Variations in Dyadic Adjustment Among Heterosexual HIV-Discordant Couples in Rural China: A Latent Profile Analysis

The systemic framework of resilience and dyadic perspective of couple coping suggests that HIV-discordant couples may show heterogeneous profiles of dyadic adjustment, shaped by contextual risks and resources. This study aimed to identify heterogeneous profiles of dyadic adjustment and thus investigate the expression of resilience among 159 heterosexual HIV-discordant couples in rural China. We hypothesized that the couples could be grouped into distinct profiles: both members showing poor well-being, both members showing good well-being, and discrepant well-being across the two members. A latent profile analysis classified the couples into three subgroups based on well-being, which was measured using the World Health Organization Well-Being Index. As expected, one subgroup, labeled Maladapted Couples (n = 58, 36.5%), reported poor well-being in both people living with HIV/AIDS (PLWHA) and the seronegative spouse. The second subgroup, labeled Resilient Couples (n = 50, 31.4%), was characterized by relatively good well-being in both partners. In the third subgroup, labeled Maladapted PLWHA and Resilient Spouses (n = 51, 32.1%), the PLWHA showed poor well-being, while the seronegative spouses demonstrated good well-being. The identified subgroups were validated against external well-being measures, including depression and self-rated health measures. Exploratory analyses identified distinct patterns of contextual risks (including HIV stigma and financial difficulties) and resource factors (including individual resources and relational resources) across the subgroups. These findings underscore the heterogeneity of adjustment among heterosexual HIV-discordant couples in rural China and suggest the potential usefulness of services tailored to specific subgroups.