ArticleSocial science & medicine (1982)2018
Marital infidelity, food insecurity, and couple instability: A web of challenges for dyadic coordination around antiretroviral therapy.
Article in Social science & medicine (1982), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
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Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- A Mixed-Methods Systematic Review: Infidelity, Romantic Jealousy and Intimate Partner Violence against Women.International journal of environmental research and public health · 2020Pooled it
- Social and Structural Determinants of Household Support for ART Adherence in Low- and Middle-Income Countries: A Systematic Review .International journal of environmental research and public health · 2020Pooled it
- Trial experiences with dyadic breathalyzer technology for alcohol monitoring and feedback among couples living with HIV in South Africa.Addiction science & clinical practice · 2026Trial
- Mlambe economic and relationship-strengthening intervention for alcohol use decreases violence and improves relationship quality in couples living with HIV in Malawi.Social science & medicine (1982) · 2024Trial
- Development of an Economic and Relationship-Strengthening Intervention for Alcohol Drinkers Living with HIV in Malawi.AIDS and behavior · 2023Trial
- "AIDS care · 2026Article
- Couples problem-solving therapy for perinatal women living with HIV and male partners in Malawi: a study protocol for a pilot trial ofBMJ open · 2026Article
- Complexity of Adherence Challenges: Understanding Syndemic Factors Affecting HIV Treatment Adherence During Treatment Initiation in Cape Town, South Africa.AIDS and behavior · 2026Article
- Intersectional Stigma and Health of People Living with HIV on ART Who Use Alcohol in Southwestern Uganda.AIDS and behavior · 2026Article
- Qualitative dyadic analysis in care partnership research: a scoping review.BMC medical research methodology · 2025Article
- Article
- Effects of economic empowerment and relationship strengthening intervention on financial behaviors among couples living with HIV: TheSSM - population health · 2025Article
- HIV and Viremia Prevalence in Nonmigrating Members of Migrant Households in Southern Uganda: A Cross-Sectional Population-Based Study.Journal of acquired immune deficiency syndromes (1999) · 2025Article
- Managing multimorbidity together: relationship dynamics and dual medication adherence for hypertension and HIV in Malawi.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2025Observational
- Expanding the food environment framework to include family dynamics: A systematic synthesis of qualitative evidence using HIV as a case study.Global food security · 2024Review
- Barriers to accessing care for cardiometabolic disorders in Malawi: partners as a source of resilience for people living with HIV.International journal for equity in health · 2024Article
- Article
- "I too have a responsibility for my partner's life": Communal coping among Malawian couples living with HIV and cardiometabolic disorders.Social science & medicine (1982) · 2024Article
- Supportive couple relationships buffer against the harms of HIV stigma on HIV treatment adherence.BMC public health · 2023Article
- Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
rationaleDespite the importance of primary partners for health, little is known about factors that constrain the ability of couples to work collaboratively towards HIV care and treatment (dyadic coordination). This study examined the interplay of marital infidelity, food insecurity, and couple instability on dyadic coordination and adherence to antiretroviral therapy (ART) in Malawi.
methodsIn 2016, we conducted 80 in-depth interviews with 25 couples with at least one partner on ART. Couples were recruited at two HIV clinics in the Zomba district when attending clinic appointments. Participants were asked about their relationship history, relationship dynamics (love, trust, conflict), experiences with HIV care and treatment, and how partners were involved. Using an innovative analysis approach, we analyzed the data at the couple-level by examining patterns within and between couples.
resultsThree patterns emerged. For some couples, ART led to positive changes in their relationships after men terminated their extramarital partnerships in exchange for love and support. For other couples with power imbalances and ongoing conflict, men's infidelity continued after ART and negatively affected dyadic coordination. Finally, some couples agreed to remain "faithful", but could not overcome stressors related to food insecurity, which directly impacted their adherence.
conclusionsCouples-based interventions targeting ART adherence should improve relationship quality, while also addressing interpersonal stressors such as marital infidelity and food insecurity. Multi-level interventions that address both dyadic and structural levels may be necessary for couples with severe food insecurity.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.