Couple communication, sexual coercion and HIV risk reduction in Kigali, Rwanda.

Important note: Information in this article was accurate in 1996. The state of the art may have changed since the publication date.

Couple communication, sexual coercion and HIV risk reduction in Kigali, Rwanda.

AIDS. 1995 Aug;9(8):935-44. Unique Identifier : AIDSLINE MED/96014969
van der Straten A; King R; Grinstead O; Serufilira A; Allen S; Center for AIDS Prevention Studies, University of California, San; Francisco, USA.

Abstract: OBJECTIVE: To describe sexual interaction and HIV-related communication in Rwandan couples and to examine their relationship to HIV testing and condom use. STUDY DESIGN: Cross-sectional survey of a longitudinal cohort. METHODS: In 1988, women recruited for an epidemiological study of HIV, and interested male partners, received confidential HIV testing and counseling. Two years after enrollment, 876 women reporting one steady partner in the past year completed a questionnaire addressing sexual and HIV-related communication, sexual motivation and violence in the partnership. RESULTS: Men control sexual decision making, and coercive sex and violence between partners is not uncommon. HIV-positive women were more likely to report coercive sex and less likely to have discussed their test results with their partner. Women with HIV-positive partners were more likely to report being physically abused. Condom use was more common if the man had been previously tested, and if women reported discussing or negotiating condom use. HIV-negative women with untested or seronegative partners were the least likely to use condoms or to discuss or attempt to negotiate condom use. CONCLUSIONS: Participation of the male partner is crucial for successful HIV risk reduction in couples. HIV testing and counseling of couples has beneficial long term effects on condom use and HIV-related communication. Couple communication is associated with condom use, but only when the discussion is specific (sexually transmitted disease risks and using condoms). Seronegative women with untested partners are at increased risk for HIV as they are the least likely to discuss or attempt to negotiate condom use.

Keywords: *Coercion Cohort Studies *Communication Condoms Counseling Cross-Sectional Studies Domestic Violence Female Human HIV Infections/EPIDEMIOLOGY/*PREVENTION & CONTROL Male Risk Factors Rwanda/EPIDEMIOLOGY *Sex Behavior Sexual Partners Support, U.S. Gov't, P.H.S. JOURNAL ARTICLE
960228
M9621060

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