Sexual Relationship Power and Periconception HIV-Risk Behavior Among HIV-Infected Men in Serodifferent Relationships

Hazar Khidir, Nzwakie Mosery, Ross Greener, Cecilia Milford, Kara Bennett, Angela Kaida, Christina Psaros, Steve A. Safren, David R. Bangsberg, Jennifer A. Smit, Lynn T. Matthews

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Gender norms affect HIV risk within serodifferent partnerships. We assessed how the sexual relationship power described by men living with HIV (MLWH) associates with periconception HIV-transmission risk behavior. Quantitative surveys were conducted with 82 MLWH reporting a recent pregnancy with an HIV-negative or unknown-serostatus partner in KwaZulu-Natal, South Africa. Surveys assessed decision-making dominance (DMD) using the Pulerwitz et al. sexual relationship power scale; partnership characteristics; and HIV-risk behaviors. Multivariable logistic regression models evaluated associations between DMD score and HIV-risk behaviors. Higher male decision-making dominance was associated with non-disclosure of HIV-serostatus to pregnancy partner (aRR 2.00, 95% CI 1.52, 2.64), not knowing partner’s HIV-serostatus (aRR 1.64, 95% CI 1.27, 2.13), condomless sex since pregnancy (aRR 1.92, 95% CI 1.08, 3.43), and concurrent relationships (aRR 1.50, 95% CI 1.20, 1.88). Efforts to minimize periconception HIV-risk behavior must address gender norms and power inequities.

Original languageEnglish (US)
Pages (from-to)881-890
Number of pages10
JournalAIDS and Behavior
Issue number3
StatePublished - Mar 1 2020


  • Behavior change
  • HIV prevention
  • HIV-serodiscordant
  • MLWH
  • Safer conception
  • South Africa

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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