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. 2022 Aug 17;2(8):e0000620.
doi: 10.1371/journal.pgph.0000620. eCollection 2022.

HIV-serodifferent couples' perspectives and practices regarding HIV prevention strategies: A mixed methods study

James M McMahon  1 , Janie Simmons  2 , Amy Braksmajer  3 , Natalie LeBlanc  1
Affiliations

HIV-serodifferent couples' perspectives and practices regarding HIV prevention strategies: A mixed methods study

James M McMahon et al. PLOS Glob Public Health. .

Abstract

A substantial proportion of heterosexually acquired HIV infections in the U.S. occur between partners in primary relationships characterized by mixed HIV status. The U.S. Centers for Disease Control and Prevention have issued guidelines prioritizing HIV-serodifferent couples for primary HIV prevention, including treatment-as-prevention and pre-exposure prophylaxis (PrEP). Yet, very little research has been conducted to understand the perspectives and practices of HIV-serodifferent couples regarding HIV prevention strategies in the U.S. To help fill this gap, we conducted a mixed methods study with 27 mostly Black/African American and Latinx HIV-serodifferent heterosexual couples residing in New York City to explore their knowledge, attitudes, practices, and perspectives regarding combination HIV prevention, including condoms, PrEP and viral control. All couples expressed the desire to maintain viral suppression in the HIV-positive partner, which was not always achieved. There was considerable heterogeneity in the use of HIV prevention methods by couples; and several patterns emerged that were largely driven by gender and relationship dynamics. Female partners, in particular, expressed high levels of anxiety around transmission of HIV and thus desired multiple methods of protection. Healthcare providers should consider couples' psychosocial well-being, relationship quality, and other motivational factors when helping to tailor HIV preventative care for mixed-status couples.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Venn diagram of combination HIV prevention strategies used by HIV-serodifferent couples.
Condoms = Consistent condom use for vaginal and anal intercourse; Viral suppression = sustained viral suppression; PrEP = HIV-negative partner currently prescribed PrEP; None = None of the three types of prevention methods used; Couple ID numbers appear in brackets.
Fig 2
Fig 2. Viral suppression.
Fig 3
Fig 3. Condom use.
Fig 4
Fig 4. Viral suppression and condom use.
Fig 5
Fig 5. PrEP use.
Fig 6
Fig 6. PrEP and condom use.
Fig 7
Fig 7. PrEP and viral suppression.
Fig 8
Fig 8. Viral suppression, condoms and PrEP.
Fig 9
Fig 9. HIV transmission anxiety.
See this image and copyright information in PMC

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