Abstract Dyadic coping among sexual minority men (SMM) has been a focus of HIV prevention research for decades, but few studies have examined relationship quality as a covariate of HIV care cascade outcomes (ART adherence and an undetectable viral load (VL)). This study utilized a 5-category relationship status variable (single; non-monogamous, sero-discordant; non-monogamous, sero-concordant; monogamous, sero-discordant; monogamous, sero-concordant) to test the hypothesis that relationship quality would moderate associations between relationship status and HIV care outcomes. Adult SMM living with HIV (LWHIV) ( n = 1389), recruited via social networking applications between January and December 2021, completed a cross-sectional, online survey. At average levels of relationship quality, only non-monogamous SMM with sero-discordant partners were more likely to be adherent to ART ( OR = 3.064, p <.001) and have an undetectable VL ( OR = 2.595, p <.001) compared to single SMM. Among non-monogamous SMM with sero-discordant partners, relationship quality was positively associated with ART adherence ( OR = 1.065, p <.001) and having an undetectable VL ( OR = 1.046, p =.003). Among monogamous SMM with sero-concordant partners, the effect of relationship quality on ART adherence ( OR =0.855, p =.007) and having an undetectable VL ( OR =0.909, p =.011) was significantly smaller compared to non-monogamous SMM with sero-discordant partners. Among non-monogamous SMM with sero-concordant partners, the effect of relationship quality on ART adherence ( OR =0.956, p =.039) was also significantly smaller compared to non-monogamous SMM with sero-discordant partners. Results suggest non-monogamous SMM with sero-discordant partners in high-quality relationships may experience the greatest motivation to engage in HIV care. Messages enhancing motivation for care engagement to improve individual health for SMM LWHIV may augment treatment as prevention.
Hillesheim et al. (Wed,) studied this question.