"Him Leaving Me - That is My Fear Now": A Mixed Methods Analysis of Relationship Dissolution Between Ugandan Pregnant and Postpartum Women Living with HIV and Their Male Partners.

Journal: AIDS and behavior

Volume: 27

Issue: 6

Year of Publication: 2023

Affiliated Institutions:  Department of Global Health, University of Washington, Ninth Avenue, Seattle, WA, , USA. mbult@uw.edu. Department of Global Health, University of Washington, Ninth Avenue, Seattle, WA, , USA. Infectious Diseases Institute, Makerere University, Kampala, Uganda. Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA. Harvard Global, Cambridge, MA, USA.

Abstract summary 

High rates of relationship dissolution among pregnant women living with HIV (PWLHIV) and their male partners might increase mothers' and children's vulnerability to financial hardship and poor health outcomes. This mixed methods analysis identified factors associated with separation between PWLHIV and their male partners. We utilized data from a randomized controlled trial ( www.ClinicalTrials.gov NCT03484533) of 500 PWLHIV attending antenatal care in Uganda and 237 male partners between 2018 and 2020 and followed until 12 months postpartum. Multivariate regression models estimated the impact of relationship factors on the adjusted relative risk of separation during follow up, and we conducted in-depth interviews with 45 women and 45 men enrolled in the trial. Overall, 23% of PWLHIV reported separation during the study period. HIV serodifferent status, financial burdens and gender expectations were sources of relationship conflict. Significant factors associated with separation included unmarried, non-cohabitating, shorter, polygamous relationships, as well as HIV non-disclosure and verbal abuse. Participants discussed potential positive and negative consequences of separation, including impact on their mental health, treatment continuation, financial security, and safety. Addressing relationship dynamics is essential to improve counseling messaging and support PWLHIV who are experiencing relationship conflict.

Authors & Co-authors:  Bulterys Michelle A MA Mujugira Andrew A Nakyanzi Agnes A Wyatt Monique A MA Kamusiime Brenda B Kasiita Vicent V Kakoola Grace Nalukwago GN Nalumansi Alisaati A Twesigye Collins C Pisarski Emily E EE Sharma Monisha M Boyer Jade J Naddunga Faith F Ware Norma C NC Celum Connie L CL

Study Outcome 

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Statistics
Citations :  UNAIDS. 2021. UNAIDS Global AIDS Update — Confronting inequalities — Lessons for pandemic responses from 40 years of AIDS. https://www.unaids.org/en/resources/documents/2021/2021-global-aids-update2021.
Authors :  15
Identifiers
Doi : 10.1007/s10461-022-03910-3
SSN : 1573-3254
Study Population
Men,Male,Women
Mesh Terms
Child
Other Terms
Couples;HIV;PMTCT;Relationship dissolution;Separation;Uganda
Study Design
Randomized Control Trial,Cross Sectional Study
Study Approach
Mixed Methods
Country of Study
Uganda
Publication Country
United States