Abstract 12908: Primary Partners Provide Key Social Support for the Management of Cardiometabolic Disorders in Sub-Saharan Africa

Abstract

Introduction: Social support from primary partners has wide-ranging impacts on disease management and health outcomes, although scant research has explored this topic for couples living with cardiometabolic disorders (CMD) in low-resource settings in sub-Saharan Africa. Objectives: To explore patterns of partner support around CMD in Malawian couples Methods: We conducted a qualitative study with 25 married couples in Malawi who had at least one partner with HIV and CMD (either hypertension or diabetes). Index patients were recruited from three HIV care clinics and primary partners were subsequently enrolled. We conducted semi-structured interviews with both partners to understand how couples cope together with CMD and offer social support. Data were coded for patterns and themes within couples and between couples and data matrices were used to summarize the findings. Results: Couples described three patterns of partner support. Instrumental support was provided by partners who offered money for medication, transportation to medical appointments, and healthy foods. Partners also provided reminders to take medication and attend medical appointments, accompanied patients to medical appointments, and monitored medication use. While household chores are typically women’s work, in some cases male partners helped with these activities when their wives were too ill or were experiencing what they believed were symptoms of CMD. Emotional support was provided by partners through encouragement to practice a healthy lifestyle (such as increasing physical activity and reducing salt intake), rest, and reduce stress and avoid arguing. Informational support was provided by partners who gave advice for successful management of CMD and in making health-related decisions such as food purchases. Conclusions: Social support from primary partners around disease management may partially ameliorate inadequate health services for people with CMD in sub-Saharan Africa. While there remains a need to fortify health systems and address barriers to accessing treatment, couple relationships could be leveraged in care services to provide key forms of social support.