Being in a primary relationship is believed to result in logistic and emotional support that provides health- promoting benefits. However, in a recent report of adherence to antiretroviral therapy (ART) among a large diverse sample of adults living with HIV, we detected a counterintuitive association in two separate samples between being in a primary relationship and worse adherence to medications. Such findings raise the question of how relationship dynamics impact adherence to HIV treatment. The purpose of the proposed study is to investigate, through qualitative and quantitative methods, the relationship factors that are associated with adherence to ART. The proposed study will be conducted in 3 phases. Based on recruitment feasibility and the epidemiology of the HIV epidemic in the San Francisco area, we will include HIV+ seroconcordant and serodiscordant male couples. Phase 1 will be a qualitative investigation of relationship dynamics and partner tactics related to adherence. Phase 2 will be the development of a medication adherence-specific measure of partner support, and will include specific tactics informed by Phase 1. Phase 3 will be a cross-sectional study of 300 couples which will (a) validate the adherence specific measure of partner support constructed in Phase II; and (b) test specific hypotheses of the inter-relationships among individual variables (e.g., quality of life, psychological well being, substance use) and couple-level variables (e.g., relationship satisfaction, conflict, adherence specific partner support), and ART adherence and clinical variables. Adherence to ART will be measured by 2 validated self-report measures. Clinical status will be assessed by viral load and CD4 count. All phases will be guided by social control theory and findings will have clinical implications for the development of interventions to improve adherence within couples and theoretical implications for understanding the role of social control in HIV treatment adherence. ? ? ?
| Gamarel, Kristi E; Neilands, Torsten B; Conroy, Amy A et al. (2017) A longitudinal study of persistent smoking among HIV-positive gay and bisexual men in primary relationships. Addict Behav 66:118-124 |
| Conroy, Amy A; Gamarel, Kristi E; Neilands, Torsten B et al. (2016) Relationship Dynamics and Partner Beliefs About Viral Suppression: A Longitudinal Study of Male Couples Living with HIV/AIDS (The Duo Project). AIDS Behav 20:1572-83 |
| Conroy, Amy A; Gamarel, Kristi E; Neilands, Torsten B et al. (2016) Partner Reports of HIV Viral Suppression Predict Sexual Behavior in Serodiscordant Male Couples. J Acquir Immune Defic Syndr 73:e31-3 |
| Gamarel, Kristi E; Comfort, Megan; Wood, Troy et al. (2016) A qualitative analysis of male couples' coping with HIV: Disentangling the ""we"". J Health Psychol 21:2125-37 |
| Gamarel, K E; Neilands, T B; Dilworth, S E et al. (2015) Smoking, internalized heterosexism, and HIV disease management among male couples. AIDS Care 27:649-54 |
| Gamarel, Kristi E; Woolf-King, Sarah E; Carrico, Adam W et al. (2015) Stimulant use patterns and HIV transmission risk among HIV-serodiscordant male couples. J Acquir Immune Defic Syndr 68:147-51 |
| Kamen, Charles; Mustian, Karen; Johnson, Mallory O et al. (2015) Same-sex couples matter in cancer care. J Oncol Pract 11:e212-5 |
| Starks, Tyrel J; Gamarel, Kristi E; Johnson, Mallory O (2014) Relationship characteristics and HIV transmission risk in same-sex male couples in HIV serodiscordant relationships. Arch Sex Behav 43:139-47 |
| Gamarel, Kristi E; Starks, T J; Dilworth, S E et al. (2014) Personal or relational? Examining sexual health in the context of HIV serodiscordant same-sex male couples. AIDS Behav 18:171-9 |
| Saberi, Parya; Neilands, Torsten B; Johnson, Mallory O (2014) Association between dog guardianship and HIV clinical outcomes. J Int Assoc Provid AIDS Care 13:300-4 |
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