Dyadic adjustment in HIV sero-concordant and sero-discordant couples

The HIV infected population in Romania is at an age when engaging in a serious relationship is more and more an issue. Dyadic adjustment is the process which most couples go through, in their attempt to form a steady relationship. It is represented by important changes that appear in one's perception of himself and the significant other. Dyadic adjustment can be measured by a series of parameters--couple's satisfaction, couple's consensus, couple's cohesion and expressing emotions.

We conducted a study on 60 young men and women (30 male, 30 female). Of these, 45 are in evidence at the laşi Regional Center (22 male, 23 female), the other 15 being their uninfected parteners (8 male, 7 female). They were evaluated using the Dyadic Adjustment Scale, developed by Graham B. Spanier.

Most couples enrolled in this study (50%) were sero-concordant (both partners were HIV-positive -15). 26% of couples were made-up an HIV-positive female and a non-infected male, and 24% were made-up of a non-infected female and an HIV-positive male. The median age was 23 years, 33.4% of them came from rural areas. Average schooling level was 6 primary classes, with extremes between two classes of primary and higher education. Only 50% of patients had a job, while the rest had no stable job and were not employed, 33.4% came from broken families or foster care. 100% of HIV infected patients are in active therapy, poliexperimented. Most patients have 5-6 treatment regimens (45%), with a maximum of 8-9 regimens. Most of the couples enrolled (83.3%) were not married, as our study evolved only 5 married couples. The relationship length varied between 4 moths and 15 years. The Dyadic Adjustment Scale revealed high scores in couple's consensus and cohesion for both concordant and discordant couples. In couples where both partners are HIV-positive, the DAS revealed average scores for all four areas of dyadic adjustmet. In Couples where one partner is HIV-positive, and the other is not infected, low scores were seen in emotional expression and in the couple's satisfaction.

The HIV infection affects an individual's life and his adjustment to a couple in the sense that a series of factors changes the couple's dynamic--physical and emotional changes specific to the infection and AIDS, ARV treatments' side-effects, the care for the uninfected partner, and preventing HIV transmission through intercourse. All these elements lower the level of dyadic adjustment and increase the level of stress in individuals that are part of an HIV couple.