Psychosocial- and disclosure-related challenges among HIV-serodiscordant couples: an interpretative phenomenological analysis study

Background: Serodiscordant refers to a couple where one has human immunodeficiency virus (HIV), and the other partner is HIV negative. HIV-serodiscordancy often results in diverse psychological and emotional challenges. Evidence demonstrates that the dynamics of living in an HIV-serodiscordant relationship are often stressful. This study explored the psychosocial- and disclosure-related challenges faced by couples in HIV-serodiscordant relationships in South Africa. Methods: An interpretative phenomenological analysis (IPA) design was followed. A total of 13 HIV-serodiscordant partners were purposively sampled. Data were collected through individual face-to-face interviews and analysed using the IPA framework. Results: The findings indicated that HIV-serodiscordant couples experienced diverse psychosocial challenges such as shock, sadness, hurt, denial and disbelief. Participants also experienced challenges such as selective disclosure and fear of further disclosure. Conclusions: The findings have implications for public health and are critical in programming and designing couple-based HIV care interventions. Couples in HIV-serodiscordant relationships would benefit more from differentiated, client-centred psychosocial support. To contribute to the HIV epidemic control and reduction of new HIV infections, specific interventions such as couples counselling, disclosure counselling, support groups, health education and safer conception risk reduction strategies need to be implemented.