Date of Conferral



Doctor of Public Health (DrPH)


Public Health


Saran Wilkins


The increase in new human immunodeficiency virus (HIV) infections among heterosexual couples in Africa may reverse the gains made by HIV prevention programs. HIV screening among such couples remains low and understudied.This qualitative study focused on the motivations for HIV screening among heterosexual couples. The primary research goal was to examine the lived experiences of heterosexual couples who were screened for HIV and received their results in Nakuru-Kenya. The health belief model (HBM) served as the theoretical framework and as a basis for the secondary questions which sought to explore the participants' perceptions on HIV based on the constructs of the HBM. Semi-structured interviews were conducted with a purposively selected sample of 14 heterosexual couples. Data were collected through face-to-face audio-recorded interviews, which were coded and analyzed using Moustakas's phenomenological data analysis method. Six major themes emerged from the clustered responses of the participants. Couples recognized that they may be susceptible to HIV infection because HIV is transmitted primarily through sexual contact. Some couples perceived HIV as a severe, life-threatening condition in their lives; others perceived HIV as chronic disease that could be managed through treatment and good health care. The fear of negative consequences was cited as a barrier to couples' willingness to receive HIV counselling and testing. Couples perceived HIV testing as having multiple benefits, including freedom from worries and as a motivation to plan their lives. Health messages and partner dialogue were major cues that encouraged couples to undergo HIV testing. Testimonials from other couples who had been tested and chose to talk about their experiences contributed to a strong feeling of self-efficacy. These study findings may help to improve HIV prevention interventions for heterosexual couples.