Open AccessProvider Perspectives on Navigating Relationship Challenges in Assisting HIV-Affected Couples to Meet Their Reproductive Goals: Lessons Learned from a Safer Conception Counseling Intervention in Uganda
Author(s) -
Deborah Mindry,
Mahlet Gizaw,
Violet Gwokyalya,
Emily A. Hurley,
Sarah Finocchario-Kessler,
Jolly Beyeza-Kashesya,
Glenn Wagner,
Rhoda K. Wanyenze,
Kathy Goggin
Publication year - 2021
Publication title -
aids and behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.994
H-Index - 106
eISSN - 1573-3254
pISSN - 1090-7165
DOI - 10.1007/s10461-021-03397-4
Subject(s) - serodiscordant , intervention (counseling) , health psychology , nursing , reproductive health , medicine , public health , qualitative research , partner notification , safer , family medicine , psychology , human immunodeficiency virus (hiv) , population , environmental health , social science , computer security , syphilis , sociology , viral load , antiretroviral therapy , computer science
In Uganda, 60% of HIV-affected couples are serodiscordant, many of whom want children. There is a need to assess their reproductive intentions and provide appropriate services that limit transmission risks while meeting reproductive goals. Our Choice intervention engaged male and female HIV-infected clients and their partners in safer conception counseling (SCC) or family planning based on their childbearing decision. We report findings of provider experiences and recommendations for engaging couples in SCC. The intervention was implemented in four clinics offering either SCC1, an intensive training and supervision arm, or SCC2, utilizing the Ministry of Health's standard approach. Qualitative interviews were conducted at 12 (N = 23) and 24 months (N = 25) after initiation of the intervention. Many partners attended at least some SCC sessions, although engaging male partners was more challenging. Providers reported partner involvement improved understanding and facilitated successful implementation of SCM, whereas confusion and challenges were common when the client participated alone. Providers shared successful strategies for engaging male partners.