Evaluating ill- Psychosocial Issues among HIV Discordant and Concordant Couples: A Mixed Method Cross-Sectional Comparative Study

Abstract

Background: Successful practical intervention strategies thrive on shared responsibility and global solidarity. Understanding of psychosocial status of this high-risk group could inform measures that sustain self-care and maximize benefits from antiretroviral therapy (ART). Objective: To determine and compare the ill- psychosocial issues and challenges of HIV discordant and concordant couples in comprehensive health centers in Anambra, Nigeria. Materials and methods: A mixed method cross--sectional comparative study of 289 (148 HIV-concordant and 141 HIV-discordant) couples, selected by two- stage sampling. Quantitative data were collected by interview using semi-structured questionnaire and analysed with statistical package for social sciences version 22.0. Chi-square and Fishers exact tests were used as appropriate, to determine associations between variables and p values < 0.05 were significant.  Qualitative information was obtained by focus group discussions (FGDs). Results: Uncertainty and anxiety/ fear constitute the commonest form of ill psychological feelings in 189(65.4%) male and 102(35.3%) female respondents, with more of the males being in discordant relationships (p=0.018). Also, 138(46.0%) had discrimination from the family, more on the discordant (p=0.000). Again, more of discordant couples faced discrimination at the workplace, emotional problems related to HIV; difficulty with adherence to ART and problem with sexuality in marriage (p<0.05) respectively. Conclusions: This study reveals that both sets of couples, though more on the discordant side, faced uncertainty, anxiety/fear, then stigma and discrimination from the family, workplace, etc. Improved sustained sero- status based counselling and psycho- social support is recommended.