This study was to determine challenges and coping strategies of HIV discordant couples seen at AMPATH Centre, Moi Teaching and Referral Hospital, Kenya. A cross sectional study design with consecutive sampling was used.384 participated. Challenges included; negotiation for sex (100%), need for children (94%) and blame for HIV infection. Females reported more abuse (65.4% against 34.6% for males). Highest incidence of abuse was reported among the unemployed HIV positive females. Coping strategies expressed included; abstinence (9%), condom use (74%), sleeping facing opposite sides in bed or separation of beds (11%) and living apart. A bivariate analysis of those participants who reported use of condom all the time and those who reported otherwise showed Age group, order of HIV testing and HIV status were significant while level of formal education of the participants and occupation were not. Negotiation for sex formed the greatest challenge while a combination of coping strategies was used. Keywords: HIV, Discordant couple, challenges, coping strategie
