Grant: Operating Grant

In the era of combination antiretroviral therapy, HIV-serodiscordant couples (SDCs) are a growing population group who are unique given that repeated exposure to HIV within the intimate relationship must be continually reconciled with rapid advances in biomedical treatment, sexual risk decision-making, and the maintenance of overall relationship satisfaction. These relationship dynamics occur in a social context where disclosure of HIV-serodiscordant status may prove challenging given HIV-related stigma. The lack of Canadian research on these issues presents a clear opportunity to expand scientific understanding of relationship dynamics within SDCs, to improve supportive services, and promote the wellbeing of these Canadian couples. To this end, we are proposing a national, cross sectional, mixed-methods study that aims to examine the links between relationship satisfaction and management of transmission risk among SDCs in Canada. SDCs will be recruited to a quantitative survey and/or qualitative interview that will gather evidence on: (1) sociodemographic and relationship characteristics of SDCs across Canada; (2) individual (e.g., age, sex, gender), dyadic (e.g., type and duration) and social (e.g., social support, satisfaction with services, stigma) determinants of relationship satisfaction; (3) associations between management of HIV risk and relationship satisfaction; (4) perceived needs and access to supportive services and (5) subjective experiences of the risks and benefits of involvement in an HIV-serodiscordant relationship. Two data sources will include a secure, online cross-sectional survey conducted among an estimated sample of individuals representing n=1,640 dyads and semi-structured in-depth qualitative interviews conducted among a purposive sample of n=120 individuals representing 60 dyads. The findings will inform the development of evidence-based interventions for improving the wellbeing of SDCs in Canada.