Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Aug;22(8):2491-2499.
doi: 10.1007/s10461-018-2038-0.

Discordance, Disclosure and Normative Gender Roles: Barriers to Couple Testing Within a Community-Level HIV Self-Testing Intervention in Urban Blantyre, Malawi

Moses Kelly Kumwenda  1   2 , Elizabeth Lucy Corbett  3   4 , Jeremiah Chikovore  5 , Mackwellings Phiri  3 , Daniel Mwale  6 , Augustine Talumba Choko  3   4 , Marriot Nliwasa  6   4 , Rodrick Sambakunsi  3 , Miriam Taegtmeyer  7 , Tore Jarl Gutteberg  8   9 , Alister Munthali  10 , Nicola Desmond  3   7
Affiliations

Discordance, Disclosure and Normative Gender Roles: Barriers to Couple Testing Within a Community-Level HIV Self-Testing Intervention in Urban Blantyre, Malawi

Moses Kelly Kumwenda et al. AIDS Behav. 2018 Aug.

Abstract

A community-based HIV self-testing study in Blantyre, Malawi demonstrated that not all individuals living in couples tested with their partner. We describe factors dissuading individuals in couples from self-testing with their partner. Data were drawn from qualitative study exploring consequences of HIV self-testing within couples. In-depth interviews were conducted with 33 individuals living in couples who tested alone. Participants expressed fear of dealing with HIV-discordant relationships. Failure to self-test with a partner was correlated with gender, with more men than women overtly declining or unconsciously unable to have joint HIV self-test. Men feared exposure of infidelity and were often not available at home for economic reasons. Barriers to uptake of couple HIV self-testing seemed to be shaped by gendered dichotomies of social-relationships. To help achieve the first 90% of the UNAIDS 90:90:90 goals, it is important to overcome structural barriers to realise the full potential of HIV self-testing.

Keywords: Couple; Disclosure; Discordance; Gender; Self-test.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest

The authors declares no conflict of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Research Involving Human Participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Figures

Fig. 1
Fig. 1
Emerging themes on key barriers to couples HIVST
Fig. 2
Fig. 2
Intersection of the key barriers to couples HIVST
See this image and copyright information in PMC

References

    1. UNAIDS. Global Report: UNAIDS report on the global AIDS epidemic 2013. Aids. Geneva; 2013.
    1. Chemaitelly H, Awad SF, Shelton JD, Abu-raddad LJ. Sources of HIV incidence among stable couples in sub-Saharan Africa. J Int AIDS Soc. 2014;17(18765):1–14. - PMC - PubMed
    1. Chemaitelly H, Cremin I, Shelton J, Hallett TB, Abu-raddad LJ. Distinct HIV discordancy patterns by epidemic size in stable sexual partnerships in sub-Saharan Africa. Sex Transm Infect. 2012;88:51–58. doi: 10.1136/sextrans-2011-050114. - DOI - PMC - PubMed
    1. de Walque D. Sero-discordant couples in five African countries: implications for prevention strategies. Popul Dev Rev. 2007;33(3):501–523. doi: 10.1111/j.1728-4457.2007.00182.x. - DOI
    1. Chemaitelly H, Shelton JD, Hallett TB, Abu-raddad LJ. Only a fraction of new HIV infections occur within identifiable stable discordant couples in sub-Saharan Africa. AIDS. 2013;27:251–260. doi: 10.1097/QAD.0b013e32835ad459. - DOI - PubMed

LinkOut - more resources