# Dyadic management of HIV cardiometabolic comorbidities among couples in Malawi

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2020 · $656,676

## Abstract

Project Summary/Abstract
As the HIV epidemic matures in sub-Saharan Africa with effective antiretroviral therapy, cardiometabolic
disorders (CMD) are the next major challenge for people living with HIV. In Malawi, for example, around 27%
of people living with HIV have comorbid hypertension or diabetes. If comorbidities are not addressed with tools
available, namely social support in couples, we may reverse progress made towards HIV outcomes and miss
opportunities to reduce mortality and morbidity associated with CMD. Research has shown that communal
coping in couples is essential for the dyadic management of single health conditions. Yet little is known about
how couples manage multiple competing health conditions, which are significantly more complex and could
have synergistic impacts on health. Additional gaps in knowledge remain in the African context. No research
has identified the structural factors involved in dyadic management such as food or water insecurity, which can
interfere with adherence to dietary advice, or health beliefs around CMD, which may impact communal coping.
Before we can intervene on dyadic processes amenable to change, we need to gain a deeper and culturally-
grounded understanding of the interplay of health beliefs, structural barriers, and communal coping that may
impact dyadic management. Our objective is to generate an empirically-driven conceptual model explaining
dyadic management and to identify opportunities for intervention. We will accomplish this using a three-phase
mixed-methods design. The target population will be married couples with at least one partner with HIV and
CMD (either hypertension or diabetes) recruited from HIV clinics in Zomba, Malawi. Our specific aims are: (1)
to develop a conceptual model on the dyadic management of HIV and CMD, thereby extending the knowledge
base on dyadic management of multiple health conditions; (2) to test the conceptual model in a longitudinal
sample of couples living with HIV and CMD; and (3) to identify opportunities for an intervention based on the
findings. For Aim 1, we will conduct in-depth interviews with 25 couples to assess beliefs about CMD and HIV,
how couples prioritize conditions and engage in communal coping, and barriers/facilitators to dyadic
management. These data, in conjunction with the theory and literature, will result in a preliminary conceptual
model and refined hypotheses for Aim 2. For Aim 2, we will enroll 250 couples and test our conceptual model
containing explanatory variables on health beliefs, communal coping, dyadic management behaviors, disease
control outcomes, and cardiovascular disease risk. For Aim 3, we will conduct focus group discussions with
key stakeholders to gain input on potential components for an intervention. Our long-term goal is to improve
clinical practice and disease management outcomes for HIV and CMD comorbidities in sub-Saharan Africa—a
high-priority area of the NIH. The conceptual model will form the basis of fu...

## Key facts

- **NIH application ID:** 10032544
- **Project number:** 1R01HL153343-01
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Amy Anne Conroy
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $656,676
- **Award type:** 1
- **Project period:** 2020-09-20 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10032544

## Citation

> US National Institutes of Health, RePORTER application 10032544, Dyadic management of HIV cardiometabolic comorbidities among couples in Malawi (1R01HL153343-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10032544. Licensed CC0.

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