A Qualitative Study Investigating the Concerns, Awareness and Behaviour of HIV Sero-Discordant Heterosexual Couples in South India

Negative partners within HIV sero-discordant represent an important at risk group for HIV acquisition. In India, risk reduction strategies target high risk groups but often overlook these individuals. We sought to discover from sero-discordant couples: issues around their awareness and understanding of HIV, changes in their behaviour within the relationship and coping mechanisms following HIV diagnosis and their main concerns for the future, in order to help inform the development of specific counselling strategies. Semi-structured interviews were conducted with discordant couples attending an urban treatment centre in South India. A widespread lack of awareness and heavy presence of stigma around HIV prevailed. Issues such as modes of transmission and prognosis were largely misunderstood and the prevalence of inter-marital difficulties and reduced sexual desire was high. Effective post test counselling is crucial but where ongoing counselling has previously focussed on the positive partner, emphasis should move to couple based strategies which would ensure that both partners receive the same information in a controlled environment and from experienced personnel. Health care professionals should look carefully at their patient's marital circumstances and educate couples about the risks of onward HIV transmission, condom use, issues around family planning and child-wish and most importantly ensure that their emotional needs are addressed.