title: Pathways That Affect Wives' HIV Risk Among Serodiscordant Couples in India: Results From the Positive Jeevan Saathi Study.
abstract: This study examined factors that mitigate or heighten HIV risk among HIV-negative wives in serodiscordant relationships in Gujarat, India. Grounded theory was used to analyze 46 interviews (23 couples) where husbands were HIV-positive and wives were HIV-negative. A conceptual framework emerged from analysis from which we identified five pathways and four key behaviors: (a) safer sex, (b) no sex, (c) coercive sex, and (d) unprotected sex. Most couples either practiced safe sex or abstained from sex. Factors such as wives' assertiveness, a wife's fear of acquiring HIV, mutual understanding, positive sex communication, and a husband's desire to protect wife influenced safe sex/sexual abstinence. Factors such as desire for children, a husband's alcohol use, and intimate partner violence influenced coercive and unprotected sex. Counseling topics on sex communication, verbal and non-verbal safer sex strategies, as well as addressing intimate partner violence and alcohol use may be important in preventing risk to HIV-negative wives.
authors: Emory University, Atlanta, Georgia, USA snpate5@emory.edu.
authors: Shilpa N
authors: SN
authors: Patel
authors: Emory University, Atlanta, Georgia, USA.
authors: Monique M
authors: MM
authors: Hennink
authors: Emory University, Atlanta, Georgia, USA.
authors: Michelle E
authors: ME
authors: Hynes
authors: Emory University, Atlanta, Georgia, USA.
authors: Kathryn M
authors: KM
authors: Yount
authors: Government Medical College, Surat, Gujarat, India.
authors: Jayesh K
authors: JK
authors: Kosambiya
authors: Emory University, Atlanta, Georgia, USA.
authors: Gina M
authors: GM
authors: Wingood
authors: Kennesaw State University, Kennesaw, Georgia, USA.
authors: Camille
authors: C
authors: Sutton-Brown-Fox
authors: Emory University, Atlanta, Georgia, USA.
authors: Frances
authors: F
authors: McCarty
authors: Emory University, Atlanta, Georgia, USA.
authors: Michael
authors: M
authors: Windle
mesh_terms: D000328:Adult; D000428:Alcohol Drinking; D005260:Female; D015658:HIV Infections / Q000635:transmission*; D006801:Humans; D006849:Hydrocephalus; D007194:India; D007398:Interpersonal Relations; D008297:Male; D008393:Marriage; D012306:Risk; D013179:Spouse Abuse; D018454:Spouses
keywords: HIV in India; HIV prevention; In depth interviews; marital sex; serodiscordant couples