{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T22:51:04Z","timestamp":1761519064537,"version":"3.41.2"},"reference-count":84,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,5,15]],"date-time":"2013-05-15T00:00:00Z","timestamp":1368576000000},"content-version":"vor","delay-in-days":134,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"funder":[{"DOI":"10.13039\/100004334","name":"Merck & Co., Inc.","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100004334","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of the International AIDS Society"],"published-print":{"date-parts":[[2013,1]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>This article explores the complex, dynamic and contextual frameworks within which men working in a mining community and their live\u2010in long\u2010term partners or spouses (termed \u201ccouples\u201d in this study) respond to the introduction of HIV into their heterosexual relationships; the way in which partners adopt gendered positions in enabling them to make sense of their illness; how they negotiate their respective masculine and feminine roles in response to the need for HIV\u2010related lifestyle changes; as well as the gendered nature of partner support in relation to antiretroviral therapy (ARV) adherence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted an in\u2010depth qualitative study with a sample of 12 HIV\u2010positive seroconcordant heterosexual couples in a South African mining organization. Transcripts based on semi\u2010structured couple's interviews were analyzed using an inductive emergent thematic analytical method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The findings present compelling evidence that the impact of HIV and AIDS is mitigated, in the main, by the nature of the dyadic relationship. Where power and agency were skewed in accordance with traditional gender scripts, the impact of HIV and AIDS was deleterious in terms of negotiating disclosure, meeting expectations of care and support, and promoting treatment adherence. As a corollary, the study also revealed that where the relational dynamic evidenced a more equitable distribution of power, the challenge of negotiating illness was embraced in a way that strengthened the couples\u2019 affiliation in profound ways, manifested not simply in a reduction in risk behaviours, but in both partner's courage to re\u2010visit sensitive issues related to managing their relationship in the context of a debilitating illness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Gendered positioning (by self and others) was found to play a crucial role in the way couples experienced HIV and ARV treatment, and underscored the positive role of a couples\u2010counselling approach in the negotiation of the illness experience. However, as part of a broader social project, the findings highlight the need to address the shortcomings of a public health discourse on illness normalization that reifies and reinforces skewed gender relations. In essence, the findings make a compelling case for targeting couples as the primary unit of analysis and intervention in HIV and AIDS praxis, not only to enhance treatment and prevention outcomes, but to impact on and potentially transform the lived identity of such relationships, in AIDS\u2010affected communities. We recommend early intervention with couples in terms of couples HIV testing, risk\u2010reduction counselling and gender\u2010based interventions giving couples opportunities to revisit and challenge their prevailing gendered identities. We note, however, that these efforts will be undermined in the long term, if the structural drivers of HIV risk and vulnerability, contained within macro\u2010level social, economic and cultural practices, are not simultaneously addressed.<\/jats:p><\/jats:sec>","DOI":"10.7448\/ias.16.1.18021","type":"journal-article","created":{"date-parts":[[2013,5,15]],"date-time":"2013-05-15T08:35:09Z","timestamp":1368606909000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Gendered constructions of the impact of HIV and AIDS in the context of the HIV\u2010positive seroconcordant heterosexual relationship"],"prefix":"10.1002","volume":"16","author":[{"given":"Anil","family":"Bhagwanjee","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaymarlin","family":"Govender","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Candice","family":"Reardon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leigh","family":"Johnstone","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gavin","family":"George","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Gordon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,5,15]]},"reference":[{"volume-title":"2009 AIDS epidemic update: sub\u2010Saharan Africa","year":"2009","author":"UNAIDS, WHO","key":"e_1_2_8_2_1"},{"key":"e_1_2_8_3_1","unstructured":"Statistics South Africa.Mid\u2010year population estimates 2011.Statistical release P0302; 27 July2011."},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.3917\/pope.503.0179"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60953-8"},{"key":"e_1_2_8_6_1","first-page":"321","article-title":"\u201cI don't know who to blame\u201d","volume":"33","author":"Long C","year":"2009","journal-title":"HIV\u2010positive South African women navigating heterosexual infection. 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