Relationship Experiences among Puerto Rican Heterosexual HIV Serodiscordant Coupl

波多黎各异性恋艾滋病毒血清不一致夫妇之间的关系经历

• 批准号: 7753451
• 负责人: Sheilla Lee Rodriguez Madera
• 金额: $ 6.3万
• 依托单位: UNIVERSITY OF PUERTO RICO AT CAROLINA
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7753451
• 关键词: AIDS prevention; AIDS/HIV problem; Accounting; Acquired Immunodeficiency Syndrome; Address; Adherence; Affect; Area; Attention; Behavior; Caribbean region; Case Study; Centers for Disease Control and Prevention (U.S.); Communication; Couples; Diagnosis; Disclosure; Disease; Domestic Violence; Epidemic; Equilibrium; Face; Female; Focus Groups; Fostering; Foundations; Future; Gender; HIV; HIV Infections; Health; Health Services Accessibility; Heterosexuals; Highly Active Antiretroviral Therapy; Individual; Infection; Infection prevention; Intervention; Interview; Joints; Latino; Life; Light; Minority Groups; Participant; Pattern; Persons; Population; Prevalence; Prevention; Process; Public Health; Publishing; Puerto Rican; Puerto Rico; Quality of life; Reporting; Research; Research Proposals; Review Literature; Risk; Safe Sex; Secondary Prevention; Sexual Transmission; Sexuality; Social support; Stigmatization; Strategic Planning; Testing; Time; United Nations; United States; Variant; Woman; Work; experience; innovation; intimate behavior; low socioeconomic status; male; member; men; prevent; programs; public health relevance; safer sex; transmission process

DESCRIPTION (provided by applicant): Racial and ethnic minorities continue to be disproportionately affected by the HIV epidemic. Latinos, including Puerto Ricans, comprise 14% of the population but accounted for 18% on new diagnoses in 2006. In turn, Puerto Rico is one of the most affected areas among the US territories with more than 32,000 reported cases. HIV heterosexual transmission continues to grow exponentially among Puerto Ricans encompassing more than 40% of all reported cases. Heterosexual serodiscordant couples (HDC) need urgent attention in order to prevent the infection of the negative partner and promote adherence to highly active antiretroviral therapy of the infected partner. Focusing on HDC is an innovative way of tackling both issues. Still, most studies and prevention efforts with Puerto Ricans continue to concentrate on the individual ignoring couple dynamics. Therefore, the proposed study has three aims: (1) Explore variables related to relationship experiences among Puerto Rican heterosexual serodiscordant couples. (2) Explore the perceived influence of these variables on safe sexual practices among couples and adherence to treatment of the person living with HIV/AIDS, from the perspective of both members of the dyad. (3) Identify issues that would need to be integrated into a couple-oriented intervention aiming to promote safer sexual practices in the dyad and adherence to treatment of the PLWHA. In order to achieve aims 1 and 2 we will carry out qualitative interviews with 20 HDC (n=40). The couples will be balanced with regards to the HIV infected partner (male or female) to explore gender variations in the results. We will first interview participants individually, and afterwards conduct a joint interview (60 interviews in total). We will explore relationship experiences through the following constructs that emerge from our literature review: (1) HIV status disclosure process; (2) couple's communication; (3) sexual intimacy; (4) social support; (5) domestic violence; (6) HIV/AIDS stigmatization; and (7) other individual and couple related issues that may arise from the qualitative work. Throughout the interviews we will also discuss patterns of adherence to treatment, safer sexual practices, and their perceived relation to experiences within the dyad. In order to achieve aim 3 we will carry out four focus groups (N=40) with men and women in HDC to identify issues needed to develop interventions targeting Puerto Rican serodiscordant couples. We will carry out groups divided by gender (male and female) and by HIV status (seropositive and seronegative). We have been unable to find published studies with Puerto Rican HDC that explore how relationship experiences with the primary partner may influence the person living with HIV/AIDS' desire and capacity to adhere to treatment, and the practice of safer sex. These concerns drive this research proposal. PUBLIC HEALTH RELEVANCE: This study seeks to understand how Puerto Rican heterosexual serodiscordant couples face the challenges of adherence to treatment and safe sex within the relationship dyad. Considering the growing amount of reported cases of heterosexual transmission in Puerto Rico, this effort can serve as the foundation for future studies that aim to develop and test interventions geared towards serodiscordant couples. This can better the lives of PLWHA, help avoid new infections within the serodiscordant couple dyad, and therefore have a positive impact on public health.

描述（由申请人提供）：种族和少数民族继续受到艾滋病毒流行的影响。拉丁美洲人，包括波多黎各人在内，占人口的14％，但在2006年的新诊断中占18％。反过来，波多黎各是美国领土中受影响最大的地区之一，报告了超过32,000例病例。 HIV异性传播在涵盖所有报告的病例中超过40％的波多黎各人中继续呈指数增长。异性恋夫妇（HDC）需要紧急注意，以防止感染负面伴侣并促进对受感染伴侣的高度活性抗逆转录病毒疗法的遵守。专注于HDC是解决这两个问题的创新方式。尽管如此，大多数对波多黎各人的研究和预防工作仍在继续集中于忽略夫妇动态的个人。因此，拟议的研究具有三个目的：（1）探索与波多黎各异性恋同性恋夫妇之间的关系经历相关的变量。 （2）从二元组的两个角度来看，探索这些变量对夫妻安全性行为的影响，并遵守艾滋病毒/艾滋病患者的治疗。 （3）确定需要将需要纳入夫妇的干预措施，旨在促进二元组中更安全的性行为，并遵守对PLWHA的治疗。为了实现目标1和2，我们将对20 HDC进行定性访谈（n = 40）。夫妻将与艾滋病毒感染伴侣（男性或女性）保持平衡，以探索结果中的性别变化。我们将首先采访参与者，然后进行联合采访（总共60次访谈）。我们将通过我们的文献综述中出现的以下结构来探索关系经验：（1）HIV状态披露过程； （2）夫妇的交流； （3）性亲密关系； （4）社会支持； （5）家庭暴力； （6）艾滋病毒/艾滋病污名化； （7）定性工作可能引起的其他个人和夫妇相关问题。在整个访谈中，我们还将讨论遵守治疗，更安全的性行为的模式以及它们与二元组内的经历的感知关系。为了实现目标3，我们将与HDC中的男性和女性一起进行四个焦点小组（n = 40），以确定针对波多黎各Serodiscordant夫妇的干预措施所需的问题。我们将执行由性别（男性和女性）和HIV状态（血清阳性和血清质）分割的小组。我们无法找到与波多黎各HDC的已发表研究，该研究探讨了与主要伴侣的关系经历如何影响艾滋病毒/艾滋病渴望和坚持治疗的能力的人以及更安全的性行为。这些关注推动了这项研究建议。公共卫生相关性：这项研究试图了解波多黎各异性恋夫妇如何面对遵守治疗和关系中的安全性的挑战。考虑到波多黎各中报告的异性传播案例的日益增长，这项工作可以作为未来研究的基础，旨在开发和测试针对血清学会夫妇的干预措施。这可以改善PLWHA的生活，有助于避免夫妻夫妇的新感染，因此对公共卫生产生积极影响。