Safer conception services for HIV-affected couples must address overlooked relationship dynamics: a commentary and call to action.
6 affiliations
- 1Department of Community Health Systems, School of Nursing, University of California, San Francisco, CA, USA.
- 2Department of Medicine, Division of Prevention Sciences, University of California, San Francisco, CA, USA.
- 3Kenya Medical Research Institute (KEMRI), Kisumu, Kenya.
- 4Impact Research and Development Organization, Kisumu, Kenya.
- 5Department of Pediatrics, University of Colorado, Colorado, CO, USA.
- 6Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA.
Abstract
Data from East and Southern Africa shows the desire for children is strong among people living with HIV (PLHIV). Concurrently, many new HIV infections in East and Southern Africa occur in long-term sero-different relationships and may be due to the couples' attempts to become pregnant. Safer conception (SC) is a promising sexual and reproductive health service for PLHIV in Africa, yet it remains underutilised for high-priority at-risk populations, presenting a missed opportunity to prevent HIV transmission. Relationship-focused couples' interventions have improved sexual and reproductive health and HIV outcomes in East, West, and Southern Africa, but this approach has not been employed in the SC realm. We suggest a shift in SC interventions by moving from an individual-level approach (e.g. approaches focused on women or men separately), to a couples-based approach informed by a couples-based theoretical model. While promising, most existing SC interventions are limited by their emphasis on individuals instead of couples, thereby failing to recognise that each partner influences the behaviours of the other either directly or indirectly. Also, existing interventions offering SC services and counselling to couples have not tried to address relationship dynamics to improve biobehavioral outcomes. We are guided by Lewis et al.'s Interdependence Model of Health Behavior Change, which posits that both partners can influence each other's health behaviours and HIV prevention decisions. SC presents an avenue for reaching sero-different couples desiring children, making it an ideal window of opportunity to engage couples in HIV care and prevention and sexual and reproductive health services.
Related
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BibTeX
@article{gutin2026safer,
title = {{Safer conception services for HIV-affected couples must address overlooked relationship dynamics: a commentary and call to action.}},
author = {Sarah A Gutin and Amy A Conroy and Zachary A Kwena and Phoebe Olugo and Lisa Abuogi and Torsten B Neilands and Carol Dawson Rose and Mark Ayallo and Carol S Camlin and Lynae A Darbes},
journal = {SAHARA J : journal of Social Aspects of HIV/AIDS Research Alliance},
year = {2026},
month = oct,
doi = {10.1080/17290376.2026.2749191},
url = {https://europepmc.org/article/MED/42896841},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Safer conception services for HIV-affected couples must address overlooked relationship dynamics: a commentary and call to action.
AU - Sarah A Gutin
AU - Amy A Conroy
AU - Zachary A Kwena
AU - Phoebe Olugo
AU - Lisa Abuogi
AU - Torsten B Neilands
AU - Carol Dawson Rose
AU - Mark Ayallo
AU - Carol S Camlin
AU - Lynae A Darbes
PY - 2026
DA - 2026/10/19
JO - SAHARA J : journal of Social Aspects of HIV/AIDS Research Alliance
DO - 10.1080/17290376.2026.2749191
UR - https://europepmc.org/article/MED/42896841
AB - Data from East and Southern Africa shows the desire for children is strong among people living with HIV (PLHIV). Concurrently, many new HIV infections in East and Southern Africa occur in long-term sero-different relationships and may be due to the couples' attempts to become pregnant. Safer conception (SC) is a promising sexual and reproductive health service for PLHIV in Africa, yet it remains underutilised for high-priority at-risk populations, presenting a missed opportunity to prevent HIV transmission. Relationship-focused couples' interventions have improved sexual and reproductive health and HIV outcomes in East, West, and Southern Africa, but this approach has not been employed in the SC realm. We suggest a shift in SC interventions by moving from an individual-level approach (e.g. approaches focused on women or men separately), to a couples-based approach informed by a couples-based theoretical model. While promising, most existing SC interventions are limited by their emphasis on individuals instead of couples, thereby failing to recognise that each partner influences the behaviours of the other either directly or indirectly. Also, existing interventions offering SC services and counselling to couples have not tried to address relationship dynamics to improve biobehavioral outcomes. We are guided by Lewis et al.'s Interdependence Model of Health Behavior Change, which posits that both partners can influence each other's health behaviours and HIV prevention decisions. SC presents an avenue for reaching sero-different couples desiring children, making it an ideal window of opportunity to engage couples in HIV care and prevention and sexual and reproductive health services.
SN - 1729-0376
SN - 1813-4424
ER -