Background Intimate partner violence (IPV) is a significant public health issue, particularly among serodiscordant couples where one partner is living with HIV while the other is HIV negative. In Sub-Saharan Africa, approximately 33% of ever married/partnered women report experiencing physical and/or sexual violence by an intimate partner during their lifetime. Mozambique, like many other countries in sub-Saharan Africa, has high rates of IPV, with 24% of women and 19% of men aged 18–49 reporting experiencing physical violence at some point in their lives. However, research on serodiscordant couples in Mozambique is limited, and there is a lack of understanding regarding IPV experiences among these couples.

Objective This study seeks to explore the experiences of IPV and HIV risk reduction strategies among serodiscordant couples in Mozambique.

Methods A qualitative study was conducted in Gaza Province in November 2022, involving 36 individual serodiscordant couples selected through purposive sampling. Data was collected using a semi-structured interview guide, with in-depth interviews conducted with consenting individual serodiscordant couples until data saturation was achieved. Thematic content analysis was utilized to identify themes and subthemes within the collected data.

Results Key themes that emerged from the study included experiences of IPV, risk behaviors associated with IPV, and HIV risk reduction strategies. IPV experiences encompassed physical, sexual, and emotional abuse, ranging from beatings and slapping to instances of sexual coercion and marital rape. Risk behaviors for IPV among participants included jealousy, alcohol abuse, and engaging in unprotected sex. Participants also reported employing various HIV risk reduction strategies, including practicing faithfulness, consistent condom use, adherence to Pre-Exposure Prophylaxis (PrEP), and adherence to Antiretroviral Therapy (ART).

Conclusion This study highlights the intricate relationship between IPV and HIV risk reduction strategies among serodiscordant couples in Mozambique. Despite facing challenges related to IPV, participants demonstrated resilience and utilized diverse strategies to reduce their risk of HIV transmission. Healthcare providers and policymakers should consider the specific needs and circumstances of serodiscordant couples experiencing IPV to enhance HIV prevention efforts and provide comprehensive support services.