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Discordance, disclosure and normative gender roles: a triad of barrier to couples HIVST provided through a community-based approach in urban Blantyre, Malawi


Author
Kumwenda et al.

Publication year
2017

Country

Type of approach
Dual

Type of assistance
Directly assisted

Specimen
Oral-fluid

Study population
General population: Heterosexual individuals in established relationships

Study design
Values and preferences

Sample size
33

UNAIDS HIV prevalence (2017)

Methodology
Data were drawn from a 12-month qualitative longitudinal cohort study exploring the long-term consequences of semi-supervised HIV self-testing within couples in Blantyre Malawi. In-depth interviews were conducted within a month of self-testing with 33 individuals living in established heterosexual relationships who tested without a sexual partner.

Summary of findings
When given a chance to self-test as a couple, both men and women who decided to test alone expressed fear of dealing with HIV discordant results within a trusting relationship. The failure to self-test with a partner was gendered with more men overtly declining or unconsciously unable to participate in joint HIV self-testing than women. Men feared blame and exposure of previous or current infidelity. Men were also often not available at home for economic or work reasons and were usually missed by the HIVST community-based approach.

Acceptability
n/a

Acceptability details
n/a

Willingness to pay
n/a

Willingness to pay details
n/a

Sensitivity
n/a

Specificity
n/a

Concordance
n/a

HIV positivity
n/a

Accuracy details
n/a

Social harm
n/a

Linkage to prevention, care and treatment
n/a


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