Relationship Dynamics and Partner Beliefs About Viral Suppression: A Longitudinal Study of Male Couples Living with HIV/AIDS (The Duo Project)

Springer Science and Business Media LLC - Tập 20 - Trang 1572-1583 - 2016
Amy A. Conroy1, Kristi E. Gamarel2, Torsten B. Neilands1, Samantha E. Dilworth1, Lynae A. Darbes3, Mallory O. Johnson1
1Department of Medicine, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, USA
2Department of Psychiatry and Human Behavior, Brown University, Providence, USA
3Department of Health Behavior and Biological Sciences, University of Michigan, Ann Arbor, USA

Tóm tắt

Accurate beliefs about partners’ viral suppression are important for HIV prevention and care. We fit multilevel mixed effects logistic regression models to examine associations between partners’ viral suppression beliefs and objective HIV RNA viral load tests, and whether relationship dynamics were associated with accurate viral suppression beliefs over time. Male couples (N = 266 couples) with at least one HIV-positive partner on antiretroviral therapy completed five assessments over 2 years. Half of the 407 HIV-positive partners were virally suppressed. Of the 40 % who had inaccurate viral load beliefs, 80 % assumed their partner was suppressed. The odds of having accurate viral load beliefs decreased over time (OR = 0.83; p = 0.042). Within-couple differences in dyadic adjustment (OR = 0.66; p < 0.01) and commitment (OR = 0.82; p = 0.022) were negatively associated with accurate viral load beliefs. Beliefs about a partner’s viral load may factor into sexual decision-making and social support. Couple-based approaches are warranted to improve knowledge of partners’ viral load.

Tài liệu tham khảo

Siedner MJ, Musinguzi N, Tsai AC, et al. Treatment as long-term prevention: sustained reduction in HIV sexual transmission risk with use of antiretroviral therapy in rural Uganda. AIDS. 2014;28:267–71. Cohen M, Chen Y, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493–505. Rodger A, Bruun T, Cambiano V, et al. HIV transmission risk through condomless sex If HIV+ partner on suppressive ART: PARTNER Study. Conference on retroviruses and opportunistic infections (CROI) on March 3–6, 2014. van den Boom W, Davidovich U, Witlox R, Stolte I. Frequent use of viral sorting by HIV-positive MSM: The consideration of viral load when deciding to engage in unprotected anal intercourse with HIV-positive and HIV-negative partners. Presented at 10th Annual Aids Impact conference, Santa Fe, New Mexico. 2011. Mitchell JW. HIV-negative and HIV-discordant gay male couples’ use of HIV Risk-reduction strategies: differences by partner type and couples’ HIV-status. AIDS Behav. 2013;17:1557–69. Horvath KJ, Smolenski D, Iantaffi A, Grey JA, Rosser BRS. Discussions of viral load in negotiating sexual episodes with primary and casual partners among men who have sex with men. AIDS Care. 2012;24(8):1052–5. Prestage G, Mao L, Kippax S, et al. Use of viral load to negotiate condom use among gay men in Sydney, Australia. AIDS Behav. 2009;13:645–51. Van de Ven P, Mao L, Fogarty A, et al. Undetectable viral load is associated with sexual risk taking in HIV serodiscordant gay couples in Sydney. AIDS. 2005;19:179–84. Crepaz N, Hart TA, Marks G. Highly active antiretroviral therapy and sexual risk behavior: a meta-analytic review. JAMA. 2004;292:224–36. Zablotska IB, Imrie J, Prestage G, et al. Gay men’s current practice of HIV seroconcordant unprotected anal intercourse: serosorting or seroguessing? AIDS Care. 2009;21:501–10. Montgomery BM. The form and function of quality communication in marriage. Fam Relat. 1981;30:21–30. Anglewicz PA, Bignami-Van Assche S, Clark S, Mkandawire J. HIV risk among currently married couples in rural Malawi: what do spouses know about each other? AIDS Behav. 2008;14(1):103–12. Anglewicz P, Chintsanya J. Disclosure of HIV status between spouses in rural Malawi. AIDS Care. 2011;23(8):998–1005. Katz DA, Kiarie JN, John-Stewart GC, et al. HIV testing men in the antenatal setting: understanding male non-disclosure. Int J STD AIDS. 2009;20(11):765–7. Conroy AA, Wong LH. How reliable are self-reports of HIV status disclosure? Evidence from couples in Malawi. Soc Sci Med. 2015;144:28–37. Meichenbaum D, Turk DC. Facilitating treatment adherence: a practitioner’s guidebook. New York: Plenum Press; 1987. Bekele T, Rourke SB, Tucker R, et al. Direct and indirect effects of perceived social support on health-related quality of life in persons living with HIV/AIDS. AIDS Care. 2013;25(3):337–46. Huynh AK, Kinsler JJ, Cunningham WE, Sayles JN. The role of mental health in mediating the relationship between social support and optimal ART adherence. AIDS Care. 2013;25(9):1179–84. Yeji F, Klipstein-Grobusch K, Newell ML, et al. Are social support and HIV coping strategies associated with lower depression in adults on antiretroviral treatment? Evidence from rural KwaZulu-Natal, South Africa. AIDS Care. 2014;26(12):1482–9. Ammassari A, Trotta MP, Murri R, Castelli F, Narciso P, Noto P, et al. Correlates and predictors of adherence to highly active antiretroviral therapy: overview of published literature. JAIDS. 2002;31:S123–7. Gonzalez JS, Penedo FJ, Antoni MH, et al. Social support, positive states of mind, and HIV treatment adherence in men and women living with HIV/AIDS. Health Psychol. 2004;23(4):413. Catz SL, Kelly JA, Bogart LM, Benotsch EG, McAuliffe TL. Patterns, correlates, and barriers to medication adherence among persons prescribed new treatments for HIV disease. Health Psychol. 2000;19(2):124. Leserman J, Perkins DO, Evans DL. Coping with the threat of AIDS: the role of social support. Am J Psychiatry. 1992;149:1514. Wrubel J, Stumbo S, Johnson MO. Antiretroviral medication support practices among partners of men who have sex with men: a qualitative study. AIDS Patient Care STDS. 2008;22(11):851–8. Wrubel J, Stumbo S, Johnson MO. Male same-sex couple dynamics and received social support for HIV medication adherence. J Soc Pers Relatsh. 2010;27(4):553–72. Hamilton MM, Razzano LA, Martin NB. The relationship between type and quality of social support and HIV medication adherence. J HIV/AIDS Soc Serv. 2007;6(1–2):39–63. Davies G, Koenig LJ, Stratford D, Palmore M, Bush T, Golde M, et al. Overview and implementation of an intervention to prevent adherence failure among HIV-infected adults initiating antiretroviral therapy: lessons learned from Project HEART. AIDS Care. 2006;18:895–903. Remien RH, Stirratt MJ, Dolezal C, et al. Couple-focused support to improve HIV medication adherence: a randomized controlled trial. AIDS. 2005;19:807–14. Lewis MA, McBride CM, Pollak KI, et al. Understanding health behavior change among couples: an interdependence and communal coping approach. Soc Sci Med. 2006;62:1369–80. Rusbult C, Lange PMAV. Interdependence, interaction, and relationships. Annu Rev Psychol. 2003;54(54):351–75. Karney BR, Hops H, Redding CA, et al. A framework for incorporating dyads in models of HIV-prevention. AIDS Behav. 2010;14(2):189–203. Darbes LA, Chakravarty D, Neilands TB, Beougher SC, Hoff CC. Sexual risk for HIV among gay male couples: a longitudinal study of the impact of relationship dynamics. Arch Sex Behav. 2014;43(1):47–60. Mitchell JW, Champeau D, Harvey SM. Actor-partner effects of demographic and relationship factors associated with HIV risk within gay male couples. Arch Sex Behav. 2013;42(7):1337–45. Mitchell JW, Harvey SM, Champeau D, Seal DW. Relationship factors associated with HIV risk among a sample of gay male couples. AIDS Behav. 2012;16:404–11. Hoff CC, Chakravarty D, Beougher SC, Neilands TB, Darbes L. Relationship characteristics associated with sexual risk behavior among MSM in committed relationships. AIDS Patient Care STDS. 2012;26(12):738–45. Gomez AM, Beougher SC, Chakravarty D, Neilands TB, Mandic CG, Darbes LA, Hoff CC. Relationship dynamics as predictors of broken agreements about outside sexual partners: implications for HIV prevention among gay couples. AIDS Behav. 2012;16(6):1584–8. Mitchell JW, Harvey SM, Champeau D, Moskowitz DA, Seal DW. Relationship factors associated with gay male couples’ concordance on aspects of their sexual agreements: establishment, type, and adherence. AIDS Behav. 2012;16:1560–9. Johnson MO, Dilworth SE, Taylor JM, et al. Primary relationships, HIV treatment adherence, and virologic control. AIDS Behav. 2012;16(6):1511–21. Turner C, Ku L, Rogers S, et al. Adolescent sexual behavior, drug use, and violence: increased reporting with computer survey technology. Science. 1998;280(5365):867–73. Funk JL, Rogge RD. Testing the ruler with item response theory: increasing precision of measurement for relationship satisfaction with the couples satisfaction index. J Fam Psychol. 2007;21(4):572–83. Sabourin S, Valois P, Lussier Y. Development and validation of a brief version of the dyadic adjustment scale with a nonparametric item analysis model. Psycholol Assess. 2005;17(1):15–27. Spanier G. Measuring dyadic adjustment: new scales for assessing the quality of marriage and similar dyads. J Marriage Fam. 1976;38:15–28. Kurdek L. Assessing multiple determinants of relationship commitment in cohabitating gay, cohabitating lesbian, dating heterosexual, and married heterosexual couples. Fam Relat. 1995;44:261–6. Christensen A, Shenk JL. Communication, conflict, and psychological distance in nondistressed, clinic, and divorcing couples. J Consult Clin Psychol. 1991;59(3):458–63. Allison P. Fixed effects regression methods for longitudinal data using SAS. Cary: SAS Institute; 2005. Neuhaus JM, Kalbfleisch JD. Between- and within-cluster covariate effects in the analysis of clustered data.”. Biometrics. 1998;54(2):638–45. Kenny DA, Kashy DA, Cook WL. Dyadic data analysis. New York: The Guilford Press; 2006. Petersen T. Analyzing panel data: fixed- and random-effects models. In: Hardy M, Bryman A, editors. Handbook of data analysis. Thousand Oaks: Sage; 2004. p. 331–45. Burnham KP, Anderson DR. Model selection and multimodel inference: a practical information-theoretic approach (second edition). New York: Springer; 2003. Harrell FE. Regression modeling strategies: with applications to linear models, logistic regression, and survival analysis. New York: Springer; 2001. Agresti A, Finlay B. Statistical methods for the social sciences. 4th ed. Upper Saddle River: Pearson Prentice Hall; 2009. Hox JJ. Multilevel analysis: techniques and applications. 2nd ed. New York: Routledge; 2010. Carrico A, Woolf-King S, Neilands T, Dilworth S, Johnson M. Stimulant use and HIV disease management among men in same-sex relationships. Drug Alcohol Depend. 2014;139:174–7. Kalichman SC, Eaton L, Cain D, et al. Changes in HIV treatment beliefs and sexual risk behaviors among gay and bisexual men. Health Psychol. 2007;26(5):650–6. Kalichman SC, Cherry C, Kalichman MO, et al. Sexual behaviors and transmission risks among people living with HIV: beliefs, perceptions, and challenges to using treatments as prevention. Arch Sex Behav. 2015. doi:10.1007/s10508-015-0559-4. Beougher S, Chakravarty D, Garcia C, et al. Risks worth taking: safety agreements among discordant gay couples. AIDS Care. 2012;24(9):1071–7. Gamarel K, Comfort M, Wood T, Neilands T, Johnson M. A qualitative analysis of male couples coping with HIV: disentangling the “we.” J Health Psychol. 2015. doi:10.1177/1359105315571975. Gamarel K, Revenson T. Dyadic adaptation to chronic illness: The importance of considering context in understanding couples’ resilience. In: Skerrett K, Fergus K, editors. Couples resilience: emerging perspectives. Dordrecht: Springer; 2015. p. 83–105. van den Boom W, Stolte I, Sandfort T, Davidovich U. Serosorting and sexual risk behaviour according to different casual partnership types among MSM: the study of one-night stands and sex buddies. AIDS Care. 2011;24(2):167–73. Mitchell JW, Garcia L, Champeau D, Harvey SM, Petroll AE. HIV-negative seroconcordant gay male couples’ attitudes, intentions, and perceived behavioral control for planned condom use within and outside of their relationships. Int J Sex Health. 2012;24(4):239–53. Dodge B, Herbenick D, Tsung-Chieh F, et al. Sexual behaviors of U.S. men by self-identified sexual orientation: results From the 2012 national survey of sexual health and behavior. J Sex Med. 2016;13(4):637–49. Sullivan PS, Salazar L, Buchbinder S, Sanchez TH. Estimating the proportion of HIV transmissions from main sex partners among men who have sex with men in five US cities. AIDS. 2009;23:1153–62. Conroy AA, McGrath N, Van Rooyen H, et al. Power and the association with relationship quality in south african couples: implications for HIV/AIDS interventions. Soc Sci Med. 2016;153:1–11. Ribaudo H, Lennox J, Currier J, et al.Virologic failure endpoint definition in clinical trials: Is using HIV-1 RNA threshold <200 copies/mL better than <50 copies/mL? An analysis of ACTG studies Paper presented at the 16th Conference on Retroviruses and Opportunistic Infection; 2009 Montreal, Canada. U.S. Department of Health and Human Services Administration. HIV/AIDS Bureau performance measures: HIV viral load suppression. http://hab.hrsa.gov/deliverhivaidscare/coremeasures.pdf. 2013. Russell R. City endorses new policy for treatment of HIV. The New York Times. 2010. http://www.nytimes.com/2010/04/04/us/04sftreatment.html. Accessed 4 Feb 2016. SFDPH. HIV epidemiology annual report. San Francisco: San Francisco Department of Public Health; 2014. Schwarcz S, Hsu LC, Scheer S. Disparities and trends in viral suppression during a transition to a “test and treat” approach to the HIV epidemic, San Francisco, 2008–2012. JAIDS. 2015;70:529–37. UNAIDS. 90-90-90: an ambitious treatment target to help end the AIDS epidemic. Geneva: UNAIDS; 2014. Burton J, Darbes LA, Operario D. Couples-focused behavioral interventions for prevention of HIV: systematic review of the state of evidence. AIDS Behav. 2010;14:1–10.