InTeRnATIonAl ConfeRenCe on Women And InfeCTIouS dISeASe
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چکیده
S Thursday, March 16, 2006 56 ICWId 2006 mARCh 16-18 ATlAnTA, GeoRGIA, uSA 4 Communication, Power, and Condom Use within HIV Sero-discordant Married Couples in Lusaka, Zambia E. Mendenhall, S. Allen, R. Stephenson; Rollins School of Public Health, Atlanta, GA. Background: This study examines the association between communication and condom use among individuals in HIV sero-discordant married couples in Lusaka, Zambia. In Lusaka, about one in four adults are HIV positive and the dominant mode of transmission is heterosexual. In African cities today, one-half to three-quarters of HIV infections occurs within married couples, making marriage a major risk for infection. This study examines patterns of gendered and economic power differentials within married couples that influence condom negotiation. Methods: The Zambia-Emory HIV Research Project (ZEHRP) collected 211 questionnaires from men (n=106) and women (n=105) in HIV discordant couples. Couples were interviewed about relationship qualities such as communication and conflict, attitudes toward gender roles, and condom use. Logistic regression was used to determine relationships between demographic information and indices of relationship quality and condom use. Results: In bivariate analysis the factors significantly associated with a low likelihood of condom use were relationship support, gender attitudes, economic status, and HIV status. Bivariate analysis shows that 80% of the population has low relationship support and are unlikely to use condoms. 73% of individuals with conservative attitudes toward gender were unlikely to use condoms. 27% of those who were unlikely to use condoms were also unemployed. 64% of individuals unlikely to use condoms were HIV negative. 56% of individuals likely to use condoms were HIV positive. Age, sex, duration of marriage and sex of the positive partner also showed significance. Conclusions: The results demonstrate that condom use in HIV serodiscordant couples is strongly tied to the quality of couples’ communication. This suggests that the balance of power within marriage can determine if a couple is high risk for non-condom use, suggesting that women have little power in sexual negotiation with their married partner.
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تاریخ انتشار 2006