"It Had a Lot of Cultural Stuff in It": HIV-Serodiscordant African American Couples' Experiences of a Culturally Congruent Sexual Health Intervention

Jacqueline Mthembu; Alison B Hamilton; Norweeta G Milburn; Deborah Sinclair; Siyabulela Mkabile; Mmathabo Mashego; Thabile Manengela; Gail E Wyatt

doi:10.18865/ed.30.2.269

"It Had a Lot of Cultural Stuff in It": HIV-Serodiscordant African American Couples' Experiences of a Culturally Congruent Sexual Health Intervention

Ethn Dis. 2020 Apr 23;30(2):269-276. doi: 10.18865/ed.30.2.269. eCollection 2020 Spring.

Authors

Jacqueline Mthembu¹, Alison B Hamilton^{2

3}, Norweeta G Milburn², Deborah Sinclair^{4

5}, Siyabulela Mkabile^{6

7}, Mmathabo Mashego^{8

9}, Thabile Manengela¹⁰, Gail E Wyatt²

Affiliations

¹ Social Aspects of Public Health Research Programme, Human Sciences Research Council, South Africa.
² Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA.
³ Center for the Study of Healthcare Innovation, Implementation, & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA.
⁴ Child and Family Studies, University of the Western Cape, South Africa.
⁵ Department of Special Needs Education, Ghent University, Belgium.
⁶ Department of Psychiatry and Mental Health, University of Cape Town, South Africa.
⁷ Department of Psychology, Stellenbosch University, Stellenbosch, South Africa.
⁸ University of Venda, Limpopo, South Africa.
⁹ Department of Community Strengthening Systems, HIV South Africa, South Africa.
¹⁰ Department of Psychology, North West University, South Africa.

Abstract

Objective: The increased life expectancy of people living with HIV has brought about an increase in serodiscordant couples, in which there is risk of HIV transmission. Therefore, interventions that promote sexual health and reduce risk are critical to develop for these couples. Given the disproportionate burden of HIV among populations of color, it is also critical that these interventions are culturally congruent. The EBAN intervention for African American serodiscordant couples recognizes the centrality of culture in shaping sexual behaviors and helps couples develop intimacy and positive prevention behaviors. The analytic objective of our study was to examine the knowledge and awareness gained by participants in the intervention.

Participants: Participants (n=17) who completed at least half of the eight intervention sessions.

Methods: Brief post-implementation semi-structured interviews were conducted between January 1, 2016 and December 31, 2016. Team-based, targeted content analysis focused on knowledge and awareness gains.

Results: Participants described learning about sexual health, expanded sexual options, and sexual communication. The "EBAN café," a component that gives couples a menu of options for safer sex behaviors, was particularly popular. Participants also noted the value of learning how to communicate with one another about their sexual health-related concerns and preferences. They appreciated the "cultural stuff" that was infused throughout the sessions, including the emphasis on learning from one another as couples.

Conclusions: Couples at risk for HIV transmission benefit from strengthening skills and knowledge related to healthy sexuality. A behavioral intervention that aligns with cultural values and imparts culturally congruent sexual health information appeals to couples who seek ways to enhance their intimacy and sexual options while also reducing risk.

Keywords: African American; Couples; Evidence-Based Intervention; HIV Serodiscordance; Qualitative; Sexual Health.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

AIDS Serodiagnosis / methods
Adult
Black or African American / psychology*
Culturally Competent Care* / ethnology
Culturally Competent Care* / methods
Female
HIV Infections* / ethnology
HIV Infections* / prevention & control
HIV Infections* / psychology
Humans
Male
Qualitative Research
Safe Sex / ethnology
Safe Sex / psychology
Sexual Health
Sexual Partners / psychology*

Abstract

Publication types

MeSH terms

Grants and funding