Metrics details. HIV stigma can impact couple relationships through stress or bring partners closer through shared experiences. Conversely, couple relationships may protect against the harms of stigma, including anticipated stigma on negative health outcomes. Yet few studies have assessed the potential link between HIV stigma, relationship dynamics, and antiretroviral therapy ART adherence.
Using dyadic data from a cross-sectional study of Malawian couples living with HIV, we tested associations between anticipated stigma and: 1 relationship dynamics e. Heterosexual couples couples, individuals with at least one partner on ART were recruited from clinics in Zomba, Malawi. Partners completed separate surveys on anticipated stigma, relationship dynamics, and ART adherence. Linear mixed models evaluated associations between anticipated stigma and relationship dynamics, and whether associations varied by gender.
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Couples' relationship length averaged Significant interaction effects showed that adherence is moderated in couples with higher partner support and sexual satisfaction such that adherence is lowest when anticipated stigma is high and social support is low, and that adherence is lowest when anticipated stigma is high and sexual satisfaction is low. Increased anticipated stigma is most associated with lower ART non-adherence at lower levels of social support and sexual satisfaction.
Conversely, supportive and fulfilling relationships may buffer the negative association between stigma and ART adherence. Peer Review reports. HIV stigma limits access to healthcare, economic, and social resources that are needed to live a healthy life with HIV [ 1 , 2 , 3 ]. Stigma refers to a social process that can lead to the exclusion of individuals or groups based on real or perceived characteristics [ 4 ].
Globally, HIV stigma remains a significant barrier to HIV testing [ 5 , 6 , 7 ], linkage to care and treatment, and adherence to antiretroviral therapy ART [ 1 , 8 , 9 , 10 ].
