Evaluating the Couples Health CoOp in South African Couples: Understanding Sexual Concurrency, Long-Term Skill Retention, and Relationship Dynamics Public Deposited

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  • March 21, 2019
Creator
  • Belus, Jennifer
    • Affiliation: College of Arts and Sciences, Department of Psychology and Neuroscience
Abstract
  • Incident rates of HIV infection continue to be unacceptably high in South Africa, where HIV is primarily transmitted through sexual contact. Couple-based HIV prevention programs, which focus on the dyad as the point of intervention, are shown to be efficacious in improving safe sex behaviors. However, not all individuals show improvement through this type of intervention, suggesting an opportunity to improve these programs. Therefore, the current study has three aims tied to improving couple-based HIV prevention programs in South Africa: (a) use individual and relationship predictors to better understand why individuals engage in outside sexual relationships, known as sexual concurrency; (b) examine the long-term effects of a particular couple-based HIV prevention program, the Couples Health CoOp; and (c) develop and initially evaluate a theory of adaptive couple functioning for Black South African couples, which can improve the relationship focus of couple-based HIV prevention programs. A quantitative investigation using a structural equation modeling framework was carried out for Study 1 using data collected from 286 South African heterosexual couples. Results show that alcohol use for both sexes, relationship satisfaction among men, and mistrust among women were predictive of different types of sexual concurrency. Study 2 used qualitative methods, specifically focus group discussions with men and women, to investigate the second and third aims. Results of Aim 2 indicated that the most salient information learned by men and women related to communication and problem-solving, safe sexual behaviors, and negative effects of alcohol. Long-term changes were reported in the areas of communication and healthier sexual behavior, but alcohol use for many participants was still an area of struggle. Finally, Aim 3 of this investigation revealed four major components associated with adaptive relationship functioning: active relationship building behaviors, emotional support/display, communication, and problem-solving. Overall, this study provides evidence that relationship factors are central to the lives of South African men and women, and it identifies a number of ways in which couple-based HIV prevention programs might be improved through enhancing various relationship factors.
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Advisor
  • Baucom, Donald
  • Panter, Abigail
  • Jones, Deborah
  • Penn, David L.
  • Wechsberg, Wendee
Degree
  • Doctor of Philosophy
Degree granting institution
  • University of North Carolina at Chapel Hill
Graduation year
  • 2018
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