Coping strategies and needs among women married to men who have sex with men living with HIV in China

Stigma towards men who have sex with men (MSM) is prevalent, and many MSM are married to women. This study aims to provide acomprehensive understanding of coping strategies and the need for support among women in serodiscordant relationships with MSM living with HIV. We conducted 19 qualitative in-depth interviews with these women living in Sichuan, China. Semi-structured interviews were recorded and transcribed. Qualitative data were transcribed verbatim and analyzed using content analysis. We found that these women utilized multiple coping strategies both within the family and externally. Coping strategies within the family included keeping husbands' HIV diagnosis confidential, integrating husband's HIV treatment management into family routines, restoring spousal relationship, protecting themselves from HIV infection, denying, self-blaming, and persuading the husbands to see the psychiatrist due to homosexual behaviors. Coping strategies outside the family included seeking information from multiple sources, peer support, and online support. Participants expressed needs for more information, psychological support, stigma reduction, and special counseling on how to handle their husband's homosexual identity and/or behavior. Women married to MSM living with HIV develop both adaptive and maladaptive coping strategies, and the majority of these women's needs are unmet under the current service system in China.