Relationship quality among people living with HIV/AIDS: a systematic review and meta-analysis

BACKGROUND: The aim of this systematic review and meta-analysis was to summarize the existing literature on the factors associated with relationship quality among people living with HIV (PLWH). METHOD: A structured literature search was performed on APA PsycArticles, ProQuest and PubMed for quantitative, peer-reviewed studies published in English between 1994 and March 2025. Fifteen studies (N = 2579; 78% men, predominantly in serodiscordant couples) met the inclusion criteria and contributed 76 effect sizes, which were categorized as either protective or risk factors for relationship quality among PLWH. A three-level meta-analytic model was employed to address the nested data structure. RESULTS: The pooled effect sizes were comparable for protective factors (r = 0.26, 95% CI [0.08, 0.43]) and risk factors (r = 0.24, 95% CI [0.16, 0.31]), reflecting small-to-moderate effects. Significant heterogeneity was observed at the between-study level, whereas within-study variability was negligible. The only significant moderator was relationship length: the association between protective factors and relationship quality was stronger in longer-term PLWH relationships. CONCLUSION: This review and meta-analysis suggest that, despite the unique context of HIV/AIDS, several correlates of relationship quality may reflect broader patterns observed across populations. The findings improve our understanding of factors associated with psychological well-being among PLWH, particularly given the importance of satisfying romantic relationships for quality of life in this population.