The role of we-ness in Chinese serodiscordant male couples’ coping with HIV: a mixed-methods study

Men who have sex with men represent a significant portion of new HIV diagnoses in China. Guided by the systemic transactional model and interdependence theory, we examined the mediating role of 'we-ness' between dyadic coping and HIV-specific support among Chinese serodiscordant male couples, and how cultural interdependence shapes this we-ness. We employed a mixed-methods design which included a cross-sectional survey of 234 couples and qualitative interviews with 20 couples. Using the actor-partner interdependence mediation model, our quantitative analysis found that (1) both positive and negative dyadic coping had significant actor effects but nonsignificant partner effects on HIV-specific support, and (2) we-ness mediated both dyadic coping strategies and HIV-specific support, with significant actor-actor effects and partner-actor effects. Our qualitative inquiry identified that we-ness is fundamentally shaped by couples' negotiated pattern of interdependence, characterised by selective independence in HIV care alongside interdependence in HIV prevention. Our findings advance theoretical understanding by demonstrating we-ness as a critical mediating mechanism and reveal how couples' negotiated interdependence extends beyond the traditional continuum between dependence and independence. Findings suggest the need for culturally embedded interventions that recognise couples' shared we-ness and strategic negotiation in HIV management.