Factors shaping initial decision-making to self-test amongst cohabiting couples in urban Blantyre, Malawi
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https://hdl.handle.net/10037/26870Date
2014-06-15Type
Journal articleTidsskriftartikkel
Peer reviewed
Author
Kumwenda, Moses; Munthali, Alister; Phiri, Mackwellings; Mwale, Daniel; Gutteberg, Tore Jarl; MacPherson, Eleanor; Theobald, Sally J.; Corbett, Liz; Desmond, NicolaAbstract
In sub-Saharan Africa, most new HIV infections occur in stable relationships, making couples testing
an important intervention for HIV prevention. We explored
factors shaping the decision-making of cohabiting couples
who opted to self-test in Blantyre, Malawi. Thirty-four
self-tested participants (17 couples) were interviewed.
Motivators for HIV self-testing (HIVST) emerged at three
main levels. Individual motivations included perceived
benefits of access to treatment, and self-checking of serostatus in the hope of having been cured by prolonged
treatment or faith-healing. HIVST was considered convenient, confidential, reassuring and an enabling new way to
test with one’s partner. Partnership motivations included
both positive (mutual encouragement) and negative (suspected infidelity) aspects. For women, long-term health and
togetherness were important goals that reinforced
motivations for couples testing, whereas men often needed
persuasion despite finding HIVST more flexible and less
onerous than facility-based testing. Internal conflict
prompted some partners to use HIVST as a way of disclosing their previously concealed HIV positive serostatus.
Thus, the implementation of community-based HIVST
should acknowledge and appropriately respond to decisionmaking processes within couples, which are shaped by
gender roles and relationship dynamics.
Publisher
Springer NatureCitation
Kumwenda, M., Munthali, A., Phiri, M. et al. Factors Shaping Initial Decision-Making to Self-test Amongst Cohabiting Couples in Urban Blantyre, Malawi. AIDS Behav 18, 396–404 (2014)Metadata
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