Behavioral Modeling and its Association with PrEP and ART Use in Ugandan HIV-Serodifferent Couples

AIDS Behav. 2024 May;28(5):1719-1730. doi: 10.1007/s10461-024-04286-2. Epub 2024 Feb 16.

Abstract

Integrating Pre-Exposure Prophylaxis (PrEP) delivery into Antiretroviral Therapy (ART) programs bridges the Human Immunodeficiency Virus (HIV) prevention gap for HIV-serodifferent couples prior to the partner living with HIV achieving viral suppression. Behavioral modeling is one mechanism that could explain health-related behavior among couples, including those using antiretroviral medications, but few tools exist to measure the extent to which behavior is modeled. Using a longitudinal observational design nested within a cluster randomized trial, this study examined the factor structure and assessed the internal consistency of a novel 24-item, four-point Likert-type scale to measure behavioral modeling and the association of behavioral modeling with medication-taking behaviors among heterosexual, cis-gender HIV-serodifferent couples. In 149 couples enrolled for research, a five-factor model provided the best statistical and conceptual fit, including attention to partner behavior, collective action, role modeling, motivation, and relationship quality. Behavioral modeling was associated with medication-taking behaviors among members of serodifferent couples. Partner modeling of ART/PrEP taking could be an important target for assessment and intervention in HIV prevention programs for HIV serodifferent couples.

Keywords: Behavioral modeling measure; HIV; Medication adherence; Observational learning; Sero-different couple.

Publication types

  • Research Support, N.I.H., Extramural
  • Observational Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anti-HIV Agents / therapeutic use
  • Female
  • HIV Infections* / drug therapy
  • HIV Infections* / prevention & control
  • HIV Infections* / psychology
  • Humans
  • Longitudinal Studies
  • Male
  • Medication Adherence / psychology
  • Medication Adherence / statistics & numerical data
  • Pre-Exposure Prophylaxis*
  • Sexual Behavior / psychology
  • Sexual Partners* / psychology
  • Uganda

Substances

  • Anti-HIV Agents