Positive Partner Research Articles

Dyadic effects of social support, illness uncertainty on anxiety and depression among lung cancer patients and their caregivers: a cross-sectional study.

To explore the dyadic relationships between perceived social support, illness uncertainty, anxiety, and depression among lung cancer patients and their family caregivers. To examine the potential mediating role of illness uncertainty and the moderating role of disease stage in lung cancer patient-caregiver dyads. A total of 308 pairs of lung cancer patients and their family caregivers from a tertiary hospital in Wuxi, China, from January 2022 to June 2022 were included. Participants' perceived social support, illness uncertainty, anxiety, and depression were assessed by corresponding questionnaires. To test for dyadic relationships between the variables, we employed the actor-partner interdependence mediation model. There were actor and partner effects of both patient and caregiver perceived social support on anxiety and depression, and illness uncertainty mediated the effect of perceived social support on anxiety and depression. Lung cancer stage plays a moderating role in lung cancer patient-caregiver dyads. There is an indirect positive partner effect of perceived social support from family caregivers on anxiety and depression in patients with early lung cancer; there is a direct or indirect negative partner effect of social support from family caregivers on anxiety and depression in patients with advanced lung cancer. This study confirmed the dyadic interdependence between perceived social support, illness uncertainty, anxiety, and depression among lung cancer patients and family caregivers. Furthermore, studies on differences between different lung cancer stages may provide a theoretical basis for different dyadic supportive interventions based on lung cancer stages.

Injection partnership characteristics and HCV status associations with syringe and equipment sharing among people who inject drugs

BackgroundSharing of syringes is the leading transmission pathway for hepatitis C (HCV) infections. The extent to which HCV can spread among people who inject drugs (PWID) is largely dependent on syringe-sharing network factors. Our study aims to better understand partnership characteristics and syringe and equipment sharing with those partners, including measures of relationship closeness, sexual activity, and social support, as well as self and partner HCV status to better inform interventions for young urban and suburban PWID.MethodsData are from baseline interviews of a longitudinal network-based study of young (aged 18–30) PWID (egos) and their injection network members (alters) in metropolitan Chicago (n = 276). All participants completed a computer-assisted interviewer-administered questionnaire and an egocentric network survey on injection, sexual, and support networks.ResultsCorrelates of syringe and ancillary equipment sharing were found to be similar. Sharing was more likely to occur in mixed-gender dyads. Participants were more likely to share syringes and equipment with injection partners who lived in the same household, who they saw every day, who they trusted, who they had an intimate relationship with that included condomless sex, and who provided personal support. PWID who had tested HCV negative within the past year were less likely to share syringes with an HCV positive partner compared to those who did not know their status.ConclusionPWID regulate their syringe and other injection equipment sharing to some extent by sharing preferentially with injection partners with whom they have a close personal or intimate relationship, and whose HCV status they are more likely to know. Our findings underscore the need for risk interventions and HCV treatment strategies to consider the social context of syringe and equipment sharing within partnerships.

Menses and Positive Partner Interactions Increase Mate Guarding Behaviors in Established Romantic Couples

Mate Guarding (Alberts et al., 1996), behaviors intended to decrease a romantic partner’s sexual access to potential extradyadic partners (e.g., touching partner around others, not attending gatherings), are thought to change throughout the menstrual cycle. Rooted in theories suggesting ovulating women’s sexual interest/behaviors increase during times of fertility, couples increase their mate guarding behaviors to limit reproductive costs (Gangestad et al., 2006). Yet, much of the research fails to examine mate guarding behaviors and fertility in established, committed couples. Using an ecological momentary assessment, romantically committed, heterosexual couples (n = 42 pairs) completed daily surveys tracking relationship dynamics for one menstrual cycle (e.g., 28 days; all naturally cycling). Dependent t-tests showed mate guarding behaviors increased during menses compared to ovulation (women, t = 4.5, p <.001; men, t = 3.5, p<.001), but positive couple interactions were unchanged. We tested actor-partner effects between positive daily partner interactions and mate guarding during menses and ovulation. Positive actor effects were found for both (menses women ß = 3.276, p <.001, men ß = 3.049, p =.002; ovulation women ß = 1.637, p =.041, men ß = 3.089, p =.011); whereas partner effects were only observed for men during ovulation (ß = 2.806, p =.006). Results demonstrate evolutionary psychological theories suggesting mate guarding increases during ovulation may not be predictive in established couples. For committed couples, times when female partners are unlikely to conceive are opportunities when couples demonstrate their fidelity.

0088 Bidirectional Pathways Linking Daily Partner Interactions to Sleep Quality in Older Adult Couples

Abstract Introduction Decreasing sleep quality is a challenge for older adults over age 65. Researchers have found significant associations between romantic relationships and sleep quality. However, most existing studies are cross-sectional; few have focused on the aging population who experience the most sleep problems; few have considered mechanisms linking close relationships and sleep quality; few have considered the specific effects of social interactions on sleep quality; and few have considered bidirectional relationships. To address these gaps in the literature, this study investigated the bidirectional pathways linking daily partner interactions to sleep quality in older adult couples. This study also tested daily negative affect, positive affect, and perceived partner responsiveness as three possible mediators explaining recursive associations between daily partner interactions and sleep quality. Methods This study recruited 238 older adult couples to complete baseline questionnaires including assessments of attachment orientation and demographics. Couple members also completed daily diaries for 7 consecutive days, reporting on their daily relationship, emotional, and sleep experiences. Results Results supported the predicted bidirectional relationship between daily partner interactions and sleep quality via three hypothesized pathways (i.e., negative affect, positive affect, and perceived partner responsiveness). Specifically, older adults who reported higher than average negative partner interactions during the day reported increases in negative affect, and decreases in positive affect and perceived partner responsiveness on the same day, which in turn were associated with worse sleep quality that night. The opposite was true for positive partner interactions. Bidirectionally, older adults who reported higher than average sleep quality on one night reported decreases in negative affect and increases in positive affect and perceived partner responsiveness the next day, which in turn were associated with fewer negative partner interactions and more positive partner interactions that day. Results also revealed moderating effects of attachment orientation and gender. Conclusion In conclusion, this study contributes to a sparse literature assessing the bidirectional relationship between daily partner interactions and sleep quality in the aging population. This research adds to our knowledge of the mechanisms underlying the recursive relationship and informs us of potential avenues for relationship-based interventions aimed at improving sleep quality. Support (if any)

Exploring the importance of predisposing, enabling, and need factors for promoting Veteran engagement in mental health therapy for post-traumatic stress: a multiple methods study

PurposeThis study explored Veteran and family member perspectives on factors that drive post-traumatic stress disorder (PTSD) therapy engagement within constructs of the Andersen model of behavioral health service utilization. Despite efforts by the Department of Veterans Affairs (VA) to increase mental health care access, the proportion of Veterans with PTSD who engage in PTSD therapy remains low. Support for therapy from family members and friends could improve Veteran therapy use.MethodsWe applied a multiple methods approach using data from VA administrative data and semi-structured individual interviews with Veterans and their support partners who applied to the VA Caregiver Support Program. We integrated findings from a machine learning analysis of quantitative data with findings from a qualitative analysis of the semi-structured interviews.ResultsIn quantitative models, Veteran medical need for health care use most influenced treatment initiation and retention. However, qualitative data suggested mental health symptoms combined with positive Veteran and support partner treatment attitudes motivated treatment engagement. Veterans indicated their motivation to seek treatment increased when family members perceived treatment to be of high value. Veterans who experienced poor continuity of VA care, group, and virtual treatment modalities expressed less care satisfaction. Prior marital therapy use emerged as a potentially new facilitator of PTSD treatment engagement that warrants more exploration.ConclusionsOur multiple methods findings represent Veteran and support partner perspectives and show that amid Veteran and organizational barriers to care, attitudes and support of family members and friends still matter. Family-oriented services and intervention could be a gateway to increase Veteran PTSD therapy engagement.

The associations between relationship self‐regulation, partner regulation, and relationship outcomes: A meta‐analysis

AbstractThe aim of this meta‐analysis was to determine whether relationship self‐regulation (changing aspects of the self for the sake of the relationship) or partner regulation (changing the partner for the sake of the self/relationship) was more strongly associated with romantic relationship quality. Twenty studies (5 on relationship self‐regulation, 15 on partner regulation; N = 15,563) were included. A moderate positive association was found between relationship self‐regulation and relationship quality (r = .42). A weak positive association was found between positive partner regulation and relationship quality (r = .14). A negative association was found between negative partner regulation strategies and relationship quality (r = −.22). Partner regulation strategies were unlikely to be successful in prompting change in targeted partners. A weak positive association was found between positive strategies and regulation success (r = .10), and a weak negative association was found between negative strategies and regulation success (r = −.09). Thus, relationship self‐regulation is more strongly associated with relationship quality than partner regulation.

부모의 스마트폰 중독, 부부갈등, 부모 참여, 초등학생의 미디어 기기 중독 간 관계

Objectives The purpose of this study was to investigate the effect of smartphone addiction of parents with elementary school children on marital conflict and to explore the structural relationships among smartphone addiction of parents, marital conflict, parental involvement, and media device addiction of their children who go to elementary school.&#x0D; Methods A total of 1,224 pairs of data from the 13th Korean Children's Panel Study (2020) were analyzed with Actor-Partner Interdependence Model (APIM). In order to compare the actor and the partner effect of smartphone addiction, an equivalence constraint model was set up and difference verification was conducted. Also, a structural equation analysis method based on the maximum likelihood method (ML) was used to verify the structural relationship among parental smartphone addiction, marital conflict, parental involvement, and elementary school students' addiction to media devices.&#x0D; Results The results are as follows: first, both mother’s and father’s smartphone addiction had a positive actor effect on the marital conflict, but a positive partner effect was only confirmed from mother’s smartphone addiction. Second, the actor effect of smartphone addiction on marital conflict was found to be greater in father than mother, however, the partner effect of father's smartphone addiction on marital conflict perceived by mother was greater than the partner effect of mother's smartphone addiction on marital conflict perceived by father. Third, mother's smartphone addiction was influenced through how she perceived marital conflict and parental involvement on students' media device addiction, while father's smartphone addiction was influenced sequentially by mother's perceived marital conflict and parental involvement on students' media device addiction.&#x0D; Conclusions This study suggests that both mother and father's smartphone addiction affect to elementary school students' media device addiction, but the mechanisms affecting on media device addiction from parents are different.

A longitudinal investigation of marital dissolution, marital quality, and generalized anxiety disorder in a national probability sample

Generalized anxiety disorder (GAD) is a common psychiatric disorder that is associated with high levels of distress and impairment. The present study was conducted to examine the 10-year longitudinal associations between marital dissolution, three measures of marital quality, and GAD among married participants from the Midlife in the United States (MIDUS) survey, a probability sample of American adults aged 24–74 years. Results indicated that GAD at baseline was significantly and positively associated with incidence of marital dissolution during the 10-year follow-up and marital strain (i.e., negative partner interaction) at baseline was significantly and positively associated with incidence of GAD at the 10-year follow-up. These associations remained statistically significant after adjusting for demographic characteristics and neuroticism. In comparison, marital satisfaction and marital support (i.e., positive partner interaction) at baseline were not significantly associated with incidence of GAD, GAD at baseline was not significantly associated with any of the three measures of marital quality at follow-up, and marital dissolution during follow-up was not significantly associated with incidence of GAD. These findings suggest that negative interactions with one’s partner may be a risk factor for GAD and that improving marital functioning may be important for the prevention and treatment of GAD.

Longitudinal associations between mindfulness and changes to body image in first-time parent couples

Pregnancy and postpartum are associated with declines in body image. Research on postpartum body image focuses almost exclusively on the person who gave birth and studies examining protective factors for postpartum body image are scarce. We assessed 257 new-parent couples from mid-pregnancy to 6-months postpartum to examine whether mindfulness—a recognized contributor to psychological well-being—buffered against declines in both partners’ perceptions of mothers’ body. Mothers’ positive body image and partners’ perception of mothers’ body were collected at four time-points (second and third trimester; 3- and 6-months postpartum); both partners’ mindfulness facets—observing, describing, awareness acting, non-judgement, and non-reactivity—were assessed in the second trimester. Dyadic latent growth curve modeling revealed that both partners’ perceptions of mothers’ body were positively correlated at all moments; however, mothers’ positive body image worsened over time, whereas partners’ perception of mothers’ body remained stable. Mindfulness facets were positively associated with mothers’ positive body image (observe, describe, and non-judging) and fathers’ (non-judging) perceptions of mothers’ body in pregnancy. Mothers’ mindfulness facets (acting with awareness, non-judging) were associated with subsequent trajectories of their own body image. By identifying mindfulness facets as targetable protective factors during pregnancy, these findings have implications for future research and interventions focused on perinatal body image.

Creating Reproductive Health Behavioral Profiles for Women of Reproductive Age in Niger Using Cross-Sectional Survey Data: A Latent Class Analysis.

Objectives: To identify health behavioral profiles for women of reproductive age in Niger. Methods: We interviewed married women of reproductive age in Niger in April 2021 (N = 2,709). Latent class analysis based on sociodemographic and behavioral determinants was used to identify classes of women related to use of antenatal care, facility delivery, and modern family planning (FP) use. Results: We found similar classes between the use of antenatal care and facility-based delivery classes with the first class composed of less educated and poor women with weaker behavioral determinants while the second class was more educated and had stronger behavioral determinants. In the facility-based delivery class was the presence of a third class that was poor and uneducated with low levels of knowledge and social norms, but in contrast had much higher levels of positive attitudes, self-efficacy, and partner communication than the first class. A fourth class of younger, more educated women with strong behavioral determinants emerged related to FP. Conclusion: The application of empirical subgrouping analysis permits an informed approach to targeted interventions and resource allocation for optimizing maternal and reproductive health.

Resource Matching in the Supply Chain Based on Environmental Friendliness under a Smart Contract

This study aims to solve the problem of environmental pollution caused by industry through the upgrading and transformation of the supply chain, supply chain resource allocation, and related aspects. Specifically, environmental friendliness is added to the resource-matching problem of the cloud platform supply chain. Additionally, learning theory and dynamic evaluation systems are introduced when creating a preference sequence. The deferred-acceptance algorithm is used for matching. Finally, the automatic matching of blockchain smart contracts ensures the interests of both matching parties. Through the analysis of the example at the end of the study, we found that (1) the deviation table of demand side 5 and supply side 7 in the example shows that the deviation between demand side 5 as demand side and supply side 7 is only 11.55186, and the deviation between supply side 7 as demand side and demand side 5 is only 6.56778, and both sides form a high-quality pairing when matched with other partners. No excessive waste of its resources occurs. (2) Effectively ensure the openness and transparency of the supply chain production process; (3) The impact of environmental factors on enterprises is fully considered. In the analysis of the calculation cases, it can be found that demand side 10 has extremely high requirements for the environmental friendliness of its partners, and although supplier 2 has a very high preference for demand side 10, it is not successfully matched because the environmental friendliness of its own enterprise is not up to the standard, while supplier 1 has an environmental friendliness of up to 92 and is finally matched with Demand side 10; (4) Through the comparison test in the appendix, it can be found that the improved GS algorithm achieves the distinction between positive and negative partners. After multiple rounds of scoring, positive demand side 1, 3 was matched with positive supply side 2, 4, which can strengthen the enthusiasm of both partners and avoid negative cooperation.

Fertility desire among HIV-positive individuals in the Chinese sociocultural context: A qualitative study.

China's recent change from a one-child policy to a two-child policy has urged many couples/families to consider having a child or an additional child. However, little is known about such fertility desire among heterosexual couples with at least one human immunodeficiency virus (HIV)-positive partner. The objective of this qualitative study was to describe fertility desire and its motivating factors and barriers among people living with HIV (PLHIV). We conducted in-depth semi-structured interviews in 31 patients at an antiretroviral therapy (ART) clinic in Kunming, China, from October to December 2020. We included only patients in a sexually active heterosexual relationship with no more than one child. Participants gave verbal informed consent before participation. Interview recordings were transcribed verbatim, translated into English, and then analyzed using thematic analysis. Participants who reported fertility desire were mostly male, while participants who reported no fertility desire were mostly female. Study participants reported motivating factors and barriers that were identical to HIV-negative persons such as 1) social norms, 2) Chinese sociocultural factors, 3) the government's two-child policy, and 4) the financial burden of having children. However, study participants also reported motivating factors and barriers unique to human immunodeficiency virus (HIV)-positive individuals that included 1) the availability of ART and prevention of mother-to-child HIV transmission services, 2) health-related concerns, 3) stigma and discrimination against PLHIV, and 4) the additional cost of child-rearing when HIV-positive. The study findings highlighted major areas of concern for relevant stakeholders. The development of PLHIV-specific health policy should consider the PLHIV-specific motivating factors and barriers reported in this study. However, social desirability and lack of generalizability should also be considered in the interpretation of this study's findings.

Depression and perceived stress among perinatal women living with HIV in Nigeria.

Pregnancy and postpartum periods are crucial stages for women's mental health, and women living with HIV are particularly susceptible to depression and psychological stress due to various factors. This study investigated the prevalence and associated factors of depression and perceived stress among women living with HIV during their perinatal period in Ibadan, Nigeria. A cross-sectional survey was conducted in three HIV treatment centers in Ibadan, Nigeria, among women living with HIV between the ages of 19 and 49 who were either pregnant or had given birth within the last 2 years. The study was conducted from September 2022 to December 2022. An interviewer-administered questionnaire was used to collect the data from the participants. Ethical approval and informed consent were obtained, and data were analyzed using the Statistical Package for Social Science version 26. The study included 402 participants, of whom 69.0 and 78.0% reported symptoms of depression and perceived stress, respectively. However, 15.2% of the participants have comorbid depression and stress. Positive partner status was significantly associated with lower perceived depression, while gestational age between 29 and 40 weeks was significantly associated with lower perceived stress. The co-occurrence of depression and perceived stress was associated with partner status, income level, family support, gestational age, and years on antiretroviral therapy. The high prevalence of depression, perceived stress, and their co-occurrence among women living with HIV during the perinatal period call for incorporating mental health care into routine maternal healthcare for all women, particularly those living with HIV. This finding emphasizes the need for public health efforts to prioritize perinatal mental health and improve access to care and support for women and their partners.

Social influences predicting involvement in couple relationship education

AbstractObjectiveThis study explored the implementation climate of couple relationship education (CRE), specifically the positive role intimate partners, group members, and program facilitators have on one's beneficial involvement in programming.BackgroundFor CRE programs to be effective, participants need to be actively involved, yet little is known about social influences in the program encouraging participation in CRE. The perceived involvement of influential others was expected to moderate the relationship between intentions to participate and actual CRE involvement, with this involvement related to improvements in marital quality.MethodParticipants (584 men; Mage = 38.9 years and 627 women; Mage = 36.4 years) completed online surveys assessing study variables pre‐ and post‐CRE programming.ResultsPerceived intimate partner involvement contributed to better individual involvement and relationship quality for women with low intentions to participate in CRE, whereas both perceived partner and group involvement tended to have a protective effect for men's involvement.ConclusionThis study primarily demonstrates the importance of the perception of one's intimate partner's involvement in predicting individual involvement in CRE programs.ImplicationsDetermining predictors of program involvement assists with understanding the context of CRE effectiveness and skill acquisition for those intended to benefit.

Sexually transmitted infections and sexual behaviour among men having sex with men from Tshwane, South Africa.

Men having sex with men (MSM) are at increased risk of acquiring sexually transmitted infections (STIs), including extra-urethral infections. This study aimed to provide information on the presence of genital and extra-genital non-viral STIs and associated risk factors among MSM in the Tshwane district of South Africa. Samples were collected from 200 MSM in the North-western area of Tshwane. After the completion of a questionnaire including demographics and sexual history and an HIV test, three swabs (pharyngeal, rectal, and urethral) were collected and tested for the presence of Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), Mycoplasma genitalium (MG) and Trichomonas vaginalis (TV). Data were collected from 199 participants and 77/199 (38.7%) participants had at least one infection regardless of specimen site. Of these 34 (17.1%) were infected with NG; 36 (18.1%) with CT, 16 (8.1%) with MG and 14 (7.0%) with TV. NG and CT were most frequently detected in rectal specimens. The HIV prevalence in this study was 66.8% (133/199), with 56 (28.1%) of participants both STI and HIV positive. Being between 18 and 20 years, and difficulty having safe sex (more sex partners and more often condomless anal sex) when high/drunk were significantly associated with having an STI. Factors with increased odds of having an STI were being HIV positive, having two or more sexual partners, depending on partner financially, performing and receiving rimming, or receiving anal sex. This study has highlighted the high burden of STIs in MSM in the local community, especially the prevalence of these pathogens in extra-genital sites.

A Multimethod Examination of Stress and Support among Sexual Minority Couples

Little is known about how sexual minority couples cope with experiences of discrimination related to sexual orientation, and whether such processes are different from the management of general life stressors. Using self-report and observational methods, we investigated differences in couple support processes by stressor type. A sample of 84 sexual minority couples ( M age = 25.4 years, SD = 4.0) completed self-report measures and two video-recorded discussions (one sexual orientation-related discrimination stressor and one general life stressor not related to sexual orientation) that were coded for observed dyadic coping and social support behavior. In self-report models, more frequent stressors experienced by either partner, regardless of type, were related to more negative dyadic coping behavior and more positive partner social support provision. Discrimination stressors were uniquely related to less positive evaluations of dyadic coping behavior, but this result did not hold when accounting for covariates and could have been confounded by age. In observed models, we found no differences in positive dyadic coping or positive social support behavior across stressor discussions, but we found significantly less negative dyadic coping behavior during discrimination stressor discussions. Future work should examine how adaptive support processes may influence relationship functioning.

2210. Follow-up of Military Blood Donors Who Screen Positive for Syphilis

Abstract Background Most data on the transmission and outcomes of syphilis occur in community sexually transmitted infection (STI) clinics and have shown increased risk for other STIs in patients who test positive. There is limited data on outcomes in other lower risk populations that undergo universal syphilis screening, such as blood donors. This study describes the initial evaluation, follow-up, and STI risk of Air Force military basic trainees who screen-positive for syphilis at blood donation. Methods Blood donor data was gathered from the Armed Services Blood Bank Center-San Antonio for Air Force basic trainees who were screen-positive for syphilis between January 2014- September 2021. For each screen-positive case, six screen-negative controls were analyzed. Prospective donors were unable to donate if they reported male-to-male sexual encounters, HIV positive partners, or a bacterial STI in the prior year. Electronic medical records of cases and controls were examined for demographic information, STI history, and additional STI positivity within three years. Results A total of 63,375 basic military trainees donated blood at the Armed Services Blood Bank Center-San Antonio during the study period, of which 23 (0.36 per 1,000 donors) screened positive for syphilis (Table 1). At time of screening, 3 (13%) trainees who screened positive for syphilis also tested positive for an additional STI. After initial treatment and screening, donors who screened positive for syphilis had a RR: 3.8 (95% CI 1.3-10.5, p=0.01) of developing an additional STI in the three years after blood donation compared to controls. Cases of N. gonorrhoeae (Table 2) in the 3-year period following blood donation were significantly higher in those who were syphilis screen-positive compared to those who were negative. Conclusion There is limited data on follow-up of blood donors who screened positive for syphilis. This study found that in a low-risk population of military donors, those who screened positive for syphilis were at increased risk of future STIs compared to donors who were screen-negative. Syphilis screen-positive donors may be a potential target for future interventions to decrease the STIs burden in this population. Disclosures All Authors: No reported disclosures.

A longitudinal study of “we‐talk” as a predictor of marital satisfaction

AbstractWe‐talk, the use of first‐person plural pronouns over the use of singular pronouns when describing relationship events, is regarded as a linguistic indicator of marital relationship functioning. A meta‐analysis revealed that we‐talk is positively associated with relationship satisfaction. However, this literature is based mostly on cross‐sectional studies. This study tested the hypothesis that we‐talk would be associated with greater marital satisfaction over time. The sample comprised 77 couples enrolled in a longitudinal study of parents of preschool‐aged children. We‐talk was assessed at baseline during a marital discussion task about parenting challenges. Couples completed a measure of marital satisfaction at baseline, 6‐ and 12‐month follow‐ups. An actor–partner interdependence model examined the effects of spouses' we‐talk on their own marital satisfaction (actor effects), and their partners' marital satisfaction (partner effects). Results indicated a positive partner effect of we‐talk at baseline, but not over time. Moreover, there was an actor effect of we‐talk on changes in marital satisfaction over time, whereby low actor we‐talk was associated with a reduction in marital satisfaction, but high actor we‐talk was not associated with such a decrease. These findings suggest that greater cognitive interdependence, as indicated by we‐talk, may protect from declines in marital satisfaction over time.

Preventing HIV infection in pregnancy: a comprehensive ANC-based intervention in Western Uganda

Abstract Introduction Pregnant women in sub-Saharan Africa represent a high-risk group for HIV infection, but most endemic countries including Uganda do not engage specific HIV prevention measures in pregnancy. This longitudinal study aimed to assess outcomes of a comprehensive, ANC-embedded strategy to prevent seroconversions during pregnancy in Western Uganda. Methods HIV-negative ANC clients were administered an HIV risk assessment tool, followed by individual risk counselling. They received a fixed appointment for repeat HIV testing after three months. Those attending ANC without partners obtained formal partner invitation letters. At follow-up after three months, women not attending repeat testing were reminded via text message. Post-intervention risk behavior engagement was captured. We analyzed uptake of the intervention, HIV incidence rate, and associations with risk behavior. Results Of 1081 participants, 116 (10.7%) reported risk behavior engagement at first ANC visit, 148/1081 (13.7%) were accompanied by partners. The repeat test visit was attended by 848/1081 (78.5%) women, 42 (5.0%, p &amp;lt; 0.001) reported post-intervention risk behavior engagement, and 248 (29.4%, p &amp;lt; 0.001) were accompanied by partners. Seroconversion occurred in two women. In multivariable logistic regression, rural facility clients compared to urban ones (aOR 3.96; 95%CI 1.53-10.26), and women with positive or unknown partner HIV-status (aOR 2.86; 1.18-6.91) and partner alcohol abuse (aOR 2.68; 1.15-6.26) had increased odds for engagement in risk behavior despite the intervention. Conclusions After our intervention, risk behavior in pregnancy was reduced by half, and partner attendance had doubled compared to baseline. Our cohort showed a 0.76/100 women-years HIV incidence rate compared to 2.85 in pre-intervention data from the same setting. Clients from rural settings and women experiencing precarious partner situations require special attention to reduce risk behavior engagement during pregnancy. Key messages • HIV incidence in pregnancy in Western Uganda can be significantly reduced through a comprehensive, ANC-based counselling intervention. • Pregnant women from rural settings and those experiencing precarious partner situations require special attention regarding sexual risk behavior.

Dialecticism in romantic relationships: An examination in Chinese and American cultural contexts

AbstractThe cultural theory of naïve dialecticism, denoting Chinese lay beliefs about expectation of change and tolerance of contradiction, was employed to examine Chinese and European Americans' representation and evaluation of their romantic partners and relationships across three studies. We found that Chinese were more likely than Euro‐Americans to spontaneously describe their partners with contradictory attributes (Study 1). While Chinese and Euro‐Americans organized their evaluative partner knowledge in equally compartmentalized ways, Chinese were more likely to hold complex knowledge structures and to value both positive and negative partner knowledge (Study 2). Moreover, Chinese were more likely than Euro‐Americans to simultaneously hold positive and negative attitudes toward their partner and relationship (i.e., being ambivalent), both implicitly and explicitly (Study 3). These findings illuminate theories and research on contradictions in intimate relationships from a cultural perspective.