Related Experiment Video
Updated: Sep 24, 2025

Visualization of Intensity Levels to Reduce the Gap Between Self-Reported and Directly Measured Physical Activity
Published on: March 7, 2019
Relationship Dynamics are Associated with Self-Reported Adherence but not an Objective Adherence Measure in Malawi
Amy A Conroy1,2, Stacey McKenna3, Allison Ruark4
1Division of Prevention Sciences, Department of Medicine, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, USA. amy.conroy@ucsf.edu.
Abstract:
Couple relationships can be leveraged to improve adherence to antiretroviral therapy (ART), but few studies have identified relationship factors to target in interventions in sub-Saharan Africa. We conducted a cross-sectional study with 211 couples in southern Malawi with at least one partner on ART to test for associations between ART adherence and relationship dynamics (intimacy, trust, relationship satisfaction, unity, commitment, and partner support). We measured ART adherence through subjective measures (patient and partner reports) and an objective measure (ART drug levels in hair) and hypothesized that more positive relationship dynamics (e.g., higher intimacy) would be associated with better adherence. Multi-level logistic and linear regression models were used to evaluate study hypotheses, controlling for the clustering of individuals within couples. High levels of adherence were found by all three measures. Unity, satisfaction, and partner support were associated with higher patient and partner reports of adherence, and additional relationship dynamics (intimacy, trust) were associated with higher partner reported adherence. No associations were found between relationship dynamics and drug levels in hair, although drug levels were high overall. Future studies should perform longitudinal assessments of relationship dynamics and objective metrics of adherence, and examine these associations in populations with lower adherence levels such as young women or individuals starting ART.
Related Concept Videos
Strategies of Self-Presentation III: Self-Monitoring
Theory of Romantic Attachment in Adulthood
Self-Discrepancy Theory
Naturalistic Observations
Relationship Formation
Self-Discrepancy and Its Effects

