, but few used them consistently. Nearly all women believed their current and former partners had outside partners. Most women living with HIV who participated in in-depth interviews believed their current or other serious partners were the source of their infection. Some women thought their partner's infidelity was due to their partner's disinterest in sex with them during menstrual/ breakthrough bleeding. Some women included their partners in contraceptive decision-making when the partner was supportive.: Relationship dynamics affected decision-making for contraceptive and condom use, as well as serodisclosure for the women living with HIV in the study. All women reported challenges with consistent condom use with their male partners, although contraceptive use was generally more acceptable. Women included their partners in their decision-making concerning contraceptive use when they were supportive.
关于关系动态及其在马拉维妇女的艾滋病毒感染、艾滋病毒披露、激素避孕药具的采用和避孕套使用中的作用，相关信息有限。
2014 年 5 月至 2015 年 4 月期间，97 名年龄在 18-45 岁的妇女在马拉维利隆圭被随机分配开始使用 depot 甲羟孕酮醋酸酯注射剂或左炔诺孕酮植入剂。妇女在随机分组后被招募参加关于艾滋病毒和计划生育的半结构化访谈，采用的是有目的抽样。使用组内和组间比较对访谈进行了主题分析。
我们对 41 名妇女进行了个人访谈和/或焦点小组讨论：30 名（73%）感染艾滋病毒的妇女和 11 名（27%）未感染艾滋病毒的妇女。大多数参与深入访谈的感染艾滋病毒的妇女向其伴侣透露了她们的状况，而大多数伴侣在披露后才同意接受艾滋病毒检测。几乎所有妇女都说她们的伴侣同意使用避孕套，但很少有人持续使用。几乎所有妇女都认为她们的当前和前任伴侣有婚外伴侣。大多数参与深入访谈的感染艾滋病毒的妇女认为她们当前或其他重要伴侣是她们感染的源头。一些妇女认为她们伴侣的不忠是由于伴侣在月经/突破性出血期间对与她们发生性关系不感兴趣。一些妇女在伴侣支持时，将伴侣纳入避孕决策。
关系动态影响了避孕和避孕套使用的决策，以及研究中感染艾滋病毒的妇女的血清学披露。所有妇女都报告说，与她们的男性伴侣持续使用避孕套存在挑战，尽管避孕药具的使用通常更能被接受。当伴侣支持时，妇女将伴侣纳入她们的避孕决策。
