Common Dyadic Coping Mediates the Associations Between We-Disease Appraisal and Relationship Satisfaction and Quality of Life in HIV Serodiscordant Couples: The Common Fate Mediation Model.

ABSTRACT

BACKGROUND: Since HIV has evolved into a lifelong but manageable condition, improving the quality of life (QoL) of persons living with HIV (PLWHs) has become increasingly important. Living with HIV is life-altering and poses substantial challenges for both PLWHs and their partners, so identifying how HIV serodiscordant couples cope with HIV together is crucial. Here, Bodenmann's Systemic Transaction Model highlights common dyadic coping (CDC), which refers to both partners working together to alleviate the negative effects of stress. PURPOSE: We examined the mediating role of CDC in linking we-disease appraisal with relationship satisfaction and QoL. METHODS: We recruited a convenience sample of 231 HIV serodiscordant couples via local grassroots organizations between June and October 2022. Participants completed measures of we-disease appraisal, CDC, relationship satisfaction, and QoL. We examined the mediation effect of CDC on the association between we-disease appraisal and outcomes using the common fate mediation model. RESULTS: The mean age of PLWHs was 32.18 years (standard deviation = 8.61 years), and that of their partners was 32.55 years (standard deviation = 9.24 years). The average time since HIV diagnosis was 4.18 years. Most couples were same-sex male couples. We found that CDC mediated the effect of we-disease appraisal on relationship satisfaction. Moreover, CDC significantly mediated the effect of we-disease appraisal on the QoL of PLWHs and their partners. CONCLUSIONS: Our findings highlight the importance of CDC in dyadic illness management among Chinese HIV serodiscordant couples.

Numerous studies have shown that HIV serodiscordant couples may face HIV-related stress as a unit. Yet, it is not clear how the appraisal of HIV as a shared illness (i.e., we-disease appraisal) may influence relationship satisfaction and both partners' quality of life (QoL) via common dyadic coping (CDC) behaviors (e.g., collaboration). In this study, we collected data from 231 HIV serodiscordant couples. Participants completed reports of how they appraise HIV as a we-disease, their CDC behaviors, and their relationship satisfaction and QoL. We found that we-disease appraisal was positively associated with CDC, which in turn was positively associated with relationship satisfaction and both partners' QoL. Future couple-based interventions should incorporate psycho-educational components to raise awareness about we-disease appraisal, as well as skill-building components to encourage the use of CDC in clinical settings.