Exploring the experiences of “trust” in intimate relationships of women living with HIV in the Western Cape, South Africa

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2023-03
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ENGLISH ABSTRACT: The largest HIV burden in South Africa lies with heterosexual people living with HIV. Women comprise of 54% of all people living with HIV (PLHIV) worldwide. In 2021, every two minutes an adolescent or young women was infected with HIV. However, there is currently very little information of how women living with HIV engage in intimate relationships with their partners. Intimacy involves individuals who reciprocates intimate moments and feelings of trust and, emotional and physical closeness towards their partners. Using qualitative data collected between 2012 and 2018 as part of the HPTN 071 (PopART) trial in South Africa, I explore how trust and intimacy is understood and experienced and how a desire for, or aversion towards intimacy in relationships coincide with the management of HIV and antiretroviral therapy (ART). I use a thematic approach to analyse in-depth qualitative data from 12 women, ranging from 17 to 48 years old, who self-disclosed that they were living with HIV. These women also reported experiences of being in intimate heterosexual relationships and had accessed ART. My findings show that trust is central to the functioning in relationships of women and intersect with women’s health-related decision making. Trust is multifaceted in that it may put women at risk of contracting HIV when ‘the wrong partners’ are trust, similarly, trust may render women vulnerable to experiencing physical, emotional, sexual, and mental trauma when women are in abusive relationships. Simultaneously, trust can be the reason for uptake in ART treatment. While trust is understood to be an important aspect of successful relationships, the desire of women living with HIV to have trusting intimate relationships impacts the management of their illness and treatment. These findings emphasise the significance of the role of understanding intimate relationships in HIV prevention and support interventions for women. It is recommended that health programmes implement HIV interventions which focuses on couples’ relationship dynamics to strengthen sexual and emotional intimacy. These interventions can be directed at building stronger foundations of commitment, fidelity, trust, openness, connectedness which assist with HIV prevention and protection of partners.
AFRIKAANSE OPSOMMING: Die grootste MIV-las in Suid-Afrika lê by heteroseksuele mense wat met MIV leef. Vroue bestaan uit 54% van alle mense wat wêreldwyd met MIV (PLHIV) leef. Gedurende 2021 is ‘n adolessent of jong vrou elke tweede minuut met MIV besmet. Daar is egter tans baie min inligting oor hoe vroue wat met MIV leef, intieme verhoudings met hul lewensmaats aangaan. Intimiteit behels individue wat intieme oomblikke en gevoelens van vertroue en emosionele en fisiese nabyheid teenoor hul maats wederkerig maak. Met behulp van kwalitatiewe data wat tussen 2012- 2018 ingesamel was as deel van die HPTN 071 (PopART)-proef in Suid-Afrika, ondersoek ek hoe vertroue en intimiteit verstaan en ervaar word en hoe 'n begeerte na of afkeer van intimiteit in verhoudings saamval met die bestuur van MIV en ART. Ek het 'n tematiese benadering gebruik om twaalf gevalle van vroue, wie se ouderdomme wissel tussen 17 en 48 jaar, ontleed en wie self bekend gemaak het dat hulle met MIV leef. Ek het ook die kwalifiserende deelnemers gekies wat ervarings gerapporteer het om in intieme heteroseksuele verhoudings te wees en tans / voorheen op ART was. My bevindinge toon dat vertroue sentraal staan in die funksionering in verhoudings van vroue en potensieel 'n groot uitwerking op gesondheidsverwante besluitnemings het. Die skending van hierdie oomblikke en gevoelens, verdraai die gemak en veiligheid van verhoudings. Vertroue is veelsydig deurdat dit vroue in gevaar kan stel om MIV op te doen wanneer 'die verkeerde vennote' vertroue het, net so kan vertroue vroue kwesbaar maak om fisiese, emosionele, seksuele en geestelike trauma te ervaar wanneer vroue in beledigende verhoudings is. Terselfdertyd kan vertroue die rede wees vir opname in ART-behandeling. Alhoewel vertroue as 'n belangrike aspek van suksesvolle verhoudings beskou word, beïnvloed die begeerte van vroue wat met MIV leef om vertrouende intieme verhoudings te hê, die bestuur van hul siekte en behandeling.
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Thesis (MA)--Stellenbosch University, 2023.
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