For persons living with HIV, effective symptom management is crucial for good health outcomes and usually involves close support persons. The collaboration of persons living with HIV and their close support persons in the process of symptom management, including symptom experience reports, was investigated using an exploratory mixed methods design. Integration of methods included hypothesis generation from participants’ narratives. Results revealed that collaboration is constituted by distinct but integrative positions of manager and partner that are reflected in diverse themes of symptom management and confirmed in quantitatively assessed symptom reports. Divergent qualitative and quantitative findings highlighted problems in neurocognitive symptom communication. Symptom management processes should be supported by better integrating the close support persons into clinical service, and further research on neurocognitive symptom experience is needed.