Interventions for thriving in HIV serodiscordant relationships in Sub-Saharan Africa: a scoping review

HIV serodiscordant relationships, where one partner is HIV-positive and the other is HIV-negative, present unique challenges despite biomedical advances including U = U (Undetectable = Untransmittable). Effective interventions are crucial to support these couples in managing their relationships, promoting treatment adherence, and reducing the risk of HIV transmission. This scoping review aims to identify, map, and evaluate the range of interventions designed to support thriving and the maintenance of healthy relationships among HIV serodiscordant couples. A comprehensive search strategy was employed across six electronic databases (PubMed, Scopus, Google Scholar, Web of Science, PsycINFO, and CINAHL) for literature published between January 2014 and March 2025. The search included explicit terms for all 49 Sub-Saharan African countries. Study selection was guided by the Population, Concept, Context (PCC) framework for scoping reviews. A total of 17 studies met the inclusion criteria. The review synthesises interventions into three primary categories: couples-based (n = 11 sources, 65%), community-based (n = 8 sources, 47%), and positive psychology interventions (n = 4 sources, 24%). Key barriers, included internal stigma, gender inequalities, and socio-economic challenges. Key facilitators included comprehensive education, community outreach, and supportive couple dynamics. Geographic distribution was uneven: East Africa (n = 7), Southern Africa (n = 6), West Africa (n = 2), Central Africa (n = 1), and global/multi-regional reviews (n = 4). Most primary studies focused on heterosexual couples (85%), with limited evidence for same-sex couples. The findings accentuate the necessity of multi-component, culturally tailored interventions that integrate biomedical, psychosocial, and structural approaches to improve health outcomes and relationship satisfaction for serodiscordant couples. This synthesis provides a foundation for developing evidence-informed interventions and highlights critical gaps for future research.