Center for Microbiology Research, Research Care & Training Program, Kenya Medical Research Institute, Box 614, Kisumu, 40100, Kenya.
Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
Arch Sex Behav. 2022 Nov;51(8):3689-3701. doi: 10.1007/s10508-021-02180-9. Epub 2022 Mar 25.
Poor marital satisfaction is associated with high-risk sexual behavior and HIV transmission. We tested whether a counselor-led couple education and counseling intervention dubbed Waya (paternal aunt) would improve marital satisfaction and reduce HIV risk behavior among married couples in Kisumu County, western Kenya. In a pre-post design, we enrolled 60 heterosexual married couples at high risk for HIV to undergo five 1-h couple education and counseling sessions over 56 days. We collected self-reported data on marital satisfaction, the number of sex partners, and condom use with extramarital partners at pre- and post-intervention visits. We used Wilcoxon and McNemar tests to examine the association of our intervention with marital relationship satisfaction and reduction in HIV risk sexual behavior. The intervention was associated with marital relationship satisfaction score improvement from a median of 5 (interquartile range [IQR], 4-5) to 6 (IQR, 6-7) among men and 4 (IQR, 3-5) to 6 (IQR, 5-6) among women (p < .01). The intervention was also associated with reducing HIV risk sexual behaviors depicted by a reduction in the number of sex partners in the past one month and an increase in consistent extramarital condom use. The number of sex partners reduced from a median of 2 (IQR, 1-2) to 1 (IQR, 1-2) and consistent extramarital condom use increased from 4% at baseline to 56% among men. Our intervention was associated with improvements in marital relationship satisfaction and reductions in HIV high-risk behaviors necessary for achieving epidemic control in HIV hotspots such as fishing communities in western Kenya.
婚姻满意度低与高危性行为和 HIV 传播有关。我们测试了一种由顾问主导的夫妻教育和咨询干预措施，称为 Waya（姑妈），是否可以提高肯尼亚西部基苏木县已婚夫妇的婚姻满意度并减少 HIV 高危行为。在一项前后设计中，我们招募了 60 对在 HIV 高危人群中处于高危状态的异性已婚夫妇，让他们在 56 天内接受 5 次 1 小时的夫妻教育和咨询课程。我们在干预前和干预后收集了自我报告的数据，包括婚姻满意度、性伴侣数量和与婚外性伴侣使用避孕套的情况。我们使用 Wilcoxon 和 McNemar 检验来检验我们的干预措施与婚姻关系满意度和减少 HIV 高危性行为之间的关联。该干预措施与男性的婚姻关系满意度评分从中位数 5（四分位距 [IQR]，4-5）提高到 6（IQR，6-7）以及女性的婚姻关系满意度评分从中位数 4（IQR，3-5）提高到 6（IQR，5-6）相关（p < 0.01）。该干预措施还与减少 HIV 高危性行为相关，具体表现为过去一个月的性伴侣数量减少和婚外性行为中持续使用避孕套的增加。性伴侣数量从中位数 2（IQR，1-2）减少到 1（IQR，1-2），而婚外性行为中持续使用避孕套的比例从基线时的 4%增加到 56%。我们的干预措施与婚姻关系满意度的提高和 HIV 高危行为的减少有关，这是在像肯尼亚西部的渔业社区这样的 HIV 热点地区实现疫情控制所必需的。
