Abstract
BackgroundFamily instability and partner conflicts are reportedly common in serodiscordant relationships. To date, the family adaptability, partnership, growth, affection and resolve (Family APGAR), a standardised tool for assessing family function, has not been used in any published literature involving this peculiar group.AimThe aim of this study was to determine the predictors of family functionality and its association with human immunodeficiency virus (HIV) serodiscordance.SettingThe study was undertaken at the Kwame Nkrumah University of Science and Technology Hospital and Komfo Anokye Teaching Hospital in Kumasi, Ghana.MethodThis was a cross-sectional study. A systematic sampling method was used to select HIV-positive clients whose partners were seropositive (concordant) or seronegative (discordant). A standardised format was used to extract relevant data. All data were analysed using STATA® (version 14). Results were reported as odds ratios with 95% confidence intervals for study and outcome variables.ResultsThe study recruited 374 respondents, of which 52% (195) were in HIV-discordant relationships. Approximately 68% (254) of the respondents rated their families as functional, 15% (57) rated as moderately dysfunctional and 17% (63) rated as severely dysfunctional. A statistically significant relationship was found between family functionality and gender, as well as between family functionality and HIV status disclosure to the partner. No association was found between the Family APGAR and HIV serodiscordance.ConclusionAmongst HIV couples, the strongest predictors of family functionality are gender and status disclosure. Healthcare providers should invest efforts into addressing gender-based challenges, utilise the Family APGAR and support disclosure of HIV status, especially amongst discordant couples.
Highlights
Any sexual relationship in which one partner is human immunodeficiency virus (HIV)-positive and the other is HIV-negative is termed serodiscordant, mixed status, serodivergent or, discordant.[1]
The World Health Organization (WHO) estimates that of HIV-positive patients who are in a sexual relationship, 50% have a ‘mixed status’
Apart from the economic burden it presents, HIV infection threatens the stability of families, especially amongst serodiscordant couples
Summary
Any sexual relationship in which one partner is human immunodeficiency virus (HIV)-positive and the other is HIV-negative is termed serodiscordant, mixed status, serodivergent or, discordant.[1] The World Health Organization (WHO) estimates that of HIV-positive patients who are in a sexual relationship, 50% have a ‘mixed status’. The prevalence of HIV discordance amongst couples in sub-Saharan Africa is between 3% and 20% in the general population.[1] Generally, in most studies involving discordant couples, there is a 50:50 male-to-female proportion.[2]. Socio-economic factors such as gender, race or ethnicity and other social determinants of health have been identified as crucial in the fight against HIV and acquired immunodeficiency syndrome (HIV and AIDS).[3] Apart from the economic burden it presents, HIV infection threatens the stability of families, especially amongst serodiscordant couples. The family adaptability, partnership, growth, affection and resolve (Family APGAR), a standardised tool for assessing family function, has not been used in any published literature involving this peculiar group
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