Antiretroviral medication support practices among partners of men who have sex with men: a qualitative study.

The aim of this qualitative study is to describe the practical support for antiretroviral therapy (ART) adherence offered by partners of men with HIV. Twenty couples in which at least one partner was HIV positive and on ART were interviewed separately about their involvement in their partners' ART adherence. The interview elicited narratives of specific recent events around taking medication, as well as accounts of what the participants usually did to support their partners' adherence. Three members of the qualitative team coded and verified the interviews for adherence support practices. Partners offered a wide range of kinds of practical support. Reminding included (1) regular reminding that was habitually offered, (2) situational reminding adapted to changing circumstances, and (3) intensive reminding, either regular (i.e., nagging) or situational. Instrumental helping involved monitoring medication adherence, bringing or setting out medications at the dose time, organizing the pills, and requesting and/or picking up refills. Coaching involved situational problem-solving and shaping behavior by reinforcing incremental gains and offering affirmations. Findings demonstrate a range of support practices for ART adherence, often tailored to partners' styles or to the changing process of adherence. By examining narratives of support transactions as they occurred, the study discriminated among the different dimensions, forms, sources and contexts of social support. These distinctions, often neglected in social support research, have implications for HIV care and research.