Background: The predominance of a coping strategy over another is determined, in part, by personal style and also by the type of threatening event. Objective: To compare the coping strategies of HIV discordant and concordant couples in comprehensive health centers in a Southeastern state in Nigeria. Materials and methods: This was a cross-sectional comparative study of 289 (148 HIV concordant and 141 HIV-discordant) couples, selected using multistage sampling technique. Data collection was by interview using semi-structured questionnaire, while analysis was with statistical package for social sciences version 22.0. Chi-square and t tests were used to identify associations between variables. A p value of < 0.05 was considered significant. Results: Respondents discriminated against in the family coped by visiting spiritual counselors (concordant 14(21.2%) vs discordant 52(78.9%), p=0.000); visiting nonspiritual counselors (concordant 21(22.1%) vs discordant 74(77.9%), p=0.000); discussing with partner and family members (concordant 9(14.1%) vs discordant 55(85.9%), p=0.000). Those with workplace discrimination: discussed with superior management (concordant 6(3.33%) vs discordant 12(66.7%), p=0.01); sought support from human rights groups (concordant 34(68%) vs discordant 16(32%); p=0.01); While those discriminated against in religious places coped by visiting spiritual counselors (concordant 19(67.9%) vs discordant 9(32.1%), p=0.04). For emotional problems, discordant couples sought support from human rights groups 109(65.3%) (p=0.000) compared to concordant couples. Conclusions: This study found that communication was key, while coping strategies adopted by both sets of couples differed based on the challenges they faced. We recommend avenues for better coping mechanisms by improving communication among couples.