Marseille 2007
| Abstract #130 - Sero-silence and sero-sharing: Managing HIV in serodiscordant heterosexuals relationships | ||||
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Session: 25.5: Couples (Parallel) on Monday @ 16.30-18.30 in PR Chaired by Jose Catalan, Giovanna Meystre-Agustone Authors: Presenting Author: Dr Asha Persson - University of New South Wales, Australia |
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| Aim: There is little international research available on how serodiscordant heterosexual couples manage HIV in their relationships. This paper examines ways of living with HIV from the perspectives of both positive and negative partners in New South Wales, Australia. Specific attention is paid to the personal and sociocultural contexts that shape experiences and modes of communication in such couples, and the implications of these modes in terms of emotional and sexual well-being. | ||||
| Method / Issue: Straightpoz is the first Australian qualitative longitudinal study to explore the experiences of men and women who live heterosexually with HIV, including HIV-negative partners. In-depth, semi-structured interviews were conducted with 46 participants in 2004 and 2006. The study includes 18 couples in all from a range of cultural and socio-economic backgrounds. In ten of the couples the male partner was positive, in seven of the couples the female partner was positive, and in one couple both partners were positive. Verbatim transcripts were coded for major themes, which were analysed to identify similarities and differences across interviews. | ||||
| Results / Comments: HIV figured in diverse ways among these couples. However, living with HIV was generally located somewhere along a continuum between two distinct modes, conceptualised here as sero-sharing and sero-silence. In sero-sharing relationships, both partners were engaged in the medical and emotional management of HIV. There was a sense of shared experience and identity as an HIV couple. Negative partners were typically well informed and HIV was openly discussed. Often the positive partner had been extremely ill or near death, shaping the lives of both partners in profound ways. In sero-silent relationships, HIV tended to be much more in the background. HIV was seen by either or both partners as the domain of the positive partner, rather than as a shared experience. Negative partners were rarely involved in the management of HIV and HIV was not often talked about. While silence around HIV enabled a comforting sense of normality for some couples, it was a source of tension for others and raised issues around trust, denial and responsibility. In some couples, it had a troubling effect on sexual decision-making. | ||||
| Discussion: These different modes intersected in complex ways with gender, illness experience, treatments, the length of relationships, and a general lack of awareness of HIV in the Australian heterosexual community. To enable effective HIV education and health promotion, it is important to recognise different modes of managing HIV among serodiscordant couples. It is particularly important to understand what shapes these modes and how they affect communication, well-being and sexual practice. In this regard, the concepts of sero-sharing and sero-silence can provide a useful model with broader applications among people living with HIV. | ||||
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