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In the era of combination antiretroviral therapy, HIV-serodiscordant couples (SDCs) are a growing population group who are unique, given that repeated exposure to HIV within the intimate relationship must be continually reconciled with rapid advances in biomedical treatment, sexual risk decision-making, and the maintenance of overall relationship satisfaction. These relationship dynamics occur in a social context where disclosure of HIV-serodiscordant status may also prove challenging, given HIV-related stigma.

The lack of Canadian research on these issues presents a clear opportunity to expand scientific understanding of relationship dynamics within SDCs, to improve supportive services, and promote the wellbeing of these Canadian couples. To this end, we are undertaking a national, cross sectional, mixed-methods study that aims to examine the links between relationship satisfaction and management of transmission risk among SDCs in Canada. SDCs will be recruited to a quantitative survey and/or qualitative interview that will gather evidence on: (1) sociodemographic and relationship characteristics of SDCs across Canada; (2) individual (e.g., age, sex, gender), dyadic (e.g., type and duration) and social (e.g., social support, satisfaction with services, stigma) determinants of relationship satisfaction; (3) associations between management of HIV risk and relationship satisfaction; (4) perceived needs and access to supportive services and (5) subjective experiences of the risks and benefits of involvement in an HIV-serodiscordant relationship. Two data sources will include a secure, online or telephone cross-sectional survey conducted among an estimated sample of individuals representing n=1,640 dyads and semi-structured in-depth qualitative interviews conducted among a purposive sample of n=120 individuals representing 60 dyads. The findings will inform the development of evidence-based interventions for improving the wellbeing of SDCs in Canada.

This study is being led by Dr. Liviana Calzavara of the University of Toronto, and is supported by the CIHR and SRC.