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Title

What’s Love Got to Do With It? Explaining Adherence to Oral Antiretroviral Pre-Exposure Prophylaxis for HIV-Serodiscordant Couples

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Other

Organization

 

Journal Name

JAIDS

Publication Date

4/15/2012

PubMed Search

http://www.ncbi.nlm.nih.gov/pubmed?term=What%E2%80%99s%20Love%20Got%20to%20Do%20With%20It%3F%20Explaining%20Adherence%20to%20Oral%20Antiretroviral%20Pre-Exposure%20Prophylaxis%20for%20HIV-Serodiscordant%20Couples

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PMID

 

Abstract

Adherence may be the "Achilles heel" of pre-exposure prophylaxis (PrEP), a promising biomedical approach to HIV prevention. This article presents an explanation of PrEP adherence for African serodiscordant couples derived from qualitative data.

DESIGN:

Explaining quantitative findings is one way qualitative investigation contributes to research in medicine and public health. This qualitative interview study was nested in the Partners PrEP Study, a phase III randomized trial evaluating oral tenofovir and emtricitabine/tenofovir PrEP to prevent HIV acquisition by HIV-uninfected partners in serodiscordant heterosexual couples.

METHODS:

In-depth qualitative interviews were provided by 60 Partners PrEP Study participants in Uganda. Interviews used open-ended questions eliciting information on adherence experiences, barriers, and facilitators. An inductive approach informed by grounded theory methodology was used to analyze study data.

RESULTS:

The proposed explanation may be summarized as follows. Serodiscordance destabilizes couples, as the HIV-negative partner reacts with anger, fear, and sadness to the implication of infidelity represented by HIV infection. A "discordance dilemma" ensues, as the desire to avoid acquiring HIV and the advantages of preserving the relationship become competing priorities. PrEP is seen as a solution-a means of safeguarding health without ending the relationship. PrEP users benefit from the support of partners, who reinforce adherence. Where discord in the relationship persists, adherence suffers.

CONCLUSIONS:

PrEP adherence in serodiscordant couples may be understood as a function of the desire to reduce risk although preserving a partnered relationship. PrEP use in stable couples may be associated with improved adherence and thus, greater effectiveness.

Keywords

 

Topic

Adherence; Serodiscordant Couples; Women

Attachments

Created at 8/1/2012 2:38 PM by Davis, Gregory P
Last modified at 8/1/2012 2:38 PM by Davis, Gregory P