The influence of HIV concordance and discordance on marital life

Abstract

Studies on the implications of HIV concordance and discordance focus largely on the sexual aspect (Bennetts et al., 1999; Campbell, 1999; Moatti and Souteyrand, 2000; White et al., 1997), that is, they examine how sexual relations between couples are affected by the virus. Only a few published works examine marital and family experiences within the context of discordance (Tangmunkongvorakul et al., 1999; Vandevanter et al., 1999; White et al., 1997). For example, Vandevanter et al. (1999) reported breaches of trust in the marital relationship with adverse implications for communication. Complications in decisions about reproduction included the pain of not having children as well as of accepting the risk of having an HIV-positive child. Anxiety about the future of the family led to discussions and planning ahead. Participants in Tangmunkongvorakul et al.’s (1999) study in Thailand stated that while disclosure of HIV status could lead to marital dissolution, the duration of the partnership was a major influence. Women’s decision-making was heavily influenced by their natal homes and played a role in whether they stayed on with their spouses or returned to their families of origin. Perceived stigma affected the extent of emotional and financial support families received, with negative effects for coping.