A qualitative study of barriers to consistent condom use among HIV-1 serodiscordant couples in Kenya

Abstract

This study explored barriers to consistent condom use among heterosexual HIV-1 serodiscordant couples who were aware of the HIV-1 serodiscordant status and had been informed about condom use as a risk reduction strategy. We conducted 28 in-depth interviews and 9 focus group discussions among purposively selected heterosexual HIV-1 serodiscordant couples from Thika and Nairobi districts in Kenya. We analyzed the transcribed data with a grounded theory approach. The most common barriers to consistent condom use included male partners' reluctance to use condoms regardless of HIV-1 status coupled with female partners' inability to negotiate condom use, misconceptions about HIV-1 serodiscordance, and desire for children. Specific areas of focus should include development of skills for women to effectively negotiate condom use, ongoing information on HIV-1 serodiscordance and education on safer conception practices that minimize risk of HIV-1 transmission.

Keywords:

• HIV-1
• serodiscordant
• condom use
• Kenya

Acknowledgements

We are thankful to the study participants for this qualitative study. Special thanks to Dr James Pfeiffer for assisting in shaping of this article during the initial stages. We are grateful to John Njoroge and Sophie Vusha for conducting and transcribing the interviews. We thank the principal investigators (Drs James Kiarie, Carey Farquhar, and Grace John-Stewart) at the Nairobi site for the Partners in Prevention HSV/HIV Transmission Study. This research was funded by NIH grants R24 HD056799 and R01 AI083034 and by the University of Washington Center for AIDS Research (CFAR), an NIH funded program (P30 AI027757) which is supported by NIAID, NCI, NIMH, NIDA, NICHD, NHLBI, NCCAM. Kenneth Ngure was a scholar in the International AIDS Training Program, supported by the Fogarty International Center, NIH Research Grant D43 TW000007.