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“I think it’s communication and trust and sharing everything”: Qualitative evidence for a model of healthy intimate relationships in Black women living with HIV and men in KwaZulu‐Natal, South Africa
Author(s) -
Belus Jennifer M.,
Bradley Valerie D.,
Heerden Alastair,
Msimango Lindani I.,
Barnabas Ruanne V.,
Rooyen Heidi
Publication year - 2022
Publication title -
family process
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.011
H-Index - 74
eISSN - 1545-5300
pISSN - 0014-7370
DOI - 10.1111/famp.12744
Subject(s) - thematic analysis , psychological intervention , human immunodeficiency virus (hiv) , gender studies , qualitative research , psychology , social psychology , sociology , medicine , family medicine , social science , psychiatry
In South Africa, couple‐based interventions (CBIs) have been used to increase HIV testing, reduce HIV transmission, and shift relationship dynamics. To understand local definitions of healthy relationships, this study sought to collect qualitative data on a model of healthy relationships in a semi‐rural area of KwaZulu‐Natal, South Africa. We conducted semi‐structured qualitative interviews with HIV‐positive women ( n = 15) and men of mixed HIV status ( n = 15) who were in heterosexual, monogamous relationships (not with each other). Thematic analyses guided coding. Three primary healthy relationship behaviour themes emerged, labelled open communication, couple‐level problem‐solving, and active relationship building, which were related to various relationship facets (trust, support, respect, commitment, and connection). We purposively explored contextual themes, namely the role of HIV, positive community involvement, and power dynamics, to better situate the healthy relationship behaviour themes. HIV was not central to relationship conceptualisations and three different power structures (shared power/flexible gender norms, shared power/traditional gender norms, male‐dominated power/traditional gender norms) were described as being healthy. This model of healthy relationships is similar to observed definitions in other African countries and in high‐income settings. Findings can inform HIV programming content for couples in KwaZulu‐Natal, particularly the active relationship building component.