Factors influencing marital stability among HIV discordant couples in northern Thailand

The burden of HIV in stable relationships places emotional, economic and ph ysical stresses on families. We compared the influence of HIV notification on marital partnerships in northern Thailand among a cohort of HIV discorda nt couples, and identified factors associated with marital disruption. Data were collected using in-depth interviews with both members of six separate d or divorced couples and 13 couples whose relationship remained intact. Fi ve factors influenced marital stability following HIV notification: longer duration of relationship; economic constraints, extended family members' op inions, especially parents; the existence of children from the marriage; an d fear of stigmatization by community members; Social influences, both oven and perceived, are important in shaping marital behaviour and decision-mak ing in HIV epidemic areas. HIV counselling needs to be extended beyond the individual seeking testing to include stable partners (and perhaps further, to include the extended family), although it is recognized that this is no t the norm for most HIV testing centres.