HIV Care and Treatment Among Serodiscordant Couples: A Systematic Review of Relationship Dynamics and Health Outcomes

Abstract

<b>Background:</b> Serodiscordant couples are relationships where one sexual partner is HIV-positive and the other is HIV-negative. Such couples experience complex relational and psychosocial challenges that significantly influence treatment adherence and health outcomes. Despite biomedical advances such as Antiretroviral Therapy (ART) and Pre-Exposure Prophylaxis (PrEP), the relational dynamics within these relationships remain underexplored in HIV intervention strategies.<br /> <b>Objective:</b> To systematically review how HIV status disclosure and partner reactions impact treatment outcomes among serodiscordant couples.<br /> <b>Method:</b> A systematic review of qualitative and mixed-methods studies published between 2010 and 2025 was conducted using databases including PubMed, PsycINFO, CINAHL, Scopus, and Google Scholar. Studies were appraised using the Critical Appraisal Skills Programme (CASP) Qualitative Checklist, and thematic synthesis was employed to analyze findings.<br /> <b>Findings and Discussion:</b> Ninety four studies met the inclusion criteria. Key themes included HIV status disclosure, communication, partner reactions, partner support and impact on treatment adherence. Challenges such as stigma and fear of rejection hindered disclosure and engagement in care in some relationships. However, support from partners was key in boosting confidence and continuity in care. <br /> <b>Conclusion:</b> HIV status disclosure is a crucial public health issue, as it has significant impact on the trajectory of serodiscordant relationships, treatment outcomes and psychosocial wellbeing of PLHIV. Building culturally sensitive, couple-centered interventions that emphasizes increased HIV awareness and knowledge is essential for improving health outcomes among serodiscordant couples.