‘It [HIV] is part of the relationship’: exploring communication among HIV-serodiscordant couples in South Africa and Tanzania

In many sub-Saharan African countries, a high proportion of people living with HIV are in long-term serodiscordant relationships. This paper explores how HIV serodiscordance shapes communication among couples in long-term HIV-serodiscordant relationships. A total of 36 couples were purposively recruited through healthcare providers and civil society organisations in South Africa (26) and Tanzania (10). We explored couples' portrayal of living in a serodiscordant relationship by conducting semi-structured interviews with each partner separately, followed by a joint interview with both partners. Using an adaptation of Persson's model on sero-silence and sero-sharing, we categorised coping style as 'sero-silent' if partners reported that they did not talk much with each other about issues related to their serodiscordant status or as 'sero-sharing' if they portrayed HIV as being an issue which they dealt with together. Some couples exhibited features of both coping styles and, at times, partners differed in their ways of coping.